NSG 436 Exam 2 V1 | NSG 436 Leadership, Ethics,
and Policy in Health Care | Actual Q&A with
Rationale (NSG436 Exam 2) | Grand Canyon
University
1. A nurse is caring for a terminal patient who refuses further chemotherapy despite family
pressure. The nurse supports the patient’s decision. Which ethical principle is being
demonstrated?
A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence
Correct Answer: A
Explanation: Autonomy refers to the right of patients to make their own decisions about
their healthcare. In this scenario, the nurse is advocating for the patient’s self-
determination even when it conflicts with the family’s wishes. This principle is
fundamental to the ANA Code of Ethics and requires that nurses respect the choices of
competent individuals.
2. When a nurse leader advocates for a change in state legislation regarding nurse-to-patient
ratios, they are engaging in which type of activity?
A. Workplace advocacy
,B. Internal policy making
C. Political activism
D. Collective bargaining
Correct Answer: C
Explanation: Political activism involves influencing public policy through interaction with
legislators and governmental bodies. By focusing on state legislation, the nurse leader is
moving beyond the clinical setting to affect the broader health care system. This role is
essential for advancing the nursing profession and improving patient safety outcomes.
3. A nurse manager is implementing a new bedside shift report protocol. Which actions
represent the ‘Unfreezing’ stage of Lewin’s Change Theory? (Select All That Apply)
A. Identifying that current reporting is inconsistent
B. Reinforcing the new behavior with rewards
C. Gathering data to show poor outcomes from old methods
D. Educating staff on the need for change
E. Establishing a permanent policy for bedside reporting
Correct Answer: A, C, D
Explanation: Unfreezing involves creating the motivation to change by identifying a
problem and making staff aware of the need for a new approach. This stage focuses on
breaking down the status quo and preparing the organization for a transition. It often
, requires data collection and transparent communication to reduce resistance among the
team.
4. The nurse is unsure if a specific task can be delegated to an Unlicensed Assistive Personnel
(UAP). Where should the nurse look for the definitive legal authority on delegation in their
state?
A. The facility’s policy and procedure manual
B. The State Nurse Practice Act
C. The ANA Code of Ethics
D. The American Association of Critical-Care Nurses (AACN) guidelines
Correct Answer: B
Explanation: The Nurse Practice Act (NPA) is the primary legal document that defines the
scope of practice and delegation authority for nurses in each state. While facility policy
provides guidance, it cannot override the legal standards set by the NPA. Understanding
the NPA is critical for maintaining professional licensure and ensuring patient safety.
5. Which of the following are included in the ‘Five Rights of Delegation’? (Select All That
Apply)
A. Right Task
B. Right Circumstance
C. Right Person
and Policy in Health Care | Actual Q&A with
Rationale (NSG436 Exam 2) | Grand Canyon
University
1. A nurse is caring for a terminal patient who refuses further chemotherapy despite family
pressure. The nurse supports the patient’s decision. Which ethical principle is being
demonstrated?
A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence
Correct Answer: A
Explanation: Autonomy refers to the right of patients to make their own decisions about
their healthcare. In this scenario, the nurse is advocating for the patient’s self-
determination even when it conflicts with the family’s wishes. This principle is
fundamental to the ANA Code of Ethics and requires that nurses respect the choices of
competent individuals.
2. When a nurse leader advocates for a change in state legislation regarding nurse-to-patient
ratios, they are engaging in which type of activity?
A. Workplace advocacy
,B. Internal policy making
C. Political activism
D. Collective bargaining
Correct Answer: C
Explanation: Political activism involves influencing public policy through interaction with
legislators and governmental bodies. By focusing on state legislation, the nurse leader is
moving beyond the clinical setting to affect the broader health care system. This role is
essential for advancing the nursing profession and improving patient safety outcomes.
3. A nurse manager is implementing a new bedside shift report protocol. Which actions
represent the ‘Unfreezing’ stage of Lewin’s Change Theory? (Select All That Apply)
A. Identifying that current reporting is inconsistent
B. Reinforcing the new behavior with rewards
C. Gathering data to show poor outcomes from old methods
D. Educating staff on the need for change
E. Establishing a permanent policy for bedside reporting
Correct Answer: A, C, D
Explanation: Unfreezing involves creating the motivation to change by identifying a
problem and making staff aware of the need for a new approach. This stage focuses on
breaking down the status quo and preparing the organization for a transition. It often
, requires data collection and transparent communication to reduce resistance among the
team.
4. The nurse is unsure if a specific task can be delegated to an Unlicensed Assistive Personnel
(UAP). Where should the nurse look for the definitive legal authority on delegation in their
state?
A. The facility’s policy and procedure manual
B. The State Nurse Practice Act
C. The ANA Code of Ethics
D. The American Association of Critical-Care Nurses (AACN) guidelines
Correct Answer: B
Explanation: The Nurse Practice Act (NPA) is the primary legal document that defines the
scope of practice and delegation authority for nurses in each state. While facility policy
provides guidance, it cannot override the legal standards set by the NPA. Understanding
the NPA is critical for maintaining professional licensure and ensuring patient safety.
5. Which of the following are included in the ‘Five Rights of Delegation’? (Select All That
Apply)
A. Right Task
B. Right Circumstance
C. Right Person
