NSG 444A Exam 1 V3 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Exam 1) | Grand Canyon University
1. A nurse manager is discussing the transition from student to professional nurse using
Benner’s model. Which characteristics are associated with the ‘Novice’ stage? (Select all that
apply)
A. Relies on rules and guidelines to perform tasks.
B. Has a limited ability to prioritize tasks independently.
C. Sees actions as part of a long-term goal.
D. Lacks experience to handle unexpected clinical situations.
E. Perceives situations as wholes rather than in parts.
F. Requires clear instructions for every step of a procedure.
Correct Answer: A, B, D, F
Explanation: The novice nurse is characterized by a reliance on objective rules and lacks
the experience required for clinical judgment in complex situations. This stage typically
applies to nursing students and new graduates who require structure and guidance to
ensure safety. Unlike the proficient or expert nurse, the novice does not yet have the ‘big
picture’ perspective or the ability to recognize patterns based on prior experience.
,2. An RN is preparing to delegate tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the RN to delegate to the LPN?
A. Developing a plan of care for a client with new-onset diabetes.
B. Performing the initial admission assessment for a patient with chest pain.
C. Administering a scheduled intramuscular injection of an antibiotic.
D. Teaching a patient how to use an incentive spirometer for the first time.
Correct Answer: C
Explanation: Administering intramuscular injections is within the scope of practice for an
LPN as it involves stable, routine medication administration. Developing care plans,
performing initial assessments, and providing initial patient education are tasks that
require the advanced clinical judgment of a Registered Nurse. The RN must always ensure
that the delegated task aligns with the Five Rights of Delegation and the state’s Nurse
Practice Act.
3. A nurse is caring for a client who is refusing a life-saving blood transfusion due to religious
beliefs. The nurse supports the client’s decision. Which ethical principle is the nurse
demonstrating?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
,Correct Answer: C
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare, even if those decisions conflict with the medical team’s
recommendations. By supporting the client’s refusal, the nurse respects the individual’s
self-determination and personal values. This principle is fundamental to the delivery of
patient-centered care and the maintenance of ethical nursing practice.
4. A charge nurse is managing a conflict between two staff nurses regarding the holiday
schedule. The charge nurse asks both nurses to identify their priorities and meet in the
middle to resolve the issue. Which conflict resolution strategy is being used?
A. Compromising
B. Competing
C. Avoiding
D. Smoothing
Correct Answer: A
Explanation: Compromising involves a ‘give and take’ approach where both parties give
up something to reach a mutually acceptable solution. This strategy is effective when both
sides have equal power or when a quick middle-ground solution is needed to maintain
harmony. While it may not result in a ‘win-win’ like collaboration, it ensures that neither
party leaves the negotiation completely dissatisfied.
, 5. A nurse is prioritizing care for four clients on a medical-surgical unit. Which client should
the nurse assess first?
A. A client who had a total hip replacement 2 days ago and reports pain as 6/10.
B. A client with chronic obstructive pulmonary disease (COPD) with an O2 saturation of
90%.
C. A client with a urinary tract infection who is waiting for discharge instructions.
D. A client who is 1-hour postoperative and has a heart rate of 124 bpm.
Correct Answer: D
Explanation: The client who is 1-hour postoperative with tachycardia (HR 124 bpm) is the
highest priority due to the risk of hemorrhage or surgical complications. According to the
ABC (Airway, Breathing, Circulation) framework, hemodynamic stability takes precedence
over routine pain management or stable chronic conditions. Assessing this client first
allows for early intervention in the event of an acute physiological decline.
6. Which of the following elements are necessary to prove nursing malpractice in a court of
law? (Select all that apply)
A. Duty to the patient.
B. Breach of duty.
C. Intent to cause harm.
D. Causation (the breach caused the injury).
Practice | Actual Q&A with Rationale (NSG444A
Exam 1) | Grand Canyon University
1. A nurse manager is discussing the transition from student to professional nurse using
Benner’s model. Which characteristics are associated with the ‘Novice’ stage? (Select all that
apply)
A. Relies on rules and guidelines to perform tasks.
B. Has a limited ability to prioritize tasks independently.
C. Sees actions as part of a long-term goal.
D. Lacks experience to handle unexpected clinical situations.
E. Perceives situations as wholes rather than in parts.
F. Requires clear instructions for every step of a procedure.
Correct Answer: A, B, D, F
Explanation: The novice nurse is characterized by a reliance on objective rules and lacks
the experience required for clinical judgment in complex situations. This stage typically
applies to nursing students and new graduates who require structure and guidance to
ensure safety. Unlike the proficient or expert nurse, the novice does not yet have the ‘big
picture’ perspective or the ability to recognize patterns based on prior experience.
,2. An RN is preparing to delegate tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the RN to delegate to the LPN?
A. Developing a plan of care for a client with new-onset diabetes.
B. Performing the initial admission assessment for a patient with chest pain.
C. Administering a scheduled intramuscular injection of an antibiotic.
D. Teaching a patient how to use an incentive spirometer for the first time.
Correct Answer: C
Explanation: Administering intramuscular injections is within the scope of practice for an
LPN as it involves stable, routine medication administration. Developing care plans,
performing initial assessments, and providing initial patient education are tasks that
require the advanced clinical judgment of a Registered Nurse. The RN must always ensure
that the delegated task aligns with the Five Rights of Delegation and the state’s Nurse
Practice Act.
3. A nurse is caring for a client who is refusing a life-saving blood transfusion due to religious
beliefs. The nurse supports the client’s decision. Which ethical principle is the nurse
demonstrating?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
,Correct Answer: C
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare, even if those decisions conflict with the medical team’s
recommendations. By supporting the client’s refusal, the nurse respects the individual’s
self-determination and personal values. This principle is fundamental to the delivery of
patient-centered care and the maintenance of ethical nursing practice.
4. A charge nurse is managing a conflict between two staff nurses regarding the holiday
schedule. The charge nurse asks both nurses to identify their priorities and meet in the
middle to resolve the issue. Which conflict resolution strategy is being used?
A. Compromising
B. Competing
C. Avoiding
D. Smoothing
Correct Answer: A
Explanation: Compromising involves a ‘give and take’ approach where both parties give
up something to reach a mutually acceptable solution. This strategy is effective when both
sides have equal power or when a quick middle-ground solution is needed to maintain
harmony. While it may not result in a ‘win-win’ like collaboration, it ensures that neither
party leaves the negotiation completely dissatisfied.
, 5. A nurse is prioritizing care for four clients on a medical-surgical unit. Which client should
the nurse assess first?
A. A client who had a total hip replacement 2 days ago and reports pain as 6/10.
B. A client with chronic obstructive pulmonary disease (COPD) with an O2 saturation of
90%.
C. A client with a urinary tract infection who is waiting for discharge instructions.
D. A client who is 1-hour postoperative and has a heart rate of 124 bpm.
Correct Answer: D
Explanation: The client who is 1-hour postoperative with tachycardia (HR 124 bpm) is the
highest priority due to the risk of hemorrhage or surgical complications. According to the
ABC (Airway, Breathing, Circulation) framework, hemodynamic stability takes precedence
over routine pain management or stable chronic conditions. Assessing this client first
allows for early intervention in the event of an acute physiological decline.
6. Which of the following elements are necessary to prove nursing malpractice in a court of
law? (Select all that apply)
A. Duty to the patient.
B. Breach of duty.
C. Intent to cause harm.
D. Causation (the breach caused the injury).
