NSG 436 Final Exam V3 | NSG 436 Leadership,
Ethics, and Policy in Health Care | Actual Q&A with
Rationale (NSG436 Final Exam) | Grand Canyon
University
1. A nurse manager is implementing a servant leadership approach on the unit. Which
behaviors are consistent with this leadership style? (Select all that apply.)
A. Prioritizing the needs of the staff above their own.
B. Focusing on the development and well-being of the team.
C. Using coercive power to ensure compliance with unit protocols.
D. Listening deeply to understand the perspectives of others.
E. Fostering a sense of community within the workplace.
F. Strictly adhering to a hierarchical top-down decision-making process.
Correct Answer: A, B, D, E
Explanation: Servant leadership is characterized by a primary focus on the growth and
well-being of people and the communities to which they belong. Unlike traditional
leadership, the servant-leader shares power, puts the needs of others first, and helps
people develop and perform as highly as possible. Coercive power and strict top-down
hierarchies are antithetical to this philosophy, which emphasizes empathy, listening, and
stewardship.
,2. A nurse is faced with an ethical dilemma where a patient’s family refuses a life-saving
blood transfusion due to religious beliefs, even though the patient is unconscious and has no
advance directive. Which ethical principle is primarily at tension with the nurse’s desire to
save the patient’s life?
A. Beneficence
B. Autonomy
C. Justice
D. Fidelity
Correct Answer: B
Explanation: Autonomy refers to the right of patients (or their legal proxies) to make their
own decisions about their medical care. In this scenario, the nurse’s duty of beneficence
(acting in the patient’s best interest) conflicts with the respect for the patient’s religious
values and self-determination represented by their family’s proxy decision. Respecting
autonomy requires the healthcare provider to honor these beliefs even when they conflict
with medical recommendations.
3. According to Lewin’s Change Theory, which stage involves the actual implementation of a
new EHR system after the staff has been prepared for the transition?
A. Unfreezing
B. Assessment
C. Refreezing
,D. Moving
Correct Answer: D
Explanation: The ‘Moving’ stage, also known as the change stage, is where the actual
transition or shift in behavior occurs. During this phase, the new system is implemented,
and staff members begin to adopt the new practices. This follows the ‘Unfreezing’ stage,
which prepares the group for change, and precedes ‘Refreezing,’ which stabilizes the
change into the organizational culture.
4. A nurse is advocating for policy changes regarding nurse-to-patient ratios at the state level.
Which action represents the most effective method of professional lobbying?
A. Joining a professional nursing organization like the ANA and participating in their
legislative days.
B. Writing an anonymous letter to a local newspaper.
C. Posting personal complaints about staffing on social media platforms.
D. Refusing to work extra shifts until the law is changed.
Correct Answer: A
Explanation: Professional nursing organizations have the resources and collective voice
necessary to influence healthcare policy effectively. Participating in legislative days allows
nurses to speak directly with lawmakers and provide expert testimony on how staffing
affects patient outcomes. While other methods like social media might raise awareness,
, formal lobbying through organized professional bodies is the standard for legislative
impact.
5. When delegating tasks to an Unlicensed Assistive Personnel (UAP), the RN must ensure the
‘Five Rights of Delegation’ are met. Which of the following are included in these rights?
(Select all that apply.)
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Salary
E. Right Direction/Communication
F. Right Supervision/Evaluation
Correct Answer: A, B, C, E, F
Explanation: The Five Rights of Delegation are a framework used to ensure that the RN
delegates safely and effectively. These include the Right Task (is it delegable?), Right
Circumstance (is the patient stable?), Right Person (is the UAP competent?), Right Direction
(clear communication), and Right Supervision (feedback and monitoring). Salary is an
administrative or contractual matter and is not part of the clinical delegation process.
6. A nurse manager is using a transactional leadership style. Which action by the manager
best demonstrates this style?
A. Inspiring the team with a vision of the future.
Ethics, and Policy in Health Care | Actual Q&A with
Rationale (NSG436 Final Exam) | Grand Canyon
University
1. A nurse manager is implementing a servant leadership approach on the unit. Which
behaviors are consistent with this leadership style? (Select all that apply.)
A. Prioritizing the needs of the staff above their own.
B. Focusing on the development and well-being of the team.
C. Using coercive power to ensure compliance with unit protocols.
D. Listening deeply to understand the perspectives of others.
E. Fostering a sense of community within the workplace.
F. Strictly adhering to a hierarchical top-down decision-making process.
Correct Answer: A, B, D, E
Explanation: Servant leadership is characterized by a primary focus on the growth and
well-being of people and the communities to which they belong. Unlike traditional
leadership, the servant-leader shares power, puts the needs of others first, and helps
people develop and perform as highly as possible. Coercive power and strict top-down
hierarchies are antithetical to this philosophy, which emphasizes empathy, listening, and
stewardship.
,2. A nurse is faced with an ethical dilemma where a patient’s family refuses a life-saving
blood transfusion due to religious beliefs, even though the patient is unconscious and has no
advance directive. Which ethical principle is primarily at tension with the nurse’s desire to
save the patient’s life?
A. Beneficence
B. Autonomy
C. Justice
D. Fidelity
Correct Answer: B
Explanation: Autonomy refers to the right of patients (or their legal proxies) to make their
own decisions about their medical care. In this scenario, the nurse’s duty of beneficence
(acting in the patient’s best interest) conflicts with the respect for the patient’s religious
values and self-determination represented by their family’s proxy decision. Respecting
autonomy requires the healthcare provider to honor these beliefs even when they conflict
with medical recommendations.
3. According to Lewin’s Change Theory, which stage involves the actual implementation of a
new EHR system after the staff has been prepared for the transition?
A. Unfreezing
B. Assessment
C. Refreezing
,D. Moving
Correct Answer: D
Explanation: The ‘Moving’ stage, also known as the change stage, is where the actual
transition or shift in behavior occurs. During this phase, the new system is implemented,
and staff members begin to adopt the new practices. This follows the ‘Unfreezing’ stage,
which prepares the group for change, and precedes ‘Refreezing,’ which stabilizes the
change into the organizational culture.
4. A nurse is advocating for policy changes regarding nurse-to-patient ratios at the state level.
Which action represents the most effective method of professional lobbying?
A. Joining a professional nursing organization like the ANA and participating in their
legislative days.
B. Writing an anonymous letter to a local newspaper.
C. Posting personal complaints about staffing on social media platforms.
D. Refusing to work extra shifts until the law is changed.
Correct Answer: A
Explanation: Professional nursing organizations have the resources and collective voice
necessary to influence healthcare policy effectively. Participating in legislative days allows
nurses to speak directly with lawmakers and provide expert testimony on how staffing
affects patient outcomes. While other methods like social media might raise awareness,
, formal lobbying through organized professional bodies is the standard for legislative
impact.
5. When delegating tasks to an Unlicensed Assistive Personnel (UAP), the RN must ensure the
‘Five Rights of Delegation’ are met. Which of the following are included in these rights?
(Select all that apply.)
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Salary
E. Right Direction/Communication
F. Right Supervision/Evaluation
Correct Answer: A, B, C, E, F
Explanation: The Five Rights of Delegation are a framework used to ensure that the RN
delegates safely and effectively. These include the Right Task (is it delegable?), Right
Circumstance (is the patient stable?), Right Person (is the UAP competent?), Right Direction
(clear communication), and Right Supervision (feedback and monitoring). Salary is an
administrative or contractual matter and is not part of the clinical delegation process.
6. A nurse manager is using a transactional leadership style. Which action by the manager
best demonstrates this style?
A. Inspiring the team with a vision of the future.
