NUR530
Systems Leadership & Collaborative
Practice
Latest Exam Review
2026
1. A nurse leader implementing a new electronic health record (EHR) system engages multiple
departments in the planning process to ensure smooth adoption. Which systems leadership
principle is best demonstrated here? A) Autocratic decision-making B) Distributed leadership
C) Transactional leadership D) Centralized authority Answer: B) Distributed leadership
Rationale: Distributed leadership involves sharing leadership responsibilities across members
of the organization, which includes engaging multiple departments.
2. In collaborative practice, what is the primary benefit of interprofessional team huddles
during shift changes? A) Speed up patient discharge B) Reduce communication errors C)
Increase paperwork accuracy D) Minimize staff breaks Answer: B) Reduce communication
errors Rationale: Team huddles promote real-time communication, reducing
misunderstandings and errors during transitions.
3. Which factor most directly influences the sustainability of system changes in healthcare
settings? A) Leadership charisma B) Financial incentives C) Stakeholder engagement D)
External regulations Answer: C) Stakeholder engagement Rationale: Engaged stakeholders are
critical for buy-in and long-term sustainability of change.
4. A nurse manager notices that interdisciplinary conflicts are affecting patient outcomes.
What is the most effective first step? A) Implement punitive measures B) Facilitate open
dialogue sessions C) Avoid confrontations D) Reassign team members immediately Answer: B)
Facilitate open dialogue sessions Rationale: Open communication allows teams to understand
perspectives and resolve conflicts collaboratively.
5. In systems leadership, what does 'complex adaptive system' refer to? A) Linear cause-effect
relationships B) A rigid hierarchical structure C) A dynamic network with multiple interacting
components D) Single-point decision-making authority Answer: C) A dynamic network with
multiple interacting components Rationale: Healthcare systems are complex adaptive systems
characterized by interdependent parts that adapt to changes.
True/False Questions (T/F)
6. T/F: Effective collaborative practice requires that all team members have equal clinical
expertise. Answer: False Rationale: Collaborative practice values diverse expertise and roles;
equality in expertise is not required but mutual respect and understanding are.
7. T/F: Systems leaders should prioritize short-term goals over long-term system improvement.
Answer: False Rationale: Systems leadership focuses on long-term sustainability and
improvement rather than just short-term results.
, 8. T/F: Psychological safety in a team setting enhances error reporting and learning from
mistakes. Answer: True Rationale: Psychological safety encourages openness and
transparency, essential for learning and improvement in healthcare.
9. T/F: Collaborative practice eliminates the need for clear role definitions within healthcare
teams. Answer: False Rationale: Clear roles are crucial to prevent role confusion and ensure
accountability even in collaborative environments.
10. T/F: Adaptive leadership involves responding flexibly to unexpected changes within a
healthcare system. Answer: True Rationale: Adaptive leadership requires flexibility and
responsiveness to evolving conditions within complex systems.
Short Answer
11. Define ‘systems thinking’ in the context of healthcare leadership. Answer: Systems thinking
is a holistic approach that focuses on understanding how different components of the
healthcare system interact and influence one another to improve outcomes. Rationale: It
emphasizes interconnections rather than isolated parts.
12. List three barriers to effective interdisciplinary collaboration in hospital settings. Answer:
Communication breakdowns, role ambiguity, and hierarchical power dynamics. Rationale:
These are common obstacles reducing collaboration and team effectiveness.
13. Explain how a transformational leader can influence collaborative practice. Answer: By
inspiring and motivating team members, fostering a shared vision, and encouraging
innovation and trust, a transformational leader enhances collaboration. Rationale:
Transformational leaders focus on empowering others and improving team morale.
14. What is the role of feedback loops in system leadership? Answer: Feedback loops help
monitor outcomes and inform adjustments for continuous improvement within complex
systems. Rationale: They provide necessary information flows for adaptive decision-making.
15. Describe one strategy to manage power imbalances during collaborative decision-making.
Answer: Establishing ground rules that promote equal voice and using a neutral facilitator to
guide discussions. Rationale: These techniques foster inclusivity and minimize dominance by
any one individual.
Matching (Match Concept to Definition/Example)
16-20. Match the concept on the left with its correct description on the right.
Concept Description
A) Boundary 1) Sharing information across different
Spanning organizational units
B) Psychological 2) Environment where individuals feel free to
Safety speak up
C) Double Loop 3) Challenging underlying assumptions for
Learning change
4) Multiple organizations working toward a
D) Collective Impact
common goal
5) Complex patterns arising from simple
E) Emergence
interactions
Answers: A-1, B-2, C-3, D-4, E-5
Rationale: Each concept corresponds to the described phenomenon in systems leadership and
collaborative practice literature.
Fill in the Blank
, 21. The ___________ model emphasizes iterative cycles of planning, acting, observing, and
reflecting to improve complex healthcare systems. Answer: Plan-Do-Study-Act (PDSA)
Rationale: PDSA is integral to continuous quality improvement processes.
22. The ___________ describes a cultural state where healthcare teams openly discuss errors
without fear of punishment to promote learning. Answer: Just Culture Rationale: Just
Culture balances accountability and learning from mistakes.
23. Effective collaborative leadership requires developing ___________, which is the ability to
orchestrate multiple stakeholders toward a shared system goal. Answer: Collective
leadership Rationale: Collective leadership leverages shared responsibility.
24. In systems thinking, feedback that reinforces a change and amplifies system behavior is
called ___________ feedback. Answer: Positive Rationale: Positive feedback increases a
certain behavior or process within the system.
25. The individual responsible for facilitating interprofessional collaboration and resolving
conflicts is often referred to as the ___________. Answer: Collaboration facilitator or nurse
navigator Rationale: These roles help coordinate and manage team dynamics.
Multiple Choice
26. Which tool best supports visualization of complex relationships within healthcare systems
for leaders? A) SWOT analysis B) Causal loop diagrams C) Gantt charts D) Fishbone diagrams
Answer: B) Causal loop diagrams Rationale: Causal loop diagrams show feedback loops and
system dynamics critical for systems thinking.
27. During an interdisciplinary meeting, a nurse leader encourages input from all team
members and resists expressing their own opinion early. This behavior best exemplifies: A)
Autocratic style B) Servant leadership C) Facilitative leadership D) Laissez-faire approach
Answer: C) Facilitative leadership Rationale: Facilitative leaders promote shared participation
without dominating.
28. Which of the following is an example of a systems leverage point for improving patient
safety? A) Punishing individual errors B) Improving communication channels C) Increasing
staffing without process review D) Adding more technology without training Answer: B)
Improving communication channels Rationale: Leverage points are places where interventions
yield significant impact; communication is a high-leverage area.
29. Which is NOT a characteristic of a complex adaptive system? A) Non-linearity B) Predictability
C) Emergence D) Adaptation Answer: B) Predictability Rationale: Complex adaptive systems
are unpredictable due to many interacting variables.
30. A nurse leader applies Lewin's Change Theory in a system transformation effort. What is the
‘Unfreezing’ stage? A) Implementing new protocols B) Preparing the system for change by
challenging status quo C) Embedding change into routine practice D) Monitoring outcomes
post-change Answer: B) Preparing the system for change by challenging status quo Rationale:
Unfreezing involves creating motivation to change.
True/False
31. T/F: High-quality collaborative practice reduces healthcare costs by avoiding duplicate
testing and reducing errors. Answer: True Rationale: Collaboration streamlines care,
promoting efficiency.
32. T/F: Systems leaders typically dictate changes without consulting front-line staff to maintain
control. Answer: False Rationale: Effective systems leaders engage staff to leverage frontline
insights.
33. T/F: Boundary spanners in healthcare act as connectors between disparate teams or
organizations. Answer: True Rationale: Boundary spanners facilitate communication and
Systems Leadership & Collaborative
Practice
Latest Exam Review
2026
1. A nurse leader implementing a new electronic health record (EHR) system engages multiple
departments in the planning process to ensure smooth adoption. Which systems leadership
principle is best demonstrated here? A) Autocratic decision-making B) Distributed leadership
C) Transactional leadership D) Centralized authority Answer: B) Distributed leadership
Rationale: Distributed leadership involves sharing leadership responsibilities across members
of the organization, which includes engaging multiple departments.
2. In collaborative practice, what is the primary benefit of interprofessional team huddles
during shift changes? A) Speed up patient discharge B) Reduce communication errors C)
Increase paperwork accuracy D) Minimize staff breaks Answer: B) Reduce communication
errors Rationale: Team huddles promote real-time communication, reducing
misunderstandings and errors during transitions.
3. Which factor most directly influences the sustainability of system changes in healthcare
settings? A) Leadership charisma B) Financial incentives C) Stakeholder engagement D)
External regulations Answer: C) Stakeholder engagement Rationale: Engaged stakeholders are
critical for buy-in and long-term sustainability of change.
4. A nurse manager notices that interdisciplinary conflicts are affecting patient outcomes.
What is the most effective first step? A) Implement punitive measures B) Facilitate open
dialogue sessions C) Avoid confrontations D) Reassign team members immediately Answer: B)
Facilitate open dialogue sessions Rationale: Open communication allows teams to understand
perspectives and resolve conflicts collaboratively.
5. In systems leadership, what does 'complex adaptive system' refer to? A) Linear cause-effect
relationships B) A rigid hierarchical structure C) A dynamic network with multiple interacting
components D) Single-point decision-making authority Answer: C) A dynamic network with
multiple interacting components Rationale: Healthcare systems are complex adaptive systems
characterized by interdependent parts that adapt to changes.
True/False Questions (T/F)
6. T/F: Effective collaborative practice requires that all team members have equal clinical
expertise. Answer: False Rationale: Collaborative practice values diverse expertise and roles;
equality in expertise is not required but mutual respect and understanding are.
7. T/F: Systems leaders should prioritize short-term goals over long-term system improvement.
Answer: False Rationale: Systems leadership focuses on long-term sustainability and
improvement rather than just short-term results.
, 8. T/F: Psychological safety in a team setting enhances error reporting and learning from
mistakes. Answer: True Rationale: Psychological safety encourages openness and
transparency, essential for learning and improvement in healthcare.
9. T/F: Collaborative practice eliminates the need for clear role definitions within healthcare
teams. Answer: False Rationale: Clear roles are crucial to prevent role confusion and ensure
accountability even in collaborative environments.
10. T/F: Adaptive leadership involves responding flexibly to unexpected changes within a
healthcare system. Answer: True Rationale: Adaptive leadership requires flexibility and
responsiveness to evolving conditions within complex systems.
Short Answer
11. Define ‘systems thinking’ in the context of healthcare leadership. Answer: Systems thinking
is a holistic approach that focuses on understanding how different components of the
healthcare system interact and influence one another to improve outcomes. Rationale: It
emphasizes interconnections rather than isolated parts.
12. List three barriers to effective interdisciplinary collaboration in hospital settings. Answer:
Communication breakdowns, role ambiguity, and hierarchical power dynamics. Rationale:
These are common obstacles reducing collaboration and team effectiveness.
13. Explain how a transformational leader can influence collaborative practice. Answer: By
inspiring and motivating team members, fostering a shared vision, and encouraging
innovation and trust, a transformational leader enhances collaboration. Rationale:
Transformational leaders focus on empowering others and improving team morale.
14. What is the role of feedback loops in system leadership? Answer: Feedback loops help
monitor outcomes and inform adjustments for continuous improvement within complex
systems. Rationale: They provide necessary information flows for adaptive decision-making.
15. Describe one strategy to manage power imbalances during collaborative decision-making.
Answer: Establishing ground rules that promote equal voice and using a neutral facilitator to
guide discussions. Rationale: These techniques foster inclusivity and minimize dominance by
any one individual.
Matching (Match Concept to Definition/Example)
16-20. Match the concept on the left with its correct description on the right.
Concept Description
A) Boundary 1) Sharing information across different
Spanning organizational units
B) Psychological 2) Environment where individuals feel free to
Safety speak up
C) Double Loop 3) Challenging underlying assumptions for
Learning change
4) Multiple organizations working toward a
D) Collective Impact
common goal
5) Complex patterns arising from simple
E) Emergence
interactions
Answers: A-1, B-2, C-3, D-4, E-5
Rationale: Each concept corresponds to the described phenomenon in systems leadership and
collaborative practice literature.
Fill in the Blank
, 21. The ___________ model emphasizes iterative cycles of planning, acting, observing, and
reflecting to improve complex healthcare systems. Answer: Plan-Do-Study-Act (PDSA)
Rationale: PDSA is integral to continuous quality improvement processes.
22. The ___________ describes a cultural state where healthcare teams openly discuss errors
without fear of punishment to promote learning. Answer: Just Culture Rationale: Just
Culture balances accountability and learning from mistakes.
23. Effective collaborative leadership requires developing ___________, which is the ability to
orchestrate multiple stakeholders toward a shared system goal. Answer: Collective
leadership Rationale: Collective leadership leverages shared responsibility.
24. In systems thinking, feedback that reinforces a change and amplifies system behavior is
called ___________ feedback. Answer: Positive Rationale: Positive feedback increases a
certain behavior or process within the system.
25. The individual responsible for facilitating interprofessional collaboration and resolving
conflicts is often referred to as the ___________. Answer: Collaboration facilitator or nurse
navigator Rationale: These roles help coordinate and manage team dynamics.
Multiple Choice
26. Which tool best supports visualization of complex relationships within healthcare systems
for leaders? A) SWOT analysis B) Causal loop diagrams C) Gantt charts D) Fishbone diagrams
Answer: B) Causal loop diagrams Rationale: Causal loop diagrams show feedback loops and
system dynamics critical for systems thinking.
27. During an interdisciplinary meeting, a nurse leader encourages input from all team
members and resists expressing their own opinion early. This behavior best exemplifies: A)
Autocratic style B) Servant leadership C) Facilitative leadership D) Laissez-faire approach
Answer: C) Facilitative leadership Rationale: Facilitative leaders promote shared participation
without dominating.
28. Which of the following is an example of a systems leverage point for improving patient
safety? A) Punishing individual errors B) Improving communication channels C) Increasing
staffing without process review D) Adding more technology without training Answer: B)
Improving communication channels Rationale: Leverage points are places where interventions
yield significant impact; communication is a high-leverage area.
29. Which is NOT a characteristic of a complex adaptive system? A) Non-linearity B) Predictability
C) Emergence D) Adaptation Answer: B) Predictability Rationale: Complex adaptive systems
are unpredictable due to many interacting variables.
30. A nurse leader applies Lewin's Change Theory in a system transformation effort. What is the
‘Unfreezing’ stage? A) Implementing new protocols B) Preparing the system for change by
challenging status quo C) Embedding change into routine practice D) Monitoring outcomes
post-change Answer: B) Preparing the system for change by challenging status quo Rationale:
Unfreezing involves creating motivation to change.
True/False
31. T/F: High-quality collaborative practice reduces healthcare costs by avoiding duplicate
testing and reducing errors. Answer: True Rationale: Collaboration streamlines care,
promoting efficiency.
32. T/F: Systems leaders typically dictate changes without consulting front-line staff to maintain
control. Answer: False Rationale: Effective systems leaders engage staff to leverage frontline
insights.
33. T/F: Boundary spanners in healthcare act as connectors between disparate teams or
organizations. Answer: True Rationale: Boundary spanners facilitate communication and
