NUR 4590 Final Exam — Professional Identity of
the Nurse Leader (Rasmussen University)
Q1: A nurse who has been practicing for 2 years is consistently able to plan and prioritize care
for a team of patients, coordinate multiple demands, and anticipate the needs of complex
patients. According to Benner's Novice to Expert model, which stage is this nurse
demonstrating?
A. Advanced Beginner
B. Proficient
C. Competent [CORRECT]
D. Expert
Correct Answer: C
Rationale: The Competent stage (typically 2-3 years of experience) is characterized by the ability
to plan and prioritize, coordinate multiple demands, and see actions in terms of long-range
goals. The Advanced Beginner still relies on rules and recognizes patterns but lacks the
organizational ability of the Competent nurse. The Proficient nurse (3-5+ years) sees the "big
picture" holistically, and the Expert uses intuitive decision-making. QSEN competencies
emphasize that competence in leadership develops through deliberate practice and experience.
Q2: A new graduate nurse is following strict, step-by-step rules and has difficulty recognizing
when a patient's condition is deteriorating because they lack clinical experience. According to
Benner's model, which stage is this nurse in?
A. Competent
B. Advanced Beginner
C. Novice [CORRECT]
D. Proficient
Correct Answer: C
Rationale: The Novice stage is characterized by rule-governed behavior, limited clinical
experience, and difficulty distinguishing relevant from irrelevant information. Advanced
Beginners can recognize patterns from prior experience, Competent nurses can plan and
prioritize, and Proficient nurses see the big picture. Understanding developmental stages helps
nurse leaders provide appropriate support and mentorship, aligning with ANA Provision 8
(collaboration with colleagues).
,Q3: A nurse with 4 years of experience demonstrates a holistic understanding of patient
situations, quickly identifies subtle changes in condition, and sees the "big picture" without
consciously analyzing all elements. According to Benner, this nurse is at which stage?
A. Competent
B. Advanced Beginner
C. Expert
D. Proficient [CORRECT]
Correct Answer: D
Rationale: The Proficient stage (3-5+ years) is marked by holistic understanding, the ability to
see the "big picture," and learned intuition that guides decision-making. The Expert stage
involves intuitive decision-making with deep understanding and focus on the most relevant
problems. The Competent nurse can plan and prioritize but does not yet demonstrate the
holistic grasp characteristic of the Proficient nurse. Benner's model supports leadership
development by identifying appropriate stretch assignments.
Q4: A nurse leader is assigning a task to a novice nurse. Which action by the nurse leader best
reflects an understanding of Benner's Novice to Expert model?
A. Assigning the novice nurse to independently manage a complex patient load to build
confidence
B. Providing clear, step-by-step instructions and close supervision for the assigned task
[CORRECT]
C. Expecting the novice nurse to intuitively prioritize tasks based on experience
D. Delegating the task to a UAP since the novice nurse lacks experience
Correct Answer: B
Rationale: Novice nurses need clear rules, step-by-step instructions, and close supervision
because they lack clinical experience and cannot yet rely on intuition or pattern recognition.
Assigning complex patients independently (A) or expecting intuition (C) is inappropriate for a
novice. Delegating to UAP (D) is unsafe because the nurse retains responsibility for assessment
and evaluation. This aligns with the ANA Scope and Standards of Practice, which require nurse
leaders to match assignments to competency levels.
Q5: According to the ANA Code of Ethics, which provision emphasizes the nurse's primary
commitment to the patient, whether an individual, family, group, or community?
A. Provision 1
B. Provision 2 [CORRECT]
C. Provision 3
D. Provision 9
,Correct Answer: B
Rationale: ANA Provision 2 states that the nurse's primary commitment is to the patient,
whether an individual, family, group, or community. Provision 1 addresses respect for human
dignity, Provision 3 addresses promotion and protection of patient health, safety, and rights,
and Provision 9 addresses social justice. Understanding these provisions is essential for ethical
leadership and professional identity formation.
Q6: A nurse witnesses a colleague coming to work appearing impaired by alcohol. According to
the ANA Code of Ethics, which provision requires the nurse to protect the patient and report
impaired practice?
A. Provision 1
B. Provision 5
C. Provision 3 [CORRECT]
D. Provision 8
Correct Answer: C
Rationale: ANA Provision 3 states the nurse has a duty to promote and protect the health,
safety, and rights of the patient. This includes reporting impaired practice through proper
channels to protect patient safety. Provision 1 addresses human dignity, Provision 5 addresses
duties to self, and Provision 8 addresses collaboration. The correct action is always to report
through proper channels—never cover up, confront alone, or delay.
Q7: A nurse is advocating for a patient who cannot afford medications and is choosing between
food and prescriptions. The nurse contacts social work, explores pharmaceutical assistance
programs, and addresses the social determinants affecting the patient's health. Which ANA
Code of Ethics provision is the nurse demonstrating?
A. Provision 2
B. Provision 9 [CORRECT]
C. Provision 5
D. Provision 3
Correct Answer: B
Rationale: ANA Provision 9 emphasizes social justice and advocacy at the policy level, including
addressing social determinants of health and advocating for equitable access to care. Provision
2 addresses primary commitment to the patient, Provision 5 addresses duties to self, and
Provision 3 addresses protection of patient rights. The nurse's actions reflect the profession's
obligation to advocate for social justice.
, Q8: A nurse leader ensures that all staff members are treated with respect regardless of their
role, background, or personal characteristics. Which ANA Code of Ethics provision is being
upheld?
A. Provision 1 [CORRECT]
B. Provision 4
C. Provision 6
D. Provision 7
Correct Answer: A
Rationale: ANA Provision 1 states that the nurse practices with compassion and respect for the
inherent dignity, worth, and unique attributes of every person. This applies to both patients and
colleagues. Provision 4 addresses authority for nursing practice, Provision 6 addresses the
environment of care, and Provision 7 addresses advancing the profession. Respect for human
dignity is foundational to professional identity.
Q9: A nurse manager is developing a shared governance council to give bedside nurses more
input into decisions affecting their practice. Which organizational concept does this best
represent?
A. Centralized decision-making
B. Span of control
C. Shared governance [CORRECT]
D. Chain of command
Correct Answer: C
Rationale: Shared governance is a structural model in which nurses at all levels participate in
decisions affecting nursing practice, quality, and work environment. Centralized decision-making
concentrates authority at the top, span of control refers to the number of subordinates
reporting to a manager, and chain of command refers to the hierarchy of authority. Shared
governance empowers nurses and supports professional identity, aligning with ANA Provision 8.
Q10: A nurse manager has 25 direct reports and is finding it difficult to provide adequate
supervision and support. Which organizational concept best describes this situation?
A. Unity of command
B. Span of control [CORRECT]
C. Decentralization
D. Shared governance
Correct Answer: B
Rationale: Span of control refers to the number of subordinates who report directly to a single
the Nurse Leader (Rasmussen University)
Q1: A nurse who has been practicing for 2 years is consistently able to plan and prioritize care
for a team of patients, coordinate multiple demands, and anticipate the needs of complex
patients. According to Benner's Novice to Expert model, which stage is this nurse
demonstrating?
A. Advanced Beginner
B. Proficient
C. Competent [CORRECT]
D. Expert
Correct Answer: C
Rationale: The Competent stage (typically 2-3 years of experience) is characterized by the ability
to plan and prioritize, coordinate multiple demands, and see actions in terms of long-range
goals. The Advanced Beginner still relies on rules and recognizes patterns but lacks the
organizational ability of the Competent nurse. The Proficient nurse (3-5+ years) sees the "big
picture" holistically, and the Expert uses intuitive decision-making. QSEN competencies
emphasize that competence in leadership develops through deliberate practice and experience.
Q2: A new graduate nurse is following strict, step-by-step rules and has difficulty recognizing
when a patient's condition is deteriorating because they lack clinical experience. According to
Benner's model, which stage is this nurse in?
A. Competent
B. Advanced Beginner
C. Novice [CORRECT]
D. Proficient
Correct Answer: C
Rationale: The Novice stage is characterized by rule-governed behavior, limited clinical
experience, and difficulty distinguishing relevant from irrelevant information. Advanced
Beginners can recognize patterns from prior experience, Competent nurses can plan and
prioritize, and Proficient nurses see the big picture. Understanding developmental stages helps
nurse leaders provide appropriate support and mentorship, aligning with ANA Provision 8
(collaboration with colleagues).
,Q3: A nurse with 4 years of experience demonstrates a holistic understanding of patient
situations, quickly identifies subtle changes in condition, and sees the "big picture" without
consciously analyzing all elements. According to Benner, this nurse is at which stage?
A. Competent
B. Advanced Beginner
C. Expert
D. Proficient [CORRECT]
Correct Answer: D
Rationale: The Proficient stage (3-5+ years) is marked by holistic understanding, the ability to
see the "big picture," and learned intuition that guides decision-making. The Expert stage
involves intuitive decision-making with deep understanding and focus on the most relevant
problems. The Competent nurse can plan and prioritize but does not yet demonstrate the
holistic grasp characteristic of the Proficient nurse. Benner's model supports leadership
development by identifying appropriate stretch assignments.
Q4: A nurse leader is assigning a task to a novice nurse. Which action by the nurse leader best
reflects an understanding of Benner's Novice to Expert model?
A. Assigning the novice nurse to independently manage a complex patient load to build
confidence
B. Providing clear, step-by-step instructions and close supervision for the assigned task
[CORRECT]
C. Expecting the novice nurse to intuitively prioritize tasks based on experience
D. Delegating the task to a UAP since the novice nurse lacks experience
Correct Answer: B
Rationale: Novice nurses need clear rules, step-by-step instructions, and close supervision
because they lack clinical experience and cannot yet rely on intuition or pattern recognition.
Assigning complex patients independently (A) or expecting intuition (C) is inappropriate for a
novice. Delegating to UAP (D) is unsafe because the nurse retains responsibility for assessment
and evaluation. This aligns with the ANA Scope and Standards of Practice, which require nurse
leaders to match assignments to competency levels.
Q5: According to the ANA Code of Ethics, which provision emphasizes the nurse's primary
commitment to the patient, whether an individual, family, group, or community?
A. Provision 1
B. Provision 2 [CORRECT]
C. Provision 3
D. Provision 9
,Correct Answer: B
Rationale: ANA Provision 2 states that the nurse's primary commitment is to the patient,
whether an individual, family, group, or community. Provision 1 addresses respect for human
dignity, Provision 3 addresses promotion and protection of patient health, safety, and rights,
and Provision 9 addresses social justice. Understanding these provisions is essential for ethical
leadership and professional identity formation.
Q6: A nurse witnesses a colleague coming to work appearing impaired by alcohol. According to
the ANA Code of Ethics, which provision requires the nurse to protect the patient and report
impaired practice?
A. Provision 1
B. Provision 5
C. Provision 3 [CORRECT]
D. Provision 8
Correct Answer: C
Rationale: ANA Provision 3 states the nurse has a duty to promote and protect the health,
safety, and rights of the patient. This includes reporting impaired practice through proper
channels to protect patient safety. Provision 1 addresses human dignity, Provision 5 addresses
duties to self, and Provision 8 addresses collaboration. The correct action is always to report
through proper channels—never cover up, confront alone, or delay.
Q7: A nurse is advocating for a patient who cannot afford medications and is choosing between
food and prescriptions. The nurse contacts social work, explores pharmaceutical assistance
programs, and addresses the social determinants affecting the patient's health. Which ANA
Code of Ethics provision is the nurse demonstrating?
A. Provision 2
B. Provision 9 [CORRECT]
C. Provision 5
D. Provision 3
Correct Answer: B
Rationale: ANA Provision 9 emphasizes social justice and advocacy at the policy level, including
addressing social determinants of health and advocating for equitable access to care. Provision
2 addresses primary commitment to the patient, Provision 5 addresses duties to self, and
Provision 3 addresses protection of patient rights. The nurse's actions reflect the profession's
obligation to advocate for social justice.
, Q8: A nurse leader ensures that all staff members are treated with respect regardless of their
role, background, or personal characteristics. Which ANA Code of Ethics provision is being
upheld?
A. Provision 1 [CORRECT]
B. Provision 4
C. Provision 6
D. Provision 7
Correct Answer: A
Rationale: ANA Provision 1 states that the nurse practices with compassion and respect for the
inherent dignity, worth, and unique attributes of every person. This applies to both patients and
colleagues. Provision 4 addresses authority for nursing practice, Provision 6 addresses the
environment of care, and Provision 7 addresses advancing the profession. Respect for human
dignity is foundational to professional identity.
Q9: A nurse manager is developing a shared governance council to give bedside nurses more
input into decisions affecting their practice. Which organizational concept does this best
represent?
A. Centralized decision-making
B. Span of control
C. Shared governance [CORRECT]
D. Chain of command
Correct Answer: C
Rationale: Shared governance is a structural model in which nurses at all levels participate in
decisions affecting nursing practice, quality, and work environment. Centralized decision-making
concentrates authority at the top, span of control refers to the number of subordinates
reporting to a manager, and chain of command refers to the hierarchy of authority. Shared
governance empowers nurses and supports professional identity, aligning with ANA Provision 8.
Q10: A nurse manager has 25 direct reports and is finding it difficult to provide adequate
supervision and support. Which organizational concept best describes this situation?
A. Unity of command
B. Span of control [CORRECT]
C. Decentralization
D. Shared governance
Correct Answer: B
Rationale: Span of control refers to the number of subordinates who report directly to a single
