BSN 465 Final Exam V3 | BSN 465
Decision-making in Nursing | Q&A with
Rationale (BSN465 Final Exam) |
Nightingale College
1. A nurse manager is utilizing the SWOT analysis tool to evaluate the nursing unit’s move to
a new electronic health record system. Which of the following factors would be classified as
an ‘Opportunity’?
A. Adequate staffing levels during the transition period.
B. A government grant providing funding for technological upgrades.
C. Resistance from senior staff regarding the new technology.
D. Frequent software glitches during the pilot phase.
Correct Answer: B
Rationale: In a SWOT analysis, opportunities are external factors that the organization can
exploit to its advantage. A government grant is an external source of funding that facilitates
the transition. Staffing levels are internal strengths, while resistance and glitches represent
internal weaknesses or external threats.
2. When applying Lewin’s Change Theory, a nurse leader is currently creating awareness of
the need for change among the staff. Which stage of the theory does this represent?
A. Moving
,B. Unfreezing
C. Refreezing
D. Assessment
Correct Answer: B
Rationale: The unfreezing stage involves identifying the need for change and preparing the
members of the unit for it. This process involves breaking down the existing status quo
before building up a new way of operating. It is a critical first step to reduce resistance and
gain buy-in from the team.
3. A charge nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which of the
following tasks is most appropriate for the LPN?
A. Performing the initial admission assessment on a new patient.
B. Developing a plan of care for a patient with complex comorbidities.
C. Administering a scheduled subcutaneous insulin injection.
D. Administering an intravenous bolus of a high-risk medication.
Correct Answer: C
Rationale: Administering subcutaneous injections is within the scope of practice for an
LPN in most jurisdictions. Initial assessments and complex care planning require the
advanced clinical judgment of a Registered Nurse (RN). High-risk IV bolus medications are
typically reserved for RN administration due to the need for continuous monitoring.
, 4. The nurse is caring for a client who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports the client’s right to choose. Which ethical principle is being
demonstrated?
A. Beneficence
B. Autonomy
C. Justice
D. Non-maleficence
Correct Answer: B
Rationale: Autonomy refers to the right of patients to make their own decisions about
their medical care. Even if the decision conflicts with medical advice, the nurse must
respect the patient’s self-determination. This principle is a cornerstone of patient-centered
care and legal ethics in nursing.
5. A nurse is using the SBAR communication tool to report a patient’s condition to a
physician. Which information belongs in the ‘Background’ section?
A. The patient’s current blood pressure and heart rate.
B. The nurse’s recommendation for a stat chest X-ray.
C. The primary problem the nurse is calling about.
D. The patient’s medical history and reason for admission.
Correct Answer: D
Decision-making in Nursing | Q&A with
Rationale (BSN465 Final Exam) |
Nightingale College
1. A nurse manager is utilizing the SWOT analysis tool to evaluate the nursing unit’s move to
a new electronic health record system. Which of the following factors would be classified as
an ‘Opportunity’?
A. Adequate staffing levels during the transition period.
B. A government grant providing funding for technological upgrades.
C. Resistance from senior staff regarding the new technology.
D. Frequent software glitches during the pilot phase.
Correct Answer: B
Rationale: In a SWOT analysis, opportunities are external factors that the organization can
exploit to its advantage. A government grant is an external source of funding that facilitates
the transition. Staffing levels are internal strengths, while resistance and glitches represent
internal weaknesses or external threats.
2. When applying Lewin’s Change Theory, a nurse leader is currently creating awareness of
the need for change among the staff. Which stage of the theory does this represent?
A. Moving
,B. Unfreezing
C. Refreezing
D. Assessment
Correct Answer: B
Rationale: The unfreezing stage involves identifying the need for change and preparing the
members of the unit for it. This process involves breaking down the existing status quo
before building up a new way of operating. It is a critical first step to reduce resistance and
gain buy-in from the team.
3. A charge nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which of the
following tasks is most appropriate for the LPN?
A. Performing the initial admission assessment on a new patient.
B. Developing a plan of care for a patient with complex comorbidities.
C. Administering a scheduled subcutaneous insulin injection.
D. Administering an intravenous bolus of a high-risk medication.
Correct Answer: C
Rationale: Administering subcutaneous injections is within the scope of practice for an
LPN in most jurisdictions. Initial assessments and complex care planning require the
advanced clinical judgment of a Registered Nurse (RN). High-risk IV bolus medications are
typically reserved for RN administration due to the need for continuous monitoring.
, 4. The nurse is caring for a client who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports the client’s right to choose. Which ethical principle is being
demonstrated?
A. Beneficence
B. Autonomy
C. Justice
D. Non-maleficence
Correct Answer: B
Rationale: Autonomy refers to the right of patients to make their own decisions about
their medical care. Even if the decision conflicts with medical advice, the nurse must
respect the patient’s self-determination. This principle is a cornerstone of patient-centered
care and legal ethics in nursing.
5. A nurse is using the SBAR communication tool to report a patient’s condition to a
physician. Which information belongs in the ‘Background’ section?
A. The patient’s current blood pressure and heart rate.
B. The nurse’s recommendation for a stat chest X-ray.
C. The primary problem the nurse is calling about.
D. The patient’s medical history and reason for admission.
Correct Answer: D
