NSG 4700 Exam 4 V1 | NSG 4700 Leadership & Management in
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 4) |
Galen
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘Unfreezing’ stage?
A. Gathering data to show that the current paper system is causing medication errors.
B. Training staff on the specific features of the new software.
C. Updating the unit policy manual to reflect the new electronic process.
D. Providing rewards to staff who reach proficiency milestones early.
Answer: A
Rationale: The unfreezing stage involves creating the motivation to change by identifying a
problem. By gathering data on errors, the manager helps staff realize that the current
status quo is no longer acceptable. This stage is essential to overcome individual resistance
and group conformity before the actual change occurs.
2. Which task is most appropriate for a nurse to delegate to an unlicensed assistive personnel
(UAP)?
A. Assessing a patient’s surgical incision for signs of infection.
B. Adjusting the flow rate of an intravenous infusion based on orders.
C. Providing discharge instructions to a patient who underwent a colonoscopy.
D. Assisting a stable patient with a post-operative bath and grooming.
Answer: D
Rationale: UAPs are trained to perform non-invasive tasks and activities of daily living for
stable patients. Assessment, teaching, and medication titration are professional nursing
responsibilities that cannot be delegated. Ensuring that the UAP has the competency to
perform the bath safely is the responsibility of the delegating nurse.
3. A nurse is using the SBAR communication tool. Which statement represents the
‘Background’ component?
A. The patient is experiencing new onset shortness of breath and chest pain.
B. I suggest we order a stat chest X-ray and an arterial blood gas.
C. The patient has a history of congestive heart failure and was admitted two days ago.
D. The patient’s oxygen saturation is currently 88% on room air.
,Answer: C
Rationale: The Background portion of SBAR provides the clinical context and history
relevant to the current situation. It includes information such as the admission diagnosis,
medical history, and recent treatments. This helps the receiver understand the patient’s
baseline and the progression of their condition.
4. A nursing leader demonstrates transformational leadership by doing which of the
following?
A. Focusing on day-to-day operations and maintaining the status quo.
B. Using a system of rewards and punishments to ensure task completion.
C. Inspiring staff with a shared vision and encouraging professional growth.
D. Avoiding decision-making and allowing the group to function without guidance.
Answer: C
Rationale: Transformational leaders motivate others by articulating a clear vision and
empowering staff to achieve their full potential. They foster an environment of innovation
and collaborative problem-solving rather than just managing tasks. This leadership style is
highly effective in increasing nurse satisfaction and improving patient outcomes.
5. What is the primary purpose of a Root Cause Analysis (RCA) after a sentinel event occurs in
a hospital?
A. To identify which individual staff member is responsible for the error.
B. To provide evidence for the hospital’s legal defense team.
C. To determine the underlying system failures that led to the event.
D. To discipline the healthcare providers involved in the incident.
Answer: C
Rationale: Root Cause Analysis is a process designed to look past the individual error to
find the systemic flaws that allowed the error to happen. It focuses on processes and
systems rather than individual blame. The goal is to implement changes that will prevent
similar events from occurring in the future.
6. A nurse manager is preparing the annual budget and needs to calculate the Full-Time
Equivalents (FTEs). How many hours per week represent 1.0 FTE?
A. 40 hours
B. 36 hours
C. 20 hours
D. 80 hours
, Answer: A
Rationale: In standard healthcare budgeting, 1.0 FTE is equivalent to 40 hours of work per
week or 2,080 hours per year. This measurement allows managers to account for the total
number of staff hours needed regardless of whether employees are part-time or full-time.
Accurate FTE calculation is vital for maintaining safe staffing levels and managing labor
costs.
7. An LPN/LVN can be assigned to which of the following patients?
A. A patient with a chronic pressure ulcer requiring a sterile dressing change.
B. A new admission from the ER with an undiagnosed abdominal mass.
C. A patient whose condition is rapidly deteriorating and requires a code blue.
D. A patient who needs an initial assessment and plan of care developed.
Answer: A
Rationale: LPNs are trained to care for stable patients with predictable outcomes and
perform specific technical tasks such as dressing changes. The RN must perform initial
assessments, care planning, and manage unstable or complex patients. This delegation
ensures that the LPN works within their scope of practice while the RN focuses on high-
acuity needs.
8. Which ethical principle is a nurse upholding when they support a patient’s right to refuse a
recommended medical treatment?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Answer: C
Rationale: Autonomy refers to the right of individuals to make their own decisions about
their healthcare. Nurses respect autonomy by ensuring patients are informed and by
honoring their choices, even if the nurse disagrees with the decision. This principle is a
cornerstone of patient-centered care and legal rights in many jurisdictions.
9. A hospital is seeking Magnet Status. Which of the following is a key characteristic of a
Magnet-designated facility?
A. A centralized decision-making structure where executives make all choices.
B. High nurse turnover rates that allow for constant new perspectives.
C. Empowerment of bedside nurses through shared governance models.
Nursing Practice | Actual Q&A with Rationale (NSG4700 Exam 4) |
Galen
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘Unfreezing’ stage?
A. Gathering data to show that the current paper system is causing medication errors.
B. Training staff on the specific features of the new software.
C. Updating the unit policy manual to reflect the new electronic process.
D. Providing rewards to staff who reach proficiency milestones early.
Answer: A
Rationale: The unfreezing stage involves creating the motivation to change by identifying a
problem. By gathering data on errors, the manager helps staff realize that the current
status quo is no longer acceptable. This stage is essential to overcome individual resistance
and group conformity before the actual change occurs.
2. Which task is most appropriate for a nurse to delegate to an unlicensed assistive personnel
(UAP)?
A. Assessing a patient’s surgical incision for signs of infection.
B. Adjusting the flow rate of an intravenous infusion based on orders.
C. Providing discharge instructions to a patient who underwent a colonoscopy.
D. Assisting a stable patient with a post-operative bath and grooming.
Answer: D
Rationale: UAPs are trained to perform non-invasive tasks and activities of daily living for
stable patients. Assessment, teaching, and medication titration are professional nursing
responsibilities that cannot be delegated. Ensuring that the UAP has the competency to
perform the bath safely is the responsibility of the delegating nurse.
3. A nurse is using the SBAR communication tool. Which statement represents the
‘Background’ component?
A. The patient is experiencing new onset shortness of breath and chest pain.
B. I suggest we order a stat chest X-ray and an arterial blood gas.
C. The patient has a history of congestive heart failure and was admitted two days ago.
D. The patient’s oxygen saturation is currently 88% on room air.
,Answer: C
Rationale: The Background portion of SBAR provides the clinical context and history
relevant to the current situation. It includes information such as the admission diagnosis,
medical history, and recent treatments. This helps the receiver understand the patient’s
baseline and the progression of their condition.
4. A nursing leader demonstrates transformational leadership by doing which of the
following?
A. Focusing on day-to-day operations and maintaining the status quo.
B. Using a system of rewards and punishments to ensure task completion.
C. Inspiring staff with a shared vision and encouraging professional growth.
D. Avoiding decision-making and allowing the group to function without guidance.
Answer: C
Rationale: Transformational leaders motivate others by articulating a clear vision and
empowering staff to achieve their full potential. They foster an environment of innovation
and collaborative problem-solving rather than just managing tasks. This leadership style is
highly effective in increasing nurse satisfaction and improving patient outcomes.
5. What is the primary purpose of a Root Cause Analysis (RCA) after a sentinel event occurs in
a hospital?
A. To identify which individual staff member is responsible for the error.
B. To provide evidence for the hospital’s legal defense team.
C. To determine the underlying system failures that led to the event.
D. To discipline the healthcare providers involved in the incident.
Answer: C
Rationale: Root Cause Analysis is a process designed to look past the individual error to
find the systemic flaws that allowed the error to happen. It focuses on processes and
systems rather than individual blame. The goal is to implement changes that will prevent
similar events from occurring in the future.
6. A nurse manager is preparing the annual budget and needs to calculate the Full-Time
Equivalents (FTEs). How many hours per week represent 1.0 FTE?
A. 40 hours
B. 36 hours
C. 20 hours
D. 80 hours
, Answer: A
Rationale: In standard healthcare budgeting, 1.0 FTE is equivalent to 40 hours of work per
week or 2,080 hours per year. This measurement allows managers to account for the total
number of staff hours needed regardless of whether employees are part-time or full-time.
Accurate FTE calculation is vital for maintaining safe staffing levels and managing labor
costs.
7. An LPN/LVN can be assigned to which of the following patients?
A. A patient with a chronic pressure ulcer requiring a sterile dressing change.
B. A new admission from the ER with an undiagnosed abdominal mass.
C. A patient whose condition is rapidly deteriorating and requires a code blue.
D. A patient who needs an initial assessment and plan of care developed.
Answer: A
Rationale: LPNs are trained to care for stable patients with predictable outcomes and
perform specific technical tasks such as dressing changes. The RN must perform initial
assessments, care planning, and manage unstable or complex patients. This delegation
ensures that the LPN works within their scope of practice while the RN focuses on high-
acuity needs.
8. Which ethical principle is a nurse upholding when they support a patient’s right to refuse a
recommended medical treatment?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Answer: C
Rationale: Autonomy refers to the right of individuals to make their own decisions about
their healthcare. Nurses respect autonomy by ensuring patients are informed and by
honoring their choices, even if the nurse disagrees with the decision. This principle is a
cornerstone of patient-centered care and legal rights in many jurisdictions.
9. A hospital is seeking Magnet Status. Which of the following is a key characteristic of a
Magnet-designated facility?
A. A centralized decision-making structure where executives make all choices.
B. High nurse turnover rates that allow for constant new perspectives.
C. Empowerment of bedside nurses through shared governance models.
