NSG 444A Final Exam V3 | NSG 444A Transition to
Practice | Actual Q&A with Rationale (NSG444A
Final Exam) | Grand Canyon University
1. A nurse manager is implementing a new evidence-based protocol for pressure ulcer
prevention. Which leadership style is most effective for encouraging staff engagement and
long-term commitment to this change?
A. Autocratic leadership
B. Transformational leadership
C. Laissez-faire leadership
D. Transactional leadership
Correct Answer: B
Explanation: Transformational leadership focuses on building relationships and
motivating staff through a shared vision. This style is highly effective for implementing
long-term changes because it empowers staff and fosters commitment. In contrast,
autocratic leadership relies on control, which may result in compliance but not genuine
engagement.
2. A registered nurse (RN) is preparing to delegate tasks to an unlicensed assistive personnel
(UAP). Which tasks are appropriate for the RN to delegate? (Select All That Apply)
A. Assisting a stable patient with ambulation
B. Performing an initial admission assessment
,C. Recording intake and output for a patient
D. Providing discharge instructions to a patient
E. Obtaining vital signs on a stable patient
F. Administering subcutaneous insulin
Correct Answer: A, C, E
Explanation: The RN can delegate tasks that are repetitive, non-invasive, and do not
require clinical judgment. Assisting with ambulation, recording I&Os, and taking vital signs
for stable patients fall under the UAP scope of practice. Assessments, teaching, and
medication administration require the professional judgment of a licensed nurse.
3. After receiving the shift report, which patient should the nurse assess first?
A. A patient with a history of heart failure reporting a 2-lb weight gain overnight.
B. A patient who is 2 days postoperative following a hip replacement and requires pain
medication.
C. A patient with asthma who has a new onset of wheezing and an oxygen saturation of
89%.
D. A patient with chronic obstructive pulmonary disease (COPD) with a capillary refill of 3
seconds.
Correct Answer: C
,Explanation: Using the ABC (Airway, Breathing, Circulation) framework, the patient with
asthma and low oxygen saturation is the highest priority. New onset wheezing indicates a
potential airway obstruction or respiratory distress. Other patients, while needing care, are
currently more stable than a patient with compromised breathing.
4. A nurse is faced with an ethical dilemma regarding a patient’s end-of-life care. The patient
has a DNR order, but the family is demanding life-saving measures. Which ethical principle is
the nurse primarily advocating for by honoring the patient’s wishes?
A. Beneficence
B. Justice
C. Autonomy
D. Non-maleficence
Correct Answer: C
Explanation: Autonomy refers to the patient’s right to make their own decisions regarding
their healthcare. By honoring the DNR order, the nurse respects the patient’s self-
determination despite family pressure. Beneficence and non-maleficence involve doing
good and avoiding harm, while justice relates to fairness in resource allocation.
5. Which of the following are components of the ‘Five Rights of Delegation’? (Select All That
Apply)
A. Right Task
B. Right Circumstance
, C. Right Documentation
D. Right Supervision and Evaluation
E. Right Person
F. Right Direction and Communication
Correct Answer: A, B, D, E, F
Explanation: The Five Rights of Delegation include the Right Task, Right Circumstance,
Right Person, Right Direction/Communication, and Right Supervision/Evaluation.
Documentation is a crucial nursing responsibility but is not formally listed as one of the
specific ‘Five Rights’ of the delegation process itself. Nurses must ensure all five
components are met to ensure patient safety when delegating.
6. A nurse is caring for a client who is scheduled for surgery. The client states, ‘I am not sure if
I want this surgery anymore; no one explained the risks to me.’ What is the nurse’s priority
action?
A. Explain the risks and benefits of the surgery to the client.
B. Notify the surgeon that the client has questions regarding the informed consent.
C. Document that the client is refusing the procedure and notify the surgeon.
D. Reassure the client that the surgeon is highly skilled and the procedure is safe.
Correct Answer: B
Practice | Actual Q&A with Rationale (NSG444A
Final Exam) | Grand Canyon University
1. A nurse manager is implementing a new evidence-based protocol for pressure ulcer
prevention. Which leadership style is most effective for encouraging staff engagement and
long-term commitment to this change?
A. Autocratic leadership
B. Transformational leadership
C. Laissez-faire leadership
D. Transactional leadership
Correct Answer: B
Explanation: Transformational leadership focuses on building relationships and
motivating staff through a shared vision. This style is highly effective for implementing
long-term changes because it empowers staff and fosters commitment. In contrast,
autocratic leadership relies on control, which may result in compliance but not genuine
engagement.
2. A registered nurse (RN) is preparing to delegate tasks to an unlicensed assistive personnel
(UAP). Which tasks are appropriate for the RN to delegate? (Select All That Apply)
A. Assisting a stable patient with ambulation
B. Performing an initial admission assessment
,C. Recording intake and output for a patient
D. Providing discharge instructions to a patient
E. Obtaining vital signs on a stable patient
F. Administering subcutaneous insulin
Correct Answer: A, C, E
Explanation: The RN can delegate tasks that are repetitive, non-invasive, and do not
require clinical judgment. Assisting with ambulation, recording I&Os, and taking vital signs
for stable patients fall under the UAP scope of practice. Assessments, teaching, and
medication administration require the professional judgment of a licensed nurse.
3. After receiving the shift report, which patient should the nurse assess first?
A. A patient with a history of heart failure reporting a 2-lb weight gain overnight.
B. A patient who is 2 days postoperative following a hip replacement and requires pain
medication.
C. A patient with asthma who has a new onset of wheezing and an oxygen saturation of
89%.
D. A patient with chronic obstructive pulmonary disease (COPD) with a capillary refill of 3
seconds.
Correct Answer: C
,Explanation: Using the ABC (Airway, Breathing, Circulation) framework, the patient with
asthma and low oxygen saturation is the highest priority. New onset wheezing indicates a
potential airway obstruction or respiratory distress. Other patients, while needing care, are
currently more stable than a patient with compromised breathing.
4. A nurse is faced with an ethical dilemma regarding a patient’s end-of-life care. The patient
has a DNR order, but the family is demanding life-saving measures. Which ethical principle is
the nurse primarily advocating for by honoring the patient’s wishes?
A. Beneficence
B. Justice
C. Autonomy
D. Non-maleficence
Correct Answer: C
Explanation: Autonomy refers to the patient’s right to make their own decisions regarding
their healthcare. By honoring the DNR order, the nurse respects the patient’s self-
determination despite family pressure. Beneficence and non-maleficence involve doing
good and avoiding harm, while justice relates to fairness in resource allocation.
5. Which of the following are components of the ‘Five Rights of Delegation’? (Select All That
Apply)
A. Right Task
B. Right Circumstance
, C. Right Documentation
D. Right Supervision and Evaluation
E. Right Person
F. Right Direction and Communication
Correct Answer: A, B, D, E, F
Explanation: The Five Rights of Delegation include the Right Task, Right Circumstance,
Right Person, Right Direction/Communication, and Right Supervision/Evaluation.
Documentation is a crucial nursing responsibility but is not formally listed as one of the
specific ‘Five Rights’ of the delegation process itself. Nurses must ensure all five
components are met to ensure patient safety when delegating.
6. A nurse is caring for a client who is scheduled for surgery. The client states, ‘I am not sure if
I want this surgery anymore; no one explained the risks to me.’ What is the nurse’s priority
action?
A. Explain the risks and benefits of the surgery to the client.
B. Notify the surgeon that the client has questions regarding the informed consent.
C. Document that the client is refusing the procedure and notify the surgeon.
D. Reassure the client that the surgeon is highly skilled and the procedure is safe.
Correct Answer: B
