NSG 444A Final Exam V1 | 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).
Which tasks are appropriate for the RN to delegate? (Select All That Apply)
A. Performing a sterile dressing change on a post-operative wound.
B. Assisting a stable patient with ambulation in the hallway.
C. Measuring and recording intake and output (I&O).
D. Evaluating the effectiveness of pain medication administered 30 minutes ago.
E. Providing perineal care to an incontinent patient.
F. Collecting a mid-stream urine specimen.
Correct Answer: B, C, E, F
Explanation: Delegation to UAPs should involve tasks that are repetitive, non-invasive, and
do not require nursing judgment or clinical assessment. The RN is responsible for sterile
procedures and the evaluation of medication efficacy, which involves assessment skills.
Ambulation of stable patients, I&O recording, hygiene, and basic specimen collection are
standard UAP duties according to the Five Rights of Delegation.
,2. A nurse manager is utilizing Lewin’s Change Theory to implement a new electronic health
record system. During the ‘unfreezing’ stage, which action is most appropriate?
A. Creating awareness about the need for change and identifying barriers.
B. Providing training sessions and support to staff during the transition.
C. Integrating the new system into the daily routine and policy manual.
D. Rewarding staff who successfully adopt the new technology.
Correct Answer: A
Explanation: The ‘unfreezing’ stage is the first phase of Lewin’s theory where the manager
must prepare the team for change by creating a sense of urgency and identifying resistance.
This involves gathering data and convincing the staff that the current way of doing things is
no longer effective. Training occurs in the ‘moving’ phase, while rewards and policy
changes occur in the ‘refreezing’ phase.
3. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with asthma who has developed a new onset of expiratory wheezing and
restlessness.
B. A patient who is 2 hours post-cholecystectomy reporting pain as 7/10.
C. A patient with a history of heart failure reporting 2+ pitting edema in the lower
extremities.
D. A patient with diabetes mellitus whose morning blood glucose is 160 mg/dL.
,Correct Answer: A
Explanation: Prioritization should follow the ABC (Airway, Breathing, Circulation)
framework. The patient with asthma showing signs of respiratory distress (wheezing and
restlessness) represents a potential airway/breathing emergency. The other patients are
stable or experiencing expected findings for their conditions, such as post-op pain or
chronic edema.
4. Which of the following are components of a SWOT analysis used in strategic nursing
leadership? (Select All That Apply)
A. Strengths
B. Weaknesses
C. Opportunities
D. Timeframes
E. Threats
Correct Answer: A, B, C, E
Explanation: SWOT stands for Strengths, Weaknesses, Opportunities, and Threats. This
tool is utilized by nurse leaders to assess internal and external factors that affect
organizational performance and goal setting. Timeframes are part of SMART goals but are
not a direct component of the SWOT analysis acronym.
, 5. A nurse is resolving a conflict between two staff members who disagree on the holiday
schedule. The nurse encourages both parties to give up something to reach a middle ground.
Which conflict resolution strategy is being used?
A. Collaborating
B. Competing
C. Avoiding
D. Compromising
Correct Answer: D
Explanation: Compromising involves a ‘lose-lose’ or ‘give-and-take’ approach where both
parties give up something to reach a mutually acceptable solution. Collaborating is a ‘win-
win’ where parties work together for a new solution, while competing is ‘win-lose.’
Compromising is often used when time is limited and a quick solution is necessary.
6. Which leadership style is characterized by a leader who inspires and motivates the team to
achieve a shared vision through intellectual stimulation and individual consideration?
A. Transactional Leadership
B. Laissez-faire Leadership
C. Autocratic Leadership
D. Transformational Leadership
Correct Answer: D
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).
Which tasks are appropriate for the RN to delegate? (Select All That Apply)
A. Performing a sterile dressing change on a post-operative wound.
B. Assisting a stable patient with ambulation in the hallway.
C. Measuring and recording intake and output (I&O).
D. Evaluating the effectiveness of pain medication administered 30 minutes ago.
E. Providing perineal care to an incontinent patient.
F. Collecting a mid-stream urine specimen.
Correct Answer: B, C, E, F
Explanation: Delegation to UAPs should involve tasks that are repetitive, non-invasive, and
do not require nursing judgment or clinical assessment. The RN is responsible for sterile
procedures and the evaluation of medication efficacy, which involves assessment skills.
Ambulation of stable patients, I&O recording, hygiene, and basic specimen collection are
standard UAP duties according to the Five Rights of Delegation.
,2. A nurse manager is utilizing Lewin’s Change Theory to implement a new electronic health
record system. During the ‘unfreezing’ stage, which action is most appropriate?
A. Creating awareness about the need for change and identifying barriers.
B. Providing training sessions and support to staff during the transition.
C. Integrating the new system into the daily routine and policy manual.
D. Rewarding staff who successfully adopt the new technology.
Correct Answer: A
Explanation: The ‘unfreezing’ stage is the first phase of Lewin’s theory where the manager
must prepare the team for change by creating a sense of urgency and identifying resistance.
This involves gathering data and convincing the staff that the current way of doing things is
no longer effective. Training occurs in the ‘moving’ phase, while rewards and policy
changes occur in the ‘refreezing’ phase.
3. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with asthma who has developed a new onset of expiratory wheezing and
restlessness.
B. A patient who is 2 hours post-cholecystectomy reporting pain as 7/10.
C. A patient with a history of heart failure reporting 2+ pitting edema in the lower
extremities.
D. A patient with diabetes mellitus whose morning blood glucose is 160 mg/dL.
,Correct Answer: A
Explanation: Prioritization should follow the ABC (Airway, Breathing, Circulation)
framework. The patient with asthma showing signs of respiratory distress (wheezing and
restlessness) represents a potential airway/breathing emergency. The other patients are
stable or experiencing expected findings for their conditions, such as post-op pain or
chronic edema.
4. Which of the following are components of a SWOT analysis used in strategic nursing
leadership? (Select All That Apply)
A. Strengths
B. Weaknesses
C. Opportunities
D. Timeframes
E. Threats
Correct Answer: A, B, C, E
Explanation: SWOT stands for Strengths, Weaknesses, Opportunities, and Threats. This
tool is utilized by nurse leaders to assess internal and external factors that affect
organizational performance and goal setting. Timeframes are part of SMART goals but are
not a direct component of the SWOT analysis acronym.
, 5. A nurse is resolving a conflict between two staff members who disagree on the holiday
schedule. The nurse encourages both parties to give up something to reach a middle ground.
Which conflict resolution strategy is being used?
A. Collaborating
B. Competing
C. Avoiding
D. Compromising
Correct Answer: D
Explanation: Compromising involves a ‘lose-lose’ or ‘give-and-take’ approach where both
parties give up something to reach a mutually acceptable solution. Collaborating is a ‘win-
win’ where parties work together for a new solution, while competing is ‘win-lose.’
Compromising is often used when time is limited and a quick solution is necessary.
6. Which leadership style is characterized by a leader who inspires and motivates the team to
achieve a shared vision through intellectual stimulation and individual consideration?
A. Transactional Leadership
B. Laissez-faire Leadership
C. Autocratic Leadership
D. Transformational Leadership
Correct Answer: D
