NSG 444A Final Exam V2 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Final Exam) | Grand Canyon University
1. A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel (UAP) on a
medical-surgical unit. Which tasks are appropriate for the RN to delegate? (Select All That
Apply)
A. Collecting a midstream urine specimen from a stable patient.
B. Feeding a patient who was admitted four hours ago with a suspected stroke.
C. Ambulating a patient for the first time following a total knee arthroplasty.
D. Recording the intake and output for a patient with congestive heart failure.
E. Performing a sterile dressing change on a stage III pressure injury.
F. Providing basic skin care to an elderly patient with dry skin.
Correct Answer: A, D, F
Explanation: The RN may delegate tasks that are routine, non-invasive, and do not require
clinical judgment or nursing assessment. Collecting a urine specimen from a stable patient
and recording intake/output are standard technical tasks suitable for a UAP. Feeding a new
stroke patient requires assessment for dysphagia, and initial ambulation requires
assessment of stability, both of which must be performed by the RN.
,2. A new graduate nurse is entering the workforce and experiences a period of frustration
and disillusionment known as ‘reality shock.’ According to Kramer, which phase is the nurse
most likely experiencing when they feel the values learned in school are not being applied in
the clinical setting?
A. Honeymoon phase
B. Recovery phase
C. Shock or Rejection phase
D. Resolution phase
Correct Answer: C
Explanation: The shock or rejection phase occurs when the new nurse realizes the
inconsistencies between the ideal nursing world of school and the reality of the workplace.
During this time, the nurse may experience conflicting values and feel overwhelmed by the
demands of the profession. Successful navigation of this phase leads to the recovery and
resolution phases where the nurse finds balance.
3. A nurse manager is utilizing a transformational leadership style to implement a new
evidence-based practice protocol. Which action by the nurse manager best demonstrates this
leadership style?
A. Offering financial bonuses to staff members who follow the protocol correctly.
B. Closely monitoring staff performance and correcting errors immediately.
C. Allowing the staff to decide for themselves if they want to adopt the new protocol.
,D. Inspiring staff to embrace the change by sharing a vision of improved patient outcomes.
Correct Answer: D
Explanation: Transformational leaders focus on inspiring and motivating followers to
achieve a shared vision and exceed expectations through charisma and intellectual
stimulation. This differs from transactional leadership, which relies on rewards and
punishments for compliance. By focusing on patient outcomes and vision, the manager
fosters professional growth and organizational commitment.
4. The nurse is prioritizing care for four patients who were just admitted to the unit. Which
patient should the nurse assess first?
A. A patient with a history of COPD who has an oxygen saturation of 91% on room air.
B. A patient scheduled for an appendectomy who reports abdominal pain of 6/10.
C. A patient with diabetes mellitus who is reporting a headache and lightheadedness.
D. A patient three hours postoperative from a cholecystectomy who is requesting a glass of
water.
Correct Answer: C
Explanation: Prioritization should be based on the ABCs and acute physiological needs.
The patient with diabetes reporting headache and lightheadedness is showing signs of
hypoglycemia, which is an acute, life-threatening situation requiring immediate
intervention. The COPD patient’s saturation is within an expected range for the condition,
and the appendectomy patient’s pain is expected.
, 5. An RN is preparing to discharge a patient who has been diagnosed with a new terminal
illness. The patient’s family requests that the nurse not tell the patient the diagnosis. Which
ethical principle is the nurse most directly upholding by choosing to inform the patient?
A. Beneficence
B. Non-maleficence
C. Justice
D. Autonomy
Correct Answer: D
Explanation: Autonomy refers to the right of the individual to make their own decisions
about their medical care and to be informed of their health status. By informing the patient,
the nurse respects the patient’s right to self-determination regardless of the family’s
wishes. This principle is foundational to informed consent and professional nursing
practice.
6. A hospital is applying for Magnet Recognition Program status. Which characteristics are
associated with the ‘Forces of Magnetism’? (Select All That Apply)
A. Structural Empowerment
B. Exemplary Professional Practice
C. Transformational Leadership
D. Maximum Nurse-to-Patient Ratios
Practice | Actual Q&A with Rationale (NSG444A
Final Exam) | Grand Canyon University
1. A registered nurse (RN) is delegating tasks to an unlicensed assistive personnel (UAP) on a
medical-surgical unit. Which tasks are appropriate for the RN to delegate? (Select All That
Apply)
A. Collecting a midstream urine specimen from a stable patient.
B. Feeding a patient who was admitted four hours ago with a suspected stroke.
C. Ambulating a patient for the first time following a total knee arthroplasty.
D. Recording the intake and output for a patient with congestive heart failure.
E. Performing a sterile dressing change on a stage III pressure injury.
F. Providing basic skin care to an elderly patient with dry skin.
Correct Answer: A, D, F
Explanation: The RN may delegate tasks that are routine, non-invasive, and do not require
clinical judgment or nursing assessment. Collecting a urine specimen from a stable patient
and recording intake/output are standard technical tasks suitable for a UAP. Feeding a new
stroke patient requires assessment for dysphagia, and initial ambulation requires
assessment of stability, both of which must be performed by the RN.
,2. A new graduate nurse is entering the workforce and experiences a period of frustration
and disillusionment known as ‘reality shock.’ According to Kramer, which phase is the nurse
most likely experiencing when they feel the values learned in school are not being applied in
the clinical setting?
A. Honeymoon phase
B. Recovery phase
C. Shock or Rejection phase
D. Resolution phase
Correct Answer: C
Explanation: The shock or rejection phase occurs when the new nurse realizes the
inconsistencies between the ideal nursing world of school and the reality of the workplace.
During this time, the nurse may experience conflicting values and feel overwhelmed by the
demands of the profession. Successful navigation of this phase leads to the recovery and
resolution phases where the nurse finds balance.
3. A nurse manager is utilizing a transformational leadership style to implement a new
evidence-based practice protocol. Which action by the nurse manager best demonstrates this
leadership style?
A. Offering financial bonuses to staff members who follow the protocol correctly.
B. Closely monitoring staff performance and correcting errors immediately.
C. Allowing the staff to decide for themselves if they want to adopt the new protocol.
,D. Inspiring staff to embrace the change by sharing a vision of improved patient outcomes.
Correct Answer: D
Explanation: Transformational leaders focus on inspiring and motivating followers to
achieve a shared vision and exceed expectations through charisma and intellectual
stimulation. This differs from transactional leadership, which relies on rewards and
punishments for compliance. By focusing on patient outcomes and vision, the manager
fosters professional growth and organizational commitment.
4. The nurse is prioritizing care for four patients who were just admitted to the unit. Which
patient should the nurse assess first?
A. A patient with a history of COPD who has an oxygen saturation of 91% on room air.
B. A patient scheduled for an appendectomy who reports abdominal pain of 6/10.
C. A patient with diabetes mellitus who is reporting a headache and lightheadedness.
D. A patient three hours postoperative from a cholecystectomy who is requesting a glass of
water.
Correct Answer: C
Explanation: Prioritization should be based on the ABCs and acute physiological needs.
The patient with diabetes reporting headache and lightheadedness is showing signs of
hypoglycemia, which is an acute, life-threatening situation requiring immediate
intervention. The COPD patient’s saturation is within an expected range for the condition,
and the appendectomy patient’s pain is expected.
, 5. An RN is preparing to discharge a patient who has been diagnosed with a new terminal
illness. The patient’s family requests that the nurse not tell the patient the diagnosis. Which
ethical principle is the nurse most directly upholding by choosing to inform the patient?
A. Beneficence
B. Non-maleficence
C. Justice
D. Autonomy
Correct Answer: D
Explanation: Autonomy refers to the right of the individual to make their own decisions
about their medical care and to be informed of their health status. By informing the patient,
the nurse respects the patient’s right to self-determination regardless of the family’s
wishes. This principle is foundational to informed consent and professional nursing
practice.
6. A hospital is applying for Magnet Recognition Program status. Which characteristics are
associated with the ‘Forces of Magnetism’? (Select All That Apply)
A. Structural Empowerment
B. Exemplary Professional Practice
C. Transformational Leadership
D. Maximum Nurse-to-Patient Ratios
