NUR 204 Exam 3 Leadership and Management
Guide Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
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SECTION 1: LEADERSHIP THEORIES & STYLES Q1 – Q10
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Question 1 of 50
A nurse manager notices that staff morale has dropped significantly after a recent policy
change. The manager holds one-on-one meetings with each team member, listens to their
concerns, and works collaboratively to redesign the workflow. Staff members report feeling
re-energized and committed to the unit's goals.
A. The manager is using a transactional approach by enforcing the new policy strictly.
B. The manager is demonstrating transformational leadership by inspiring and engaging staff.
✓ CORRECT
C. The manager is applying autocratic leadership to maintain control over the unit.
D. The manager is practicing laissez-faire leadership by allowing staff to self-direct.
Correct Answer: B
Rationale: Transformational leadership focuses on inspiring followers, fostering innovation,
and building commitment through shared vision and individualized consideration.
Transactional leadership relies on contingent rewards and management-by-exception, which
does not match the collaborative engagement described. On the NGN exam, look for
keywords like inspire, energize, and transform when identifying this style.
Question 2 of 50
During a code blue on a busy medical-surgical unit, the charge nurse immediately assigns
roles, directs the resuscitation effort with clear commands, and makes rapid decisions
without seeking group consensus. The team responds efficiently and the patient stabilizes.
A. This reflects democratic leadership because the charge nurse involved the team in
decision-making.
,B. This demonstrates servant leadership by prioritizing the needs of the patient above all
else.
C. This is an example of transformational leadership during a crisis situation.
D. This illustrates autocratic leadership, which is appropriate during emergency situations. ✓
CORRECT
Correct Answer: D
Rationale: Autocratic leadership involves centralized decision-making and direct commands,
which is effective and often necessary during life-threatening emergencies when time is
critical. Democratic leadership requires group input and consensus-building, which would
delay critical interventions during a code. In leadership exams, match the style to the context:
autocratic for emergencies, democratic for routine problem-solving.
Question 3 of 50
A hospital is preparing to implement a new bar-code medication administration system. The
nurse manager begins by explaining why the current paper-based system is no longer safe,
shares data on medication errors, and involves staff in designing the new workflow before
the go-live date.
A. The manager is following Lewin's unfreeze-change-refreeze model by preparing staff for
change. ✓ CORRECT
B. The manager is using Kotter's final step of anchoring change in the organizational culture.
C. The manager is demonstrating laissez-faire leadership by allowing staff to design the
system independently.
D. The manager is applying situational leadership by delegating all implementation tasks to
staff.
Correct Answer: A
Rationale: Lewin's change theory begins with unfreezing, which involves creating awareness
that change is necessary by challenging existing beliefs and presenting compelling data.
Kotter's anchoring step occurs after implementation, not during preparation. Fortis exams
frequently test whether you can distinguish the unfreeze stage from the actual change and
refreeze stages.
Question 4 of 50
A newly hired nurse manager on a telemetry unit has a team of experienced nurses who have
worked together for ten years. The manager provides the team with clear goals and
expectations but allows them to determine their own patient assignments and scheduling
preferences with minimal oversight.
A. This manager is using a democratic leadership style by seeking consensus on every
decision.
, B. This manager is demonstrating transformational leadership by challenging the team to
innovate.
C. This manager is applying a laissez-faire approach, which may suit experienced
self-directed staff. ✓ CORRECT
D. This manager is practicing situational leadership at the selling stage of team development.
Correct Answer: C
Rationale: Laissez-faire leadership provides minimal direction and delegates decision-making
to the team, which can work well with highly experienced, motivated staff but risks poor
outcomes if team members lack expertise. Democratic leadership requires active
participation in decision-making, not just setting goals and stepping back. Be cautious on
exams: laissez-faire is not always wrong—it depends on the readiness of the followers.
Question 5 of 50
A nurse manager consistently puts the needs of the nursing staff first, removes barriers to
patient care, and mentors new nurses by sharing personal experiences and encouraging
professional growth. Staff turnover on this unit is the lowest in the hospital.
A. This manager is exhibiting servant leadership by prioritizing staff development and
well-being. ✓ CORRECT
B. This manager is using transactional leadership through contingent rewards and
recognition.
C. This manager is demonstrating autocratic leadership by controlling all aspects of the work
environment.
D. This manager is applying situational leadership by adapting to each nurse's individual
needs only.
Correct Answer: A
Rationale: Servant leadership emphasizes leaders who serve their followers first, focusing on
growth, well-being, and empowerment rather than self-interest. Transactional leadership
depends on exchange relationships and rewards, which is not the primary focus here. Servant
leadership is a high-yield concept on nursing leadership exams because it directly links leader
behavior to staff retention and satisfaction.
Question 6 of 50
The director of nursing tells a unit manager that if the unit achieves a 95% patient
satisfaction score this quarter, the staff will receive a bonus and public recognition at the
hospital-wide meeting. If scores drop below 85%, mandatory overtime and additional
documentation audits will be implemented.
A. This is an example of democratic leadership because the director involved the manager in
setting goals.
Guide Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
══════════════════════════════════════
SECTION 1: LEADERSHIP THEORIES & STYLES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A nurse manager notices that staff morale has dropped significantly after a recent policy
change. The manager holds one-on-one meetings with each team member, listens to their
concerns, and works collaboratively to redesign the workflow. Staff members report feeling
re-energized and committed to the unit's goals.
A. The manager is using a transactional approach by enforcing the new policy strictly.
B. The manager is demonstrating transformational leadership by inspiring and engaging staff.
✓ CORRECT
C. The manager is applying autocratic leadership to maintain control over the unit.
D. The manager is practicing laissez-faire leadership by allowing staff to self-direct.
Correct Answer: B
Rationale: Transformational leadership focuses on inspiring followers, fostering innovation,
and building commitment through shared vision and individualized consideration.
Transactional leadership relies on contingent rewards and management-by-exception, which
does not match the collaborative engagement described. On the NGN exam, look for
keywords like inspire, energize, and transform when identifying this style.
Question 2 of 50
During a code blue on a busy medical-surgical unit, the charge nurse immediately assigns
roles, directs the resuscitation effort with clear commands, and makes rapid decisions
without seeking group consensus. The team responds efficiently and the patient stabilizes.
A. This reflects democratic leadership because the charge nurse involved the team in
decision-making.
,B. This demonstrates servant leadership by prioritizing the needs of the patient above all
else.
C. This is an example of transformational leadership during a crisis situation.
D. This illustrates autocratic leadership, which is appropriate during emergency situations. ✓
CORRECT
Correct Answer: D
Rationale: Autocratic leadership involves centralized decision-making and direct commands,
which is effective and often necessary during life-threatening emergencies when time is
critical. Democratic leadership requires group input and consensus-building, which would
delay critical interventions during a code. In leadership exams, match the style to the context:
autocratic for emergencies, democratic for routine problem-solving.
Question 3 of 50
A hospital is preparing to implement a new bar-code medication administration system. The
nurse manager begins by explaining why the current paper-based system is no longer safe,
shares data on medication errors, and involves staff in designing the new workflow before
the go-live date.
A. The manager is following Lewin's unfreeze-change-refreeze model by preparing staff for
change. ✓ CORRECT
B. The manager is using Kotter's final step of anchoring change in the organizational culture.
C. The manager is demonstrating laissez-faire leadership by allowing staff to design the
system independently.
D. The manager is applying situational leadership by delegating all implementation tasks to
staff.
Correct Answer: A
Rationale: Lewin's change theory begins with unfreezing, which involves creating awareness
that change is necessary by challenging existing beliefs and presenting compelling data.
Kotter's anchoring step occurs after implementation, not during preparation. Fortis exams
frequently test whether you can distinguish the unfreeze stage from the actual change and
refreeze stages.
Question 4 of 50
A newly hired nurse manager on a telemetry unit has a team of experienced nurses who have
worked together for ten years. The manager provides the team with clear goals and
expectations but allows them to determine their own patient assignments and scheduling
preferences with minimal oversight.
A. This manager is using a democratic leadership style by seeking consensus on every
decision.
, B. This manager is demonstrating transformational leadership by challenging the team to
innovate.
C. This manager is applying a laissez-faire approach, which may suit experienced
self-directed staff. ✓ CORRECT
D. This manager is practicing situational leadership at the selling stage of team development.
Correct Answer: C
Rationale: Laissez-faire leadership provides minimal direction and delegates decision-making
to the team, which can work well with highly experienced, motivated staff but risks poor
outcomes if team members lack expertise. Democratic leadership requires active
participation in decision-making, not just setting goals and stepping back. Be cautious on
exams: laissez-faire is not always wrong—it depends on the readiness of the followers.
Question 5 of 50
A nurse manager consistently puts the needs of the nursing staff first, removes barriers to
patient care, and mentors new nurses by sharing personal experiences and encouraging
professional growth. Staff turnover on this unit is the lowest in the hospital.
A. This manager is exhibiting servant leadership by prioritizing staff development and
well-being. ✓ CORRECT
B. This manager is using transactional leadership through contingent rewards and
recognition.
C. This manager is demonstrating autocratic leadership by controlling all aspects of the work
environment.
D. This manager is applying situational leadership by adapting to each nurse's individual
needs only.
Correct Answer: A
Rationale: Servant leadership emphasizes leaders who serve their followers first, focusing on
growth, well-being, and empowerment rather than self-interest. Transactional leadership
depends on exchange relationships and rewards, which is not the primary focus here. Servant
leadership is a high-yield concept on nursing leadership exams because it directly links leader
behavior to staff retention and satisfaction.
Question 6 of 50
The director of nursing tells a unit manager that if the unit achieves a 95% patient
satisfaction score this quarter, the staff will receive a bonus and public recognition at the
hospital-wide meeting. If scores drop below 85%, mandatory overtime and additional
documentation audits will be implemented.
A. This is an example of democratic leadership because the director involved the manager in
setting goals.
