NSG 436 Exam 4 V1 | NSG 436 Leadership,
Ethics, and Policy in Health Care | Actual
Q&A with Rationale (NSG436 Exam 4) |
Grand Canyon University
1. A nurse manager is utilizing transformational leadership to improve unit morale. Which
actions by the manager align with this leadership style? (Select All That Apply)
A. Setting clear goals and rewarding employees when they are met.
B. Encouraging staff to challenge the status quo to improve outcomes.
C. Inspiring a shared vision for the future of the unit.
D. Using a hands-off approach and letting the team make all decisions.
E. Providing individual mentorship and coaching to junior staff.
F. Focusing primarily on administrative tasks and day-to-day operations.
Correct Answer: B, C, E
Explanation: Transformational leadership focuses on inspiring and motivating followers
to achieve extraordinary outcomes. It involves intellectual stimulation, inspirational
motivation, and individualized consideration for staff growth. Transactional leadership, by
contrast, focuses more on rewards and punishments for performance.
,2. A nurse is faced with a situation where a patient refuses a life-saving blood transfusion due
to religious beliefs. The nurse supports the patient’s right to refuse. Which ethical principle is
the nurse upholding?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Justice
Correct Answer: C
Explanation: Autonomy refers to the patient’s right to make their own decisions regarding
their healthcare, even if those decisions conflict with medical advice. The nurse must
respect this right provided the patient is competent. This principle is fundamental to the
patient-provider relationship in modern healthcare.
3. Which of the following are characteristics of a ‘Just Culture’ within a healthcare
organization? (Select All That Apply)
A. Zero tolerance for any clinical errors regardless of intent.
B. Distinguishing between human error, at-risk behavior, and reckless behavior.
C. Encouraging staff to report near-misses without fear of retribution.
D. Strictly penalizing the first person who reports a systemic failure.
E. Focusing on system design rather than individual blame for simple mistakes.
, Correct Answer: B, C, E
Explanation: Just Culture seeks to balance individual accountability with a recognition of
system-level factors that contribute to errors. It encourages open communication and
reporting to prevent future adverse events. Reckless behavior is still held accountable, but
honest mistakes are used as learning opportunities.
4. A nurse manager is preparing a budget and notes that fixed costs remain constant
regardless of patient volume. Which is an example of a fixed cost?
A. Medical supplies
B. Nursing salaries (hourly)
C. Patient medications
D. Mortgage or rent on the facility
Correct Answer: D
Explanation: Fixed costs are those that do not fluctuate with the level of service provided,
such as rent or insurance. Variable costs, like supplies and medications, change based on
the number of patients treated. Understanding these categories is essential for effective
unit-based financial management.
5. During a staff meeting, the manager uses Lewin’s Change Theory to implement a new
charting system. Which phase involves reinforcing the new behavior so it becomes the new
status quo?
A. Unfreezing
Ethics, and Policy in Health Care | Actual
Q&A with Rationale (NSG436 Exam 4) |
Grand Canyon University
1. A nurse manager is utilizing transformational leadership to improve unit morale. Which
actions by the manager align with this leadership style? (Select All That Apply)
A. Setting clear goals and rewarding employees when they are met.
B. Encouraging staff to challenge the status quo to improve outcomes.
C. Inspiring a shared vision for the future of the unit.
D. Using a hands-off approach and letting the team make all decisions.
E. Providing individual mentorship and coaching to junior staff.
F. Focusing primarily on administrative tasks and day-to-day operations.
Correct Answer: B, C, E
Explanation: Transformational leadership focuses on inspiring and motivating followers
to achieve extraordinary outcomes. It involves intellectual stimulation, inspirational
motivation, and individualized consideration for staff growth. Transactional leadership, by
contrast, focuses more on rewards and punishments for performance.
,2. A nurse is faced with a situation where a patient refuses a life-saving blood transfusion due
to religious beliefs. The nurse supports the patient’s right to refuse. Which ethical principle is
the nurse upholding?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Justice
Correct Answer: C
Explanation: Autonomy refers to the patient’s right to make their own decisions regarding
their healthcare, even if those decisions conflict with medical advice. The nurse must
respect this right provided the patient is competent. This principle is fundamental to the
patient-provider relationship in modern healthcare.
3. Which of the following are characteristics of a ‘Just Culture’ within a healthcare
organization? (Select All That Apply)
A. Zero tolerance for any clinical errors regardless of intent.
B. Distinguishing between human error, at-risk behavior, and reckless behavior.
C. Encouraging staff to report near-misses without fear of retribution.
D. Strictly penalizing the first person who reports a systemic failure.
E. Focusing on system design rather than individual blame for simple mistakes.
, Correct Answer: B, C, E
Explanation: Just Culture seeks to balance individual accountability with a recognition of
system-level factors that contribute to errors. It encourages open communication and
reporting to prevent future adverse events. Reckless behavior is still held accountable, but
honest mistakes are used as learning opportunities.
4. A nurse manager is preparing a budget and notes that fixed costs remain constant
regardless of patient volume. Which is an example of a fixed cost?
A. Medical supplies
B. Nursing salaries (hourly)
C. Patient medications
D. Mortgage or rent on the facility
Correct Answer: D
Explanation: Fixed costs are those that do not fluctuate with the level of service provided,
such as rent or insurance. Variable costs, like supplies and medications, change based on
the number of patients treated. Understanding these categories is essential for effective
unit-based financial management.
5. During a staff meeting, the manager uses Lewin’s Change Theory to implement a new
charting system. Which phase involves reinforcing the new behavior so it becomes the new
status quo?
A. Unfreezing
