NSG 444A Exam 2 V3 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Exam 2) | Grand Canyon University
1. A nurse manager is utilizing Lewin’s Change Theory to implement a new electronic health
record system. During the ‘unfreezing’ stage, which action should the manager prioritize?
A. Providing hands-on training for all clinical staff members.
B. Creating a sense of urgency and explaining why the change is necessary.
C. Reinforcing the new behavior through positive feedback and rewards.
D. Developing new policies to support the permanent adoption of the system.
Correct Answer: B
Explanation: The unfreezing stage is the first step in Lewin’s theory, where the need for
change is identified and resistance is addressed. By creating urgency, the manager prepares
the staff to let go of old processes. This stage is critical for ensuring that staff are
psychologically ready for the transition.
2. Which of the following tasks are appropriate for a Registered Nurse (RN) to delegate to an
Unlicensed Assistive Personnel (UAP)? (Select All That Apply)
A. Measuring and recording intake and output (I&O).
B. Providing discharge instructions to a patient with a new diagnosis.
C. Performing routine vital signs on a stable patient.
,D. Assisting a patient with basic activities of daily living (ADLs).
E. Evaluating the effectiveness of pain medication administered an hour ago.
F. Reporting changes in skin integrity to the nurse.
Correct Answer: A, C, D, F
Explanation: UAPs can perform routine tasks that do not require clinical judgment or
assessment, such as I&O, vital signs on stable patients, and ADLs. They are also responsible
for reporting observations back to the RN. Assessment, teaching, and evaluation (TAPE)
must remain the responsibility of the licensed nurse.
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 being
demonstrated?
A. Beneficence
B. Autonomy
C. Justice
D. Nonmaleficence
Correct Answer: B
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare. In this scenario, the nurse respects the client’s self-
, determination despite the medical outcome. This principle is fundamental to patient-
centered care and professional nursing practice.
4. According to Benner’s Stages of Clinical Competence, a nurse who has been on the same
unit for 2 to 3 years and can coordinate multiple complex care requirements is at which
stage?
A. Novice
B. Advanced Beginner
C. Competent
D. Proficient
Correct Answer: C
Explanation: The ‘Competent’ nurse has typically been in the same job for a few years and
begins to see actions in terms of long-range goals. They are able to plan and organize care
efficiently but may still lack the speed and flexibility of more advanced stages. This stage
represents a milestone in the transition from student to professional.
5. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
B. A client who is 2 hours post-operative and reports a pain level of 8 out of 10.
C. A client scheduled for discharge who needs instructions on wound care.
D. A client with a new onset of shortness of breath and an oxygen saturation of 88%.
Practice | Actual Q&A with Rationale (NSG444A
Exam 2) | Grand Canyon University
1. A nurse manager is utilizing Lewin’s Change Theory to implement a new electronic health
record system. During the ‘unfreezing’ stage, which action should the manager prioritize?
A. Providing hands-on training for all clinical staff members.
B. Creating a sense of urgency and explaining why the change is necessary.
C. Reinforcing the new behavior through positive feedback and rewards.
D. Developing new policies to support the permanent adoption of the system.
Correct Answer: B
Explanation: The unfreezing stage is the first step in Lewin’s theory, where the need for
change is identified and resistance is addressed. By creating urgency, the manager prepares
the staff to let go of old processes. This stage is critical for ensuring that staff are
psychologically ready for the transition.
2. Which of the following tasks are appropriate for a Registered Nurse (RN) to delegate to an
Unlicensed Assistive Personnel (UAP)? (Select All That Apply)
A. Measuring and recording intake and output (I&O).
B. Providing discharge instructions to a patient with a new diagnosis.
C. Performing routine vital signs on a stable patient.
,D. Assisting a patient with basic activities of daily living (ADLs).
E. Evaluating the effectiveness of pain medication administered an hour ago.
F. Reporting changes in skin integrity to the nurse.
Correct Answer: A, C, D, F
Explanation: UAPs can perform routine tasks that do not require clinical judgment or
assessment, such as I&O, vital signs on stable patients, and ADLs. They are also responsible
for reporting observations back to the RN. Assessment, teaching, and evaluation (TAPE)
must remain the responsibility of the licensed nurse.
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 being
demonstrated?
A. Beneficence
B. Autonomy
C. Justice
D. Nonmaleficence
Correct Answer: B
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare. In this scenario, the nurse respects the client’s self-
, determination despite the medical outcome. This principle is fundamental to patient-
centered care and professional nursing practice.
4. According to Benner’s Stages of Clinical Competence, a nurse who has been on the same
unit for 2 to 3 years and can coordinate multiple complex care requirements is at which
stage?
A. Novice
B. Advanced Beginner
C. Competent
D. Proficient
Correct Answer: C
Explanation: The ‘Competent’ nurse has typically been in the same job for a few years and
begins to see actions in terms of long-range goals. They are able to plan and organize care
efficiently but may still lack the speed and flexibility of more advanced stages. This stage
represents a milestone in the transition from student to professional.
5. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
B. A client who is 2 hours post-operative and reports a pain level of 8 out of 10.
C. A client scheduled for discharge who needs instructions on wound care.
D. A client with a new onset of shortness of breath and an oxygen saturation of 88%.
