BSN 465 Exam 4 V3 | BSN 465 Decision-
making in Nursing | Q&A with Rationale
(BSN465 Exam 4) | Nightingale College
1. A nurse manager is implementing a new EHR system and identifies that several staff
members are resistant to the change. According to Lewin’s Change Theory, which action
should the manager take during the ‘unfreezing’ stage?
A. Create a sense of urgency by explaining the risks of the old system.
B. Provide technical support during the first week of go-live.
C. Implement the new charting templates immediately.
D. Reward nurses who master the new system quickly.
Correct Answer: A
Rationale: The unfreezing stage is the first step in Lewin’s theory, where the status quo is
challenged to prepare for change. By creating a sense of urgency, the manager helps staff
understand why the current system is inadequate and why change is necessary. This step is
crucial for overcoming resistance and ensuring staff are psychologically ready to move
forward.
2. A nursing unit is consistently over budget due to high overtime costs. Which type of budget
is primarily affected by these labor costs?
A. Capital Budget
,B. Strategic Budget
C. Project Budget
D. Operating Budget
Correct Answer: D
Rationale: The operating budget covers the day-to-day expenses required to run the unit,
including staff salaries and supplies. Overtime costs are direct labor expenses that fall
under this category rather than the capital budget, which is for large equipment.
Monitoring the operating budget allows managers to identify variances and adjust staffing
levels to improve fiscal responsibility.
3. A nurse is using the ‘Salami’ method of conflict resolution, where small concessions are
made by both parties. Which conflict management style is being utilized?
A. Collaborating
B. Compromising
C. Avoiding
D. Competing
Correct Answer: B
Rationale: Compromising involves a ‘give-and-take’ approach where both parties
relinquish something of value to reach a middle ground. While it resolves the conflict
, quickly, it may result in a ‘lose-lose’ situation if the root cause isn’t addressed. This style is
most effective when goals are moderately important and time is of the essence.
4. When conducting a Root Cause Analysis (RCA) after a medication error, what is the primary
focus of the investigation team?
A. Identifying systemic failures that allowed the error to occur.
B. Determining which nurse was at fault for the error.
C. Assigning mandatory remedial training to the staff involved.
D. Reducing the hospital’s liability in potential lawsuits.
Correct Answer: A
Rationale: Root Cause Analysis is a retrospective process used to identify underlying
systemic factors rather than blaming individuals. It aims to understand the ‘why’ and ‘how’
of an event to prevent future occurrences. By focusing on processes and systems, the
facility can implement permanent changes that improve patient safety.
5. A nurse manager is evaluating a new staff member’s performance using a 360-degree
feedback tool. What is the main advantage of this method?
A. It provides a comprehensive view of performance from multiple perspectives.
B. It eliminates the need for a face-to-face meeting.
C. It is the fastest method for completing annual reviews.
D. It focuses solely on clinical skills and objective data.
making in Nursing | Q&A with Rationale
(BSN465 Exam 4) | Nightingale College
1. A nurse manager is implementing a new EHR system and identifies that several staff
members are resistant to the change. According to Lewin’s Change Theory, which action
should the manager take during the ‘unfreezing’ stage?
A. Create a sense of urgency by explaining the risks of the old system.
B. Provide technical support during the first week of go-live.
C. Implement the new charting templates immediately.
D. Reward nurses who master the new system quickly.
Correct Answer: A
Rationale: The unfreezing stage is the first step in Lewin’s theory, where the status quo is
challenged to prepare for change. By creating a sense of urgency, the manager helps staff
understand why the current system is inadequate and why change is necessary. This step is
crucial for overcoming resistance and ensuring staff are psychologically ready to move
forward.
2. A nursing unit is consistently over budget due to high overtime costs. Which type of budget
is primarily affected by these labor costs?
A. Capital Budget
,B. Strategic Budget
C. Project Budget
D. Operating Budget
Correct Answer: D
Rationale: The operating budget covers the day-to-day expenses required to run the unit,
including staff salaries and supplies. Overtime costs are direct labor expenses that fall
under this category rather than the capital budget, which is for large equipment.
Monitoring the operating budget allows managers to identify variances and adjust staffing
levels to improve fiscal responsibility.
3. A nurse is using the ‘Salami’ method of conflict resolution, where small concessions are
made by both parties. Which conflict management style is being utilized?
A. Collaborating
B. Compromising
C. Avoiding
D. Competing
Correct Answer: B
Rationale: Compromising involves a ‘give-and-take’ approach where both parties
relinquish something of value to reach a middle ground. While it resolves the conflict
, quickly, it may result in a ‘lose-lose’ situation if the root cause isn’t addressed. This style is
most effective when goals are moderately important and time is of the essence.
4. When conducting a Root Cause Analysis (RCA) after a medication error, what is the primary
focus of the investigation team?
A. Identifying systemic failures that allowed the error to occur.
B. Determining which nurse was at fault for the error.
C. Assigning mandatory remedial training to the staff involved.
D. Reducing the hospital’s liability in potential lawsuits.
Correct Answer: A
Rationale: Root Cause Analysis is a retrospective process used to identify underlying
systemic factors rather than blaming individuals. It aims to understand the ‘why’ and ‘how’
of an event to prevent future occurrences. By focusing on processes and systems, the
facility can implement permanent changes that improve patient safety.
5. A nurse manager is evaluating a new staff member’s performance using a 360-degree
feedback tool. What is the main advantage of this method?
A. It provides a comprehensive view of performance from multiple perspectives.
B. It eliminates the need for a face-to-face meeting.
C. It is the fastest method for completing annual reviews.
D. It focuses solely on clinical skills and objective data.
