### Leadership & Management in Nursing
Exam Prep | 2026 BSN Pathway | NCLEX-
Style Ultimate Bundle for Exam Success
**100 Questions with Verified
Rationales**
---
**1. A charge nurse is making patient assignments for a medical-surgical unit. Which client should be
assigned to the most experienced registered nurse (RN)?**
A) A client with a chest tube who has continuous bubbling in the water seal chamber
B) A client who is 24 hours post-operative from an appendectomy
C) A client who requires a blood transfusion
D) A client who needs discharge teaching
🎯CORRECT CHOICE: A
💡EXPLANATION: A client with a chest tube and continuous bubbling indicates an air leak, which
requires the most experienced RN because this is an unstable situation that requires advanced
assessment and intervention skills. The other clients are more stable and can be assigned to less
experienced staff or delegated appropriately.
**2. A nurse manager is implementing a new evidence-based practice protocol for fall prevention.
Which of the following is the most effective strategy to ensure successful implementation?**
A) Mandating that all staff follow the new protocol without exception
B) Posting the new protocol on the unit bulletin board
C) Involving staff nurses in the planning and implementation process
,D) Providing a one-time in-service training session
🎯CORRECT CHOICE: C
💡EXPLANATION: Involving staff nurses in the planning and implementation process increases buy-in,
ownership, and adherence to the new protocol. Change is more successful when those affected by the
change are included in the process, as it addresses their concerns and leverages their expertise.
**3. A nurse is delegating tasks to a licensed practical/vocational nurse (LPN/LVN). Which of the
following tasks is appropriate to delegate to an LPN/LVN?**
A) Administering intravenous push medications
B) Developing the initial nursing care plan
C) Performing a comprehensive admission assessment
D) Administering oral medications to stable clients
🎯CORRECT CHOICE: D
💡EXPLANATION: LPN/LVNs can administer oral medications to stable clients with predictable outcomes.
The RN cannot delegate tasks that require nursing judgment, such as developing care plans (B),
performing comprehensive assessments (C), or administering IV push medications (A), which are outside
the LPN/LVN scope of practice.
**4. A nurse is leading a team on a busy medical-surgical unit. Which of the following conflict resolution
strategies is most effective in a situation where two staff members are in disagreement about a patient
care approach?**
A) Avoiding the conflict to allow the staff to work it out themselves
B) Forcing a solution to quickly resolve the situation
C) Collaborating to find a solution that satisfies both parties
D) Compromising by having each party give up something
🎯CORRECT CHOICE: C
💡EXPLANATION: Collaboration is the most effective conflict resolution strategy because it involves
open communication, mutual respect, and finding a win-win solution that addresses the concerns of
both parties. This approach fosters teamwork and leads to better patient outcomes. Avoiding (A) and
forcing (B) are not effective long-term strategies.
**5. A nurse manager is conducting a performance evaluation for a staff nurse. Which of the following is
the most appropriate way to provide feedback?**
,A) Focusing solely on the nurse's weaknesses
B) Providing only positive feedback to avoid discouragement
C) Using specific examples of both strengths and areas for improvement
D) Comparing the nurse's performance to another staff member
🎯CORRECT CHOICE: C
💡EXPLANATION: Effective performance evaluations use specific, objective examples to illustrate both
strengths and areas for improvement. This approach provides clear, actionable feedback that helps the
nurse grow professionally. It should be a collaborative, constructive process, not a comparison to others.
**6. A charge nurse notices that a staff nurse is consistently late for shifts and appears fatigued. Which
of the following actions should the charge nurse take first?**
A) Report the nurse to the nurse manager immediately
B) Document the nurse's lateness in their personnel file
C) Have a private conversation with the nurse to discuss the observations
D) Assign the nurse to less demanding patient assignments
🎯CORRECT CHOICE: C
💡EXPLANATION: The first step is to address the issue directly with the nurse in a private, non-
confrontational manner. This allows the nurse to explain the situation and allows the charge nurse to
express concern and offer support. Reporting (A) or documenting (B) should come after an attempt to
discuss the issue.
**7. A nurse is providing care to a client who is verbally abusive and demanding. Which of the following
is the most appropriate nursing response?**
A) Ignoring the client's behavior to avoid escalation
B) Telling the client to stop being rude
C) Setting firm, calm limits on acceptable behavior
D) Leaving the room until the client calms down
🎯CORRECT CHOICE: C
💡EXPLANATION: Setting firm, calm limits on acceptable behavior is the most therapeutic response. It
communicates that abusive behavior is not acceptable while maintaining a professional and caring
demeanor. The nurse should use "I" statements and state the consequences of continued behavior,
ensuring safety.
, **8. A nurse manager is planning a budget for the upcoming fiscal year. Which of the following is a fixed
cost in the nursing unit's budget?**
A) Salaries of full-time nursing staff
B) Cost of medical supplies
C) Overtime pay for staff
D) Temporary staffing agency fees
🎯CORRECT CHOICE: A
💡EXPLANATION: Fixed costs do not change with the volume of services provided. Salaries of full-time
staff are fixed costs. Variable costs (B, C, D) fluctuate with patient census and activity levels.
Understanding the difference is essential for effective budget management.
**9. A nurse is experiencing moral distress related to an ethical dilemma. Which of the following is the
best strategy for the nurse to manage this distress?**
A) Ignoring the distress and continuing with regular duties
B) Discussing the situation with a trusted colleague or supervisor
C) Resigning from the position to avoid the dilemma
D) Blaming other staff members for the situation
🎯CORRECT CHOICE: B
💡EXPLANATION: Discussing the situation with a trusted colleague, supervisor, or ethics committee is an
effective way to process moral distress. It allows the nurse to express feelings, gain perspective, and
explore options for resolution, which can help prevent burnout.
**10. A charge nurse is making assignments for a shift. The unit has an unlicensed assistive personnel
(UAP) and an LPN. Which of the following clients is most appropriate to assign to the UAP?**
A) A client who is 2 days post-operative and requires vital signs every 4 hours
B) A client who requires a complex wound dressing change
C) A client who needs a sterile urinary catheter insertion
D) A client who requires assessment for signs of stroke
🎯CORRECT CHOICE: A
Exam Prep | 2026 BSN Pathway | NCLEX-
Style Ultimate Bundle for Exam Success
**100 Questions with Verified
Rationales**
---
**1. A charge nurse is making patient assignments for a medical-surgical unit. Which client should be
assigned to the most experienced registered nurse (RN)?**
A) A client with a chest tube who has continuous bubbling in the water seal chamber
B) A client who is 24 hours post-operative from an appendectomy
C) A client who requires a blood transfusion
D) A client who needs discharge teaching
🎯CORRECT CHOICE: A
💡EXPLANATION: A client with a chest tube and continuous bubbling indicates an air leak, which
requires the most experienced RN because this is an unstable situation that requires advanced
assessment and intervention skills. The other clients are more stable and can be assigned to less
experienced staff or delegated appropriately.
**2. A nurse manager is implementing a new evidence-based practice protocol for fall prevention.
Which of the following is the most effective strategy to ensure successful implementation?**
A) Mandating that all staff follow the new protocol without exception
B) Posting the new protocol on the unit bulletin board
C) Involving staff nurses in the planning and implementation process
,D) Providing a one-time in-service training session
🎯CORRECT CHOICE: C
💡EXPLANATION: Involving staff nurses in the planning and implementation process increases buy-in,
ownership, and adherence to the new protocol. Change is more successful when those affected by the
change are included in the process, as it addresses their concerns and leverages their expertise.
**3. A nurse is delegating tasks to a licensed practical/vocational nurse (LPN/LVN). Which of the
following tasks is appropriate to delegate to an LPN/LVN?**
A) Administering intravenous push medications
B) Developing the initial nursing care plan
C) Performing a comprehensive admission assessment
D) Administering oral medications to stable clients
🎯CORRECT CHOICE: D
💡EXPLANATION: LPN/LVNs can administer oral medications to stable clients with predictable outcomes.
The RN cannot delegate tasks that require nursing judgment, such as developing care plans (B),
performing comprehensive assessments (C), or administering IV push medications (A), which are outside
the LPN/LVN scope of practice.
**4. A nurse is leading a team on a busy medical-surgical unit. Which of the following conflict resolution
strategies is most effective in a situation where two staff members are in disagreement about a patient
care approach?**
A) Avoiding the conflict to allow the staff to work it out themselves
B) Forcing a solution to quickly resolve the situation
C) Collaborating to find a solution that satisfies both parties
D) Compromising by having each party give up something
🎯CORRECT CHOICE: C
💡EXPLANATION: Collaboration is the most effective conflict resolution strategy because it involves
open communication, mutual respect, and finding a win-win solution that addresses the concerns of
both parties. This approach fosters teamwork and leads to better patient outcomes. Avoiding (A) and
forcing (B) are not effective long-term strategies.
**5. A nurse manager is conducting a performance evaluation for a staff nurse. Which of the following is
the most appropriate way to provide feedback?**
,A) Focusing solely on the nurse's weaknesses
B) Providing only positive feedback to avoid discouragement
C) Using specific examples of both strengths and areas for improvement
D) Comparing the nurse's performance to another staff member
🎯CORRECT CHOICE: C
💡EXPLANATION: Effective performance evaluations use specific, objective examples to illustrate both
strengths and areas for improvement. This approach provides clear, actionable feedback that helps the
nurse grow professionally. It should be a collaborative, constructive process, not a comparison to others.
**6. A charge nurse notices that a staff nurse is consistently late for shifts and appears fatigued. Which
of the following actions should the charge nurse take first?**
A) Report the nurse to the nurse manager immediately
B) Document the nurse's lateness in their personnel file
C) Have a private conversation with the nurse to discuss the observations
D) Assign the nurse to less demanding patient assignments
🎯CORRECT CHOICE: C
💡EXPLANATION: The first step is to address the issue directly with the nurse in a private, non-
confrontational manner. This allows the nurse to explain the situation and allows the charge nurse to
express concern and offer support. Reporting (A) or documenting (B) should come after an attempt to
discuss the issue.
**7. A nurse is providing care to a client who is verbally abusive and demanding. Which of the following
is the most appropriate nursing response?**
A) Ignoring the client's behavior to avoid escalation
B) Telling the client to stop being rude
C) Setting firm, calm limits on acceptable behavior
D) Leaving the room until the client calms down
🎯CORRECT CHOICE: C
💡EXPLANATION: Setting firm, calm limits on acceptable behavior is the most therapeutic response. It
communicates that abusive behavior is not acceptable while maintaining a professional and caring
demeanor. The nurse should use "I" statements and state the consequences of continued behavior,
ensuring safety.
, **8. A nurse manager is planning a budget for the upcoming fiscal year. Which of the following is a fixed
cost in the nursing unit's budget?**
A) Salaries of full-time nursing staff
B) Cost of medical supplies
C) Overtime pay for staff
D) Temporary staffing agency fees
🎯CORRECT CHOICE: A
💡EXPLANATION: Fixed costs do not change with the volume of services provided. Salaries of full-time
staff are fixed costs. Variable costs (B, C, D) fluctuate with patient census and activity levels.
Understanding the difference is essential for effective budget management.
**9. A nurse is experiencing moral distress related to an ethical dilemma. Which of the following is the
best strategy for the nurse to manage this distress?**
A) Ignoring the distress and continuing with regular duties
B) Discussing the situation with a trusted colleague or supervisor
C) Resigning from the position to avoid the dilemma
D) Blaming other staff members for the situation
🎯CORRECT CHOICE: B
💡EXPLANATION: Discussing the situation with a trusted colleague, supervisor, or ethics committee is an
effective way to process moral distress. It allows the nurse to express feelings, gain perspective, and
explore options for resolution, which can help prevent burnout.
**10. A charge nurse is making assignments for a shift. The unit has an unlicensed assistive personnel
(UAP) and an LPN. Which of the following clients is most appropriate to assign to the UAP?**
A) A client who is 2 days post-operative and requires vital signs every 4 hours
B) A client who requires a complex wound dressing change
C) A client who needs a sterile urinary catheter insertion
D) A client who requires assessment for signs of stroke
🎯CORRECT CHOICE: A
