NR 447 EXAM 2 QUESTIONS AND ANSWERS
STUDY GUIDE | LATEST UPDATE 2026/2027 |
ACTUAL EXAM | PRACTICE QUESTIONS AND
ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS
This comprehensive practice examination is designed for nursing students
enrolled in NR 447: Collaborative Healthcare, specifically targeting the content
covered in Exam 2. It provides an advanced assessment of the principles and
practices essential for effective delegation, supervision, conflict resolution, quality
improvement, interprofessional teamwork, ethical decision-making, and
leadership within complex healthcare systems. The 100 multiple-choice questions
blend theoretical foundations with real-world clinical scenarios, challenging
students to apply concepts at the application and analysis levels. Each item is
crafted to mirror the complexity of proctored assessments and NCLEX-style
questions. Detailed, multi-sentence rationales explain the correct answer and why
each alternative is incorrect, reinforcing the critical thinking and clinical judgment
necessary for safe, collaborative, patient-centered care. Updated for the 2026–
2027 academic cycle, this resource provides verified solutions to help you identify
knowledge gaps, synthesize interdisciplinary concepts, and excel on Exam 2.
Table of Contents
I. Delegation, Supervision, and Scope of Practice
II. Interprofessional Collaboration and Teamwork
III. Communication and Conflict Resolution
IV. Leadership and Management
V. Quality Improvement and Patient Safety
VI. Ethical and Legal Considerations in Collaborative Practice
VII. Health Policy, Economics, and Systems Thinking
, 1. A registered nurse (RN) is planning care for a team of patients and must
delegate tasks to a licensed practical nurse (LPN) and unlicensed assistive
personnel (UAP). Which of the following tasks should the RN delegate to
the UAP?
A) Administering an intramuscular injection
B) Obtaining a routine blood glucose level from a stable diabetic patient
C) Developing the nursing plan of care
D) Providing discharge instructions to a patient
Correct Answer: B
Obtaining a routine blood glucose level is a task that does not require nursing
judgment and falls within the UAP’s scope of practice. Administering an injection
(A) requires the knowledge and skill of a licensed nurse. Developing the plan of
care (C) is an RN responsibility that cannot be delegated. Discharge instructions
(D) involve ongoing assessment and education that must be provided by the RN.
Therefore, only the blood glucose check is appropriate for delegation to the UAP.
2. A nurse manager is leading a quality improvement team that is investigating
a recent increase in patient falls on a medical-surgical unit. The team
identifies that falls are most frequent during the 7:00 AM to 8:00 AM shift
change. Using the Plan-Do-Study-Act (PDSA) cycle, which of the following
actions should the team take next?
A) Immediately implement a new fall prevention policy across the entire
hospital
B) Develop a small-scale test of change, such as implementing hourly
rounding during the shift change period on one pod
C) Conduct a root cause analysis of every fall over the past year
D) Document the finding and continue monitoring without intervention
Correct Answer: B
The PDSA cycle begins with a small test of change to evaluate effectiveness before
widespread implementation. A small-scale test on one pod allows the team to
gather data and refine the intervention. Implementing a hospital-wide policy (A) is
premature without first testing. A root cause analysis (C) may have already been
,part of the “Plan” phase, but the next step is to “Do.” Documenting without
intervening (D) fails to address the problem. Thus, a pilot test is the most
appropriate next step.
3. A nurse is caring for a patient whose family demands continued aggressive
treatment for a terminally ill patient, despite the patient’s advance directive
indicating a preference for comfort care only. The interprofessional team
agrees that further treatment would be futile. Which ethical principle best
supports the team’s decision to honor the advance directive?
A) Beneficence
B) Nonmaleficence
C) Autonomy
D) Justice
Correct Answer: C
Autonomy is the right of individuals to make decisions about their own healthcare,
including the right to refuse treatment. The advance directive expresses the
patient’s autonomous wishes, which must be respected even if family disagrees.
Beneficence (A) is doing good, but here the patient’s own definition of good is
comfort, not aggressive treatment. Nonmaleficence (B) supports avoiding harm,
which could include avoiding futile treatment, but the primary principle driving the
decision to honor the directive is autonomy. Justice (D) relates to fairness.
Therefore, autonomy is the most directly applicable principle.
4. A charge nurse is making patient assignments for the oncoming shift. The
team includes one RN, one LPN, and one UAP. Which of the following
patients should the RN care for personally?
A) A patient who had an uncomplicated hip replacement 3 days ago and is
awaiting discharge
B) A patient who was admitted during the night with acute chest pain and
has an unstable blood pressure
C) A patient who requires a routine dressing change on a healing surgical
wound
D) A patient who needs assistance with morning hygiene and ambulation
, Correct Answer: B
The RN must assume care for patients who are unstable or require frequent
assessment and complex clinical judgment. The patient with acute chest pain and
unstable blood pressure needs ongoing evaluation and rapid decision-making that
only the RN can provide. The stable post-operative patient (A) can be managed by
the LPN. The routine dressing change (C) is within the LPN’s scope, and assistance
with hygiene and ambulation (D) can be delegated to the UAP. Therefore, the RN
should care for the unstable patient.
5. A nurse is participating in a root cause analysis (RCA) after a medication
error occurred on the unit. Which of the following statements best reflects
the philosophy of a just culture during the RCA process?
A) “We need to find out who made the error so that we can take
appropriate disciplinary action.”
B) “The goal is to identify the system failures that contributed to the error
and to support the nurse involved.”
C) “Medication errors are always the result of individual negligence.”
D) “We should focus only on the actions of the nurse and not consider
environmental factors.”
Correct Answer: B
A just culture balances system accountability with individual accountability,
recognizing that errors often result from flawed processes rather than individual
negligence alone. The goal of an RCA is to uncover underlying system failures and
to improve safety, not to assign blame. Options A, C, and D emphasize individual
blame and ignore the complex system factors that contribute to errors. Therefore,
B correctly reflects a just culture approach.
6. A nurse is using the TEAMSTEPPS framework to communicate a safety
concern to a provider. The nurse says, “I am concerned about the patient’s
oxygen saturation dropping without intervention.” This statement
represents which step of the CUS technique?
A) Concern
B) Uncomfortable
STUDY GUIDE | LATEST UPDATE 2026/2027 |
ACTUAL EXAM | PRACTICE QUESTIONS AND
ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS
This comprehensive practice examination is designed for nursing students
enrolled in NR 447: Collaborative Healthcare, specifically targeting the content
covered in Exam 2. It provides an advanced assessment of the principles and
practices essential for effective delegation, supervision, conflict resolution, quality
improvement, interprofessional teamwork, ethical decision-making, and
leadership within complex healthcare systems. The 100 multiple-choice questions
blend theoretical foundations with real-world clinical scenarios, challenging
students to apply concepts at the application and analysis levels. Each item is
crafted to mirror the complexity of proctored assessments and NCLEX-style
questions. Detailed, multi-sentence rationales explain the correct answer and why
each alternative is incorrect, reinforcing the critical thinking and clinical judgment
necessary for safe, collaborative, patient-centered care. Updated for the 2026–
2027 academic cycle, this resource provides verified solutions to help you identify
knowledge gaps, synthesize interdisciplinary concepts, and excel on Exam 2.
Table of Contents
I. Delegation, Supervision, and Scope of Practice
II. Interprofessional Collaboration and Teamwork
III. Communication and Conflict Resolution
IV. Leadership and Management
V. Quality Improvement and Patient Safety
VI. Ethical and Legal Considerations in Collaborative Practice
VII. Health Policy, Economics, and Systems Thinking
, 1. A registered nurse (RN) is planning care for a team of patients and must
delegate tasks to a licensed practical nurse (LPN) and unlicensed assistive
personnel (UAP). Which of the following tasks should the RN delegate to
the UAP?
A) Administering an intramuscular injection
B) Obtaining a routine blood glucose level from a stable diabetic patient
C) Developing the nursing plan of care
D) Providing discharge instructions to a patient
Correct Answer: B
Obtaining a routine blood glucose level is a task that does not require nursing
judgment and falls within the UAP’s scope of practice. Administering an injection
(A) requires the knowledge and skill of a licensed nurse. Developing the plan of
care (C) is an RN responsibility that cannot be delegated. Discharge instructions
(D) involve ongoing assessment and education that must be provided by the RN.
Therefore, only the blood glucose check is appropriate for delegation to the UAP.
2. A nurse manager is leading a quality improvement team that is investigating
a recent increase in patient falls on a medical-surgical unit. The team
identifies that falls are most frequent during the 7:00 AM to 8:00 AM shift
change. Using the Plan-Do-Study-Act (PDSA) cycle, which of the following
actions should the team take next?
A) Immediately implement a new fall prevention policy across the entire
hospital
B) Develop a small-scale test of change, such as implementing hourly
rounding during the shift change period on one pod
C) Conduct a root cause analysis of every fall over the past year
D) Document the finding and continue monitoring without intervention
Correct Answer: B
The PDSA cycle begins with a small test of change to evaluate effectiveness before
widespread implementation. A small-scale test on one pod allows the team to
gather data and refine the intervention. Implementing a hospital-wide policy (A) is
premature without first testing. A root cause analysis (C) may have already been
,part of the “Plan” phase, but the next step is to “Do.” Documenting without
intervening (D) fails to address the problem. Thus, a pilot test is the most
appropriate next step.
3. A nurse is caring for a patient whose family demands continued aggressive
treatment for a terminally ill patient, despite the patient’s advance directive
indicating a preference for comfort care only. The interprofessional team
agrees that further treatment would be futile. Which ethical principle best
supports the team’s decision to honor the advance directive?
A) Beneficence
B) Nonmaleficence
C) Autonomy
D) Justice
Correct Answer: C
Autonomy is the right of individuals to make decisions about their own healthcare,
including the right to refuse treatment. The advance directive expresses the
patient’s autonomous wishes, which must be respected even if family disagrees.
Beneficence (A) is doing good, but here the patient’s own definition of good is
comfort, not aggressive treatment. Nonmaleficence (B) supports avoiding harm,
which could include avoiding futile treatment, but the primary principle driving the
decision to honor the directive is autonomy. Justice (D) relates to fairness.
Therefore, autonomy is the most directly applicable principle.
4. A charge nurse is making patient assignments for the oncoming shift. The
team includes one RN, one LPN, and one UAP. Which of the following
patients should the RN care for personally?
A) A patient who had an uncomplicated hip replacement 3 days ago and is
awaiting discharge
B) A patient who was admitted during the night with acute chest pain and
has an unstable blood pressure
C) A patient who requires a routine dressing change on a healing surgical
wound
D) A patient who needs assistance with morning hygiene and ambulation
, Correct Answer: B
The RN must assume care for patients who are unstable or require frequent
assessment and complex clinical judgment. The patient with acute chest pain and
unstable blood pressure needs ongoing evaluation and rapid decision-making that
only the RN can provide. The stable post-operative patient (A) can be managed by
the LPN. The routine dressing change (C) is within the LPN’s scope, and assistance
with hygiene and ambulation (D) can be delegated to the UAP. Therefore, the RN
should care for the unstable patient.
5. A nurse is participating in a root cause analysis (RCA) after a medication
error occurred on the unit. Which of the following statements best reflects
the philosophy of a just culture during the RCA process?
A) “We need to find out who made the error so that we can take
appropriate disciplinary action.”
B) “The goal is to identify the system failures that contributed to the error
and to support the nurse involved.”
C) “Medication errors are always the result of individual negligence.”
D) “We should focus only on the actions of the nurse and not consider
environmental factors.”
Correct Answer: B
A just culture balances system accountability with individual accountability,
recognizing that errors often result from flawed processes rather than individual
negligence alone. The goal of an RCA is to uncover underlying system failures and
to improve safety, not to assign blame. Options A, C, and D emphasize individual
blame and ignore the complex system factors that contribute to errors. Therefore,
B correctly reflects a just culture approach.
6. A nurse is using the TEAMSTEPPS framework to communicate a safety
concern to a provider. The nurse says, “I am concerned about the patient’s
oxygen saturation dropping without intervention.” This statement
represents which step of the CUS technique?
A) Concern
B) Uncomfortable
