EXAM 3: NUR 204/ NUR204
Leadership and Management
2026-2028 Testing Cycle | Newly Released
50 Q & A| Grade A+ | Guaranteed Pass
100% Correct Verified Solutions - Fortis
Operations | Staffing Models, Patient Classification Systems, Just Culture |
Quality Improvement (RCA, PDSA cycles), Risk Management
Q1: The nurse manager is comparing two staffing models. Which statement best describes a core
limitation of using a pure mandatory nurse-to-patient ratio without any acuity adjustment?
A. It guarantees a safe number of nurses for high-acuity patients every shift.
B. It allows for flexible redeployment of staff between units.
C. It may overstaff on low-acuity days and understaff when patient complexity spikes.
D. It eliminates the need for any type of Patient Classification System.
Correct Answer: C
Rationale: Correct because fixed ratios do not account for daily variations in patient acuity,
leading to inefficient overstaffing or dangerous understaffing depending on the mix.
Q2: A nursing unit uses a validated Patient Classification System (PCS) to determine daily
staffing. The PCS assigns points based on nursing interventions, mobility, and monitoring needs.
What is the primary benefit of using a PCS rather than a simple census count?
A. It matches nursing resources to the actual intensity of care required by each patient.
B. It eliminates the need for charge nurse judgment.
C. It reduces the number of RNs needed on every shift.
D. It guarantees that every patient receives exactly 4 hours of nursing care.
Correct Answer: A
Rationale: Correct because a PCS measures the complexity and time required for care, enabling
objective, need-based staffing decisions.
,Q3: The quality improvement team is planning a pilot study to reduce catheter-associated urinary
tract infections (CAUTI). Which of the following actions should occur during the Plan phase of
the PDSA cycle? (Select all that apply.)
A. Collect baseline CAUTI rates from the past 6 months. [CORRECT]
B. Implement the new urinary catheter maintenance bundle on one pilot unit.
C. Identify the most common deviations from the current catheter care protocol. [CORRECT]
D. Roll out the successful intervention to all hospital units.
Correct Answer: A, C
Rationale: Correct because the Plan phase includes problem identification, baseline data
collection, and analyzing current practice gaps – before implementing any change.
Q4: After implementing a new fall prevention bundle on a single unit for 30 days, the team
compares post-intervention fall rates to the baseline. This comparative analysis occurs in which
phase of the PDSA cycle?
A. Plan
B. Study
C. Do
D. Act
Correct Answer: B
Rationale: Correct because the Study phase is where the team reviews the data to determine
whether the intervention produced the desired improvement.
Q5: A sentinel event occurs on the unit. The hospital activates its Root Cause Analysis (RCA)
team. What is the primary focus of an RCA?
A. Determining which staff member made the final error.
B. Immediately terminating the involved employees.
C. Creating a new policy without reviewing old ones.
D. Uncovering latent system failures and workflow vulnerabilities that allowed the event to
happen.
Correct Answer: D
Rationale: Correct because RCA is a retrospective, non-punitive process aimed at identifying
systemic issues, not individual blame.
Q6: The nurse manager is fostering a Just Culture on the unit. A nurse makes a serious
medication error because two vials look nearly identical, and the nurse did not check the label
twice. The nurse had no prior history of errors. Under Just Culture, the manager’s initial response
should include: (Select all that apply.)
, A. Issuing a written warning for reckless behavior.
B. Reviewing the system factors, such as labeling and storage, that contributed to the slip.
[CORRECT]
C. Providing coaching on double-checking techniques. [CORRECT]
D. Suspending the nurse pending an investigation.
Correct Answer: B, C
Rationale: Correct because this is classified as human error (or at-risk behavior at worst); the
response should include system redesign and coaching, not punishment.
Q7: A charge nurse calculates that the unit has 18 patients: 6 classified as high acuity (needing 5
nursing hours/day), 8 as moderate (3 hours/day), and 4 as low (2 hours/day). What is the total
nursing hours required for this patient census?
A. 30 + 24 + 8 = 62 hours
B. 18 × 4 = 72 hours
C. 6 × 5 + 8 × 3 + 4 × 2 = 30 + 24 + 8 = 62 hours [CORRECT]
D. 6 + 8 + 4 = 18 hours
Correct Answer: C
Rationale: Correct because the calculation is (6×5) + (8×3) + (4×2) = 30 + 24 + 8 = 62 total
nursing hours needed.
Q8: A near miss is reported when a nurse almost gives a double dose of insulin but catches the
error before administration. The nurse manager should:
A. File a disciplinary action for the near miss.
B. Ignore the report since no harm occurred.
C. Investigate the circumstances to identify system weaknesses and thank the nurse for reporting.
D. Immediately change the patient’s insulin order.
Correct Answer: C
Rationale: Correct because near misses are invaluable opportunities to learn about system
vulnerabilities; reporting should be encouraged and investigated.
Q9: The nurse manager is orienting a new charge nurse to the unit’s acuity-based staffing tool.
The manager explains that the tool uses nursing hours per patient day (NHPPD). If the unit’s
target NHPPD is 8.0 and the unit has 15 patients, what is the total nursing hours needed for that
day?
A. 100 hours
B. 120 hours
C. 140 hours
Leadership and Management
2026-2028 Testing Cycle | Newly Released
50 Q & A| Grade A+ | Guaranteed Pass
100% Correct Verified Solutions - Fortis
Operations | Staffing Models, Patient Classification Systems, Just Culture |
Quality Improvement (RCA, PDSA cycles), Risk Management
Q1: The nurse manager is comparing two staffing models. Which statement best describes a core
limitation of using a pure mandatory nurse-to-patient ratio without any acuity adjustment?
A. It guarantees a safe number of nurses for high-acuity patients every shift.
B. It allows for flexible redeployment of staff between units.
C. It may overstaff on low-acuity days and understaff when patient complexity spikes.
D. It eliminates the need for any type of Patient Classification System.
Correct Answer: C
Rationale: Correct because fixed ratios do not account for daily variations in patient acuity,
leading to inefficient overstaffing or dangerous understaffing depending on the mix.
Q2: A nursing unit uses a validated Patient Classification System (PCS) to determine daily
staffing. The PCS assigns points based on nursing interventions, mobility, and monitoring needs.
What is the primary benefit of using a PCS rather than a simple census count?
A. It matches nursing resources to the actual intensity of care required by each patient.
B. It eliminates the need for charge nurse judgment.
C. It reduces the number of RNs needed on every shift.
D. It guarantees that every patient receives exactly 4 hours of nursing care.
Correct Answer: A
Rationale: Correct because a PCS measures the complexity and time required for care, enabling
objective, need-based staffing decisions.
,Q3: The quality improvement team is planning a pilot study to reduce catheter-associated urinary
tract infections (CAUTI). Which of the following actions should occur during the Plan phase of
the PDSA cycle? (Select all that apply.)
A. Collect baseline CAUTI rates from the past 6 months. [CORRECT]
B. Implement the new urinary catheter maintenance bundle on one pilot unit.
C. Identify the most common deviations from the current catheter care protocol. [CORRECT]
D. Roll out the successful intervention to all hospital units.
Correct Answer: A, C
Rationale: Correct because the Plan phase includes problem identification, baseline data
collection, and analyzing current practice gaps – before implementing any change.
Q4: After implementing a new fall prevention bundle on a single unit for 30 days, the team
compares post-intervention fall rates to the baseline. This comparative analysis occurs in which
phase of the PDSA cycle?
A. Plan
B. Study
C. Do
D. Act
Correct Answer: B
Rationale: Correct because the Study phase is where the team reviews the data to determine
whether the intervention produced the desired improvement.
Q5: A sentinel event occurs on the unit. The hospital activates its Root Cause Analysis (RCA)
team. What is the primary focus of an RCA?
A. Determining which staff member made the final error.
B. Immediately terminating the involved employees.
C. Creating a new policy without reviewing old ones.
D. Uncovering latent system failures and workflow vulnerabilities that allowed the event to
happen.
Correct Answer: D
Rationale: Correct because RCA is a retrospective, non-punitive process aimed at identifying
systemic issues, not individual blame.
Q6: The nurse manager is fostering a Just Culture on the unit. A nurse makes a serious
medication error because two vials look nearly identical, and the nurse did not check the label
twice. The nurse had no prior history of errors. Under Just Culture, the manager’s initial response
should include: (Select all that apply.)
, A. Issuing a written warning for reckless behavior.
B. Reviewing the system factors, such as labeling and storage, that contributed to the slip.
[CORRECT]
C. Providing coaching on double-checking techniques. [CORRECT]
D. Suspending the nurse pending an investigation.
Correct Answer: B, C
Rationale: Correct because this is classified as human error (or at-risk behavior at worst); the
response should include system redesign and coaching, not punishment.
Q7: A charge nurse calculates that the unit has 18 patients: 6 classified as high acuity (needing 5
nursing hours/day), 8 as moderate (3 hours/day), and 4 as low (2 hours/day). What is the total
nursing hours required for this patient census?
A. 30 + 24 + 8 = 62 hours
B. 18 × 4 = 72 hours
C. 6 × 5 + 8 × 3 + 4 × 2 = 30 + 24 + 8 = 62 hours [CORRECT]
D. 6 + 8 + 4 = 18 hours
Correct Answer: C
Rationale: Correct because the calculation is (6×5) + (8×3) + (4×2) = 30 + 24 + 8 = 62 total
nursing hours needed.
Q8: A near miss is reported when a nurse almost gives a double dose of insulin but catches the
error before administration. The nurse manager should:
A. File a disciplinary action for the near miss.
B. Ignore the report since no harm occurred.
C. Investigate the circumstances to identify system weaknesses and thank the nurse for reporting.
D. Immediately change the patient’s insulin order.
Correct Answer: C
Rationale: Correct because near misses are invaluable opportunities to learn about system
vulnerabilities; reporting should be encouraged and investigated.
Q9: The nurse manager is orienting a new charge nurse to the unit’s acuity-based staffing tool.
The manager explains that the tool uses nursing hours per patient day (NHPPD). If the unit’s
target NHPPD is 8.0 and the unit has 15 patients, what is the total nursing hours needed for that
day?
A. 100 hours
B. 120 hours
C. 140 hours
