BSN 465 Final Exam V1 | BSN 465
Decision-making in Nursing | Q&A with
Rationale (BSN465 Final Exam) |
Nightingale College
1. A nurse manager is utilizing the normative-prescriptive model of decision-making. Which
action best reflects this approach?
A. Following a structured, step-by-step process to reach the most logical choice.
B. Choosing the first solution that meets minimum requirements.
C. Relying on intuition and past experiences to make a rapid decision.
D. Allowing the team to reach a consensus without managerial input.
Correct Answer: A
Rationale: The normative-prescriptive model is a rational approach that follows a linear,
structured path to identify the optimal solution. It assumes that decision-makers have all
necessary information and behave logically to maximize outcomes. This model is often
contrasted with descriptive models which account for human cognitive limitations.
2. When applying Tanner’s Model of Clinical Judgment, what is the primary focus of the
‘Noticing’ phase?
A. Identifying cues from the environment and patient assessment.
B. Developing a plan of care based on subjective data.
,C. Evaluating the outcomes of a nursing intervention.
D. Justifying the reasoning behind a specific clinical action.
Correct Answer: A
Rationale: Noticing involves the nurse’s expectations of the situation and the initial grasp
of the patient’s status based on assessment. It is influenced by the nurse’s knowledge,
experience, and relationship with the patient. Without effective noticing, the nurse cannot
accurately interpret the patient’s needs or respond appropriately.
3. A registered nurse (RN) is delegating tasks to a Licensed Practical Nurse (LPN). Which task is
most appropriate for the LPN?
A. Administering a routine scheduled subcutaneous insulin injection.
B. Developing the initial discharge teaching plan for a post-operative patient.
C. Performing an admission assessment on a complex trauma patient.
D. Interpreting the significance of a sudden change in vital signs.
Correct Answer: A
Rationale: Administering routine medications falls within the scope of practice for an LPN
in most jurisdictions. Tasks involving initial assessment, planning, or complex
interpretation require the advanced clinical judgment of an RN. Delegating appropriately
ensures patient safety and adheres to the Five Rights of Delegation.
, 4. Which ethical principle is prioritized when a nurse respects a patient’s decision to refuse
life-saving chemotherapy?
A. Beneficence
B. Justice
C. Non-maleficence
D. Autonomy
Correct Answer: D
Rationale: Autonomy refers to the patient’s right to self-determination and making their
own healthcare choices. Even if the nurse believes a treatment is beneficial, they must
respect the competent patient’s refusal. This principle is a cornerstone of ethical decision-
making and informed consent.
5. The nurse is using the ‘S’ in SBAR to communicate with a physician. What information
should be included in this section?
A. The patient’s full medical history and allergies.
B. The nurse’s suggestion for a change in the treatment plan.
C. A brief description of the current issue or reason for the call.
D. The most recent set of vital signs and lab results.
Correct Answer: C
Decision-making in Nursing | Q&A with
Rationale (BSN465 Final Exam) |
Nightingale College
1. A nurse manager is utilizing the normative-prescriptive model of decision-making. Which
action best reflects this approach?
A. Following a structured, step-by-step process to reach the most logical choice.
B. Choosing the first solution that meets minimum requirements.
C. Relying on intuition and past experiences to make a rapid decision.
D. Allowing the team to reach a consensus without managerial input.
Correct Answer: A
Rationale: The normative-prescriptive model is a rational approach that follows a linear,
structured path to identify the optimal solution. It assumes that decision-makers have all
necessary information and behave logically to maximize outcomes. This model is often
contrasted with descriptive models which account for human cognitive limitations.
2. When applying Tanner’s Model of Clinical Judgment, what is the primary focus of the
‘Noticing’ phase?
A. Identifying cues from the environment and patient assessment.
B. Developing a plan of care based on subjective data.
,C. Evaluating the outcomes of a nursing intervention.
D. Justifying the reasoning behind a specific clinical action.
Correct Answer: A
Rationale: Noticing involves the nurse’s expectations of the situation and the initial grasp
of the patient’s status based on assessment. It is influenced by the nurse’s knowledge,
experience, and relationship with the patient. Without effective noticing, the nurse cannot
accurately interpret the patient’s needs or respond appropriately.
3. A registered nurse (RN) is delegating tasks to a Licensed Practical Nurse (LPN). Which task is
most appropriate for the LPN?
A. Administering a routine scheduled subcutaneous insulin injection.
B. Developing the initial discharge teaching plan for a post-operative patient.
C. Performing an admission assessment on a complex trauma patient.
D. Interpreting the significance of a sudden change in vital signs.
Correct Answer: A
Rationale: Administering routine medications falls within the scope of practice for an LPN
in most jurisdictions. Tasks involving initial assessment, planning, or complex
interpretation require the advanced clinical judgment of an RN. Delegating appropriately
ensures patient safety and adheres to the Five Rights of Delegation.
, 4. Which ethical principle is prioritized when a nurse respects a patient’s decision to refuse
life-saving chemotherapy?
A. Beneficence
B. Justice
C. Non-maleficence
D. Autonomy
Correct Answer: D
Rationale: Autonomy refers to the patient’s right to self-determination and making their
own healthcare choices. Even if the nurse believes a treatment is beneficial, they must
respect the competent patient’s refusal. This principle is a cornerstone of ethical decision-
making and informed consent.
5. The nurse is using the ‘S’ in SBAR to communicate with a physician. What information
should be included in this section?
A. The patient’s full medical history and allergies.
B. The nurse’s suggestion for a change in the treatment plan.
C. A brief description of the current issue or reason for the call.
D. The most recent set of vital signs and lab results.
Correct Answer: C
