NUR475/NUR 475 Final Exam Study Guide | with Questions and answers rationales | 100% updated Fall 2025/26.

NUR 475 Final Exam Study Guide Theory + Research Nursing Theorists - Hildegard Peplau o Created the Interpersonal Relations Model - Virginia Henderson o Outlined fundamental basic needs of all people (i.e. breathing, sleeping, maintaining body temp, worship) - Betty Neuman o Stated intrapersonal, interpersonal, and extrapersonal stressors affect patients - Madeline Leininger o Stressed the importance of cultural competence - Patricia Benner o Novice to expert theory - Florence Nightingale o Noted the importance of the patient environment and cleanliness o First to support formal nursing education - Jean Watson o Theory of Transpersonal Caring Concepts – abstract ideas or mental images of phenomena or reality - The building blocks of theories - A group of concepts is called a conceptual framework Magnet Hospitals – hospitals that are a great environment for nurses - Nurses here have a high level of job satisfaction, have low turnover rates, and have great patient outcomes related to nursing Variables in an experiment - Independent: what the researcher is changing or manipulating - Dependent: changes based on the independent variable Nursing process - Assess, diagnose, planning, implementing, evaluating Time Management Ways to improve time management - Prioritizing tasks is one of the most important time management skills. - Starting by planning your day and creating reasonable, flexible lists of tasks that need to be done - Creating a time inventory to map out activities’ hour by hour - Schedule meetings and interactions rather than having an open-door policy - Avoid large, complex plans. Break them into smaller, more manageable pieces - Be flexible and re-evaluate your plan as needed - Document interventions as soon as possible to avoid errors - Complete high priority tasks first - Complete one task before jumping to another The nurse-manager is creating a list in order to promote efficiency and productivity. What is the manager’s best action? a. Use long-term goals as the framework for creating the list. b. Include slightly more activities than can be completed in a day, in order to motivate. c. Begin by ranking the priority of tasks that need to be accomplished. d. Keep each day’s list as similar as possible to each other day’s lists. Which task should the team leader perform first when planning care for a group of clients? a. Plan so that each client on the team receives equal amounts of nursing care. b. Prioritize the amount and type of nursing care each client requires. c. Identify the staff who will comprise the individual care teams. d. Assign clients to the specific nursing teams. A manager is trying to get in the habit of creating a daily list of tasks. The manager should: a) avoid changing the list once initial planning is completed. b) Include flexibility in the list implementation. c)include all relevant short-term, intermediate, and long-term goals. d)keep the list highly structured, thus decreasing the possibility of procrastination. A nurse-manager admits to feeling frustrated and confused by the fact that each day “just slips away,” leaving many important tasks undone. How should this manager begin develop better time management skills? a. Identify a mentor who can plan the manager’s schedule. b. Complete a time inventory to identify how time is used. c. Experiment with adjustments to the daily schedule. d. Request a temporary reduction in workload. A nurse-manager has recognized that unproductive socialization is making it difficult to complete each day’s tasks. What action should the manager take to prevent this cause of inefficiency? a. Maintain an open-door policy so employees can have more rapid interactions with the manager. b. Schedule appointments so that interactions can be predicted and controlled. c. Request a transfer to a site where the manager knows fewer coworkers and employees. d. Ban socialization on the unit during working hours. A nurse-manager is responsible for implementing a large and complex plan that will require much time and effort. How should the manager address this large task? a. Work on the task with few breaks in order to finish as quickly as possible. b. Delegate as much of the task as possible to employees and focus on evaluation. c. Break the task into smaller, less intimidating units. d. Delay beginning the task until it has the manager’s undivided attention. How should the nurse-manager most effectively deal with the ever-changing nature of the nursing work environment? a. Evaluating the management skills of the nursing team leaders b. Providing time management classes for staff members c. Frequently reassessing personally established priorities d. Encouraging staff to engage in daily planning A nurse-manager makes lists of tasks for each day. What should the manager do in order to ensure that lists accurately reflect changes in priorities? a. Reevaluate the lists on a regular basis and adjust them as needed. b. Ensure that each day’s list is significantly different from the previous day’s list. c. Make lists as detailed as possible in terms of the time allocated and the specifics of each task. d. Have the lists reviewed by a trusted colleague on a regular basis. Time management can be reduced to cyclic steps that include which of the following? Select all that apply. a. Allow time for planning and establish priorities. b. Complete tasks according to their difficulty, from easiest to most difficult. c. Complete the highest priority task, and whenever possible, finish one task before beginning another. d. Reprioritize based on remaining tasks and new information that may have been received. e. Divide each day into 1-hour blocks. , C, D “Do Now” “Do Later” “Don’t Do” - Sorting activities into these categories can help with prioritization - Do now o High priority tasks that need immediate attention or have high importance to the unit or patient  i.e. planning for adequate staffing, solving life threatening situations, day to day operational needs - Do later o Tasks that don’t need to be done immediately or are not life threatening  I.e. baths, education - Don’t do o Unimportant tasks, tasks that can wait until the next shift  i.e. learning module due a week from now A nurse-manager is prioritizing tasks. Which tasks should the manager put into the “do now” category? a. Adding follow-up comments to an incident report from the previous day b. Covering sick calls for the upcoming shift to ensure there are enough nurses c. Conducting a new employee’s initial performance review d. Meeting with the chairperson of the hospital’s strategic planning committee The nurse-manager of a hospital unit has categorized some tasks in the “do now” category. The tasks most likely reflect: a. the unit’s day-to-day operational needs. b. issues related to long-term goals. c. large, time-consuming tasks. d. problems that cannot be safely delegated. Identifying personal goals and priorities will help you have greater control over time Career Development Portfolio – a document with all of your work experience, educational background, achievements, and certifications - Keep this up to date to give to employers to give examples of your professional growth A nurse has applied for a new position and has presented a nursing portfolio to the human resources department. This portfolio will allow the nurse to: a. present his or her specific career goals. b. justify salary expectations. c. give examples of professional growth. d. showcase his or her academic credentials. Benner’s Novice to Expert Theory - New graduate nurses start off as novices. Over time as they gain more experience and learn new things, they become more competent and get to the level of an expert. They move from being task oriented to being able to view the whole patient picture and think critically. A nurse who has transferred to a new workplace setting self-identifies as “competent” on Benner’s continuum from novice to expert. What characteristic does this nurse most likely possess? a. A Bachelor of Science in Nursing degree b. Two to 3 years of clinical experience c. Basic health-care management skills d. A well-defined career plan Obsolescence - As nurses age in the field, they must continue to gain new skills and learn about new technology/best practices to avoid becoming obsolete A nurse has more than four decades of experience. In order to ensure that the nurse is not seen as obsolete by peers and colleagues, the nurse should: a. seek a leadership position. b. offer to mentor newly graduated nurses. c. change jobs as frequently as possible. d. continually seek new knowledge and experience. Continued competence: continuously seeking out new learning opportunities and acquiring new skills as a nurse Cover Letter - Given with a resume to introduce yourself as a candidate. You should introduce yourself, give key points/achievements from your resume, and explain why you want the job A nurse is applying for a job and is now writing a cover letter. The nurse should integrate what characteristics of a cover letter? Select all that apply. a. Introduce the applicant. b. Briefly highlight key points of the resume. c. List the contact information for the nurse’s references. d. Make a positive first impression. e. Always used when submitting a resume. , B, D, E Certification - Specializing in a certain field of nursing (i.e. psych, pediatrics, cardiac, etc...) shows employers that you have a higher level of expertise in that area. - Benefits o Higher self esteem o Higher wage o Resume booster o Great way to advance career How can a nursing professional best demonstrate advanced achievement of competencies? a. Participating in career planning b. Achieving a new specialty certification c. Transfer to a new department d. Maintaining ethical standards of practice A nurse is considering certification in an area of specialty. What potential benefits of certification should the nurse consider? Select all that apply. a. A personal sense of accomplishment b. Exemption from continuing education requirements c. Increased career options d. Increased potential for advancement and promotions e. Higher salaries , C, D, E Engaging in reflective practice - Reflecting on your strengths and weaknesses can help you set goals and seek out learning opportunities to help your professional growth A nurse is selecting areas to focus on for continuing education and personal growth over the next year. During this process, the nurse should: a. prioritize learning that can take place in a college or university setting. b. ask the manager to perform this task, if possible. c. prioritize areas of study that are new to the nurse. d. engage in reflective practice. A nurse will soon be creating a plan for continuing competence. What activity should the nurse prioritize when making this plan? a. Reflecting on his or her own practice b. Eliciting input from trusted nursing colleagues c. Eliciting input from members of other health disciplines d. Setting 3-year and 5-year career goals Transition to practice programs - Help new nurses go from being a student to being a new nurse - Helps them socialize, learn new skills, and practice autonomy - This cuts down on turnover and boosts retention rates Organizing Patient Care Types of nursing care models - Total patient care o One nurse cares for a group of patients over the course of their shift o Most common model - Functional nursing o Each person on the team has one job for all the patients  i.e. medication nurse, IV/phlebotomy nurse, care tech for ADLs - Team and modular nursing o One nurse leads a team of ancillary staff to care for a group of patients  Team would include LPNs, care techs, and housekeeping staff o Requires good communication between all members of the team - Primary nursing o One nurse organizes the care plan of a patient for a 24-hour period and gives specific instructions for the oncoming staff that cares for the patient when the nurse is off. This lasts from admission to discharge o Primary nurse assigns tasks to the rest of the care team based on expertise and experience - Case management o A case manager connects a patient to resources and specialties throughout their entire stay o Uses multidisciplinary action plans o Provides cost effective plans for the care of the patient o Care is more individualized to the patient o When plans do not work out, variances are reported Which aspect of care at a long-term care facility most clearly suggests that a functional model of care delivery is being used? a. One nurse is assigned to provide all of a resident’s care during a shift. b. Unlicensed assistive personnels (UAPs) coordinate each resident’s care and occasionally delegate to practical nurses. c. Registered nurses perform all assessments while UAPs provide all feeding and hygiene. d. A pairing of one registered nurse and one practical nurse provides all the care for a designated pool of residents. The nurse is assigned to administer medications to all patients throughout the shift. What is this an example of? a. Team nursing b. Case method nursing c. Primary care delivery d. Functional nursing care A registered nurse is providing care in a setting that uses modular nursing. What task should the nurse perform during a shift? a. Providing every aspect of care to one half to one third of the mini-team’s assigned patients b. Collaborating with another registered nurse to plan the care of all the mini-team’s assigned patients c. Confirming that each member of the mini-team is completing his or her assigned tasks d. Providing total patient care to the most acutely ill patients that the miniteam is assigned A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? a. Planning nursing care independently of others b. Assigning work according to the expertise of group members c. Being responsible for care planning only during the shift when he or she works d. Carrying out the majority of personal care for assigned patients A nurse-manager has recently learned that the health-care facility will be moving toward a case management approach. What factor is most likely driving this change? a. The need to address cost-effective options for care b. The need to provide challenging work for nurses and other members of the care team c. The need to enhance professionalism throughout the organization d. The need to obtain magnet designation Changing care models - No one model is the best, but each one has its strengths and weaknesses. This must be assessed prior to changing models - Model changes should be based on patient needs - Changing models can affect the dynamic and social interactions of the care team The manager can best ensure the successful introduction of a new delivery system by: a. assigning a senior registered nurse to lead the implementation. b. explaining the implications of the proposed change to patients and families. c. carefully studying the best method for implementing the planned change. d. hiring nurses who have experience in providing the new delivery system. Nurse navigators/Disease Management - Guide patients through their chronic disease process - Connects them to resources needed to manage their disease - Nurses specialize in certain disease processes and what care the population needs (i.e. diabetes, COPD, hear failure, etc...) A patient who has just been diagnosed with lung cancer has been assigned a nurse navigator. What task should the nurse prioritize in this role? a. Providing evidence-based guidance on treatment options and treatment decisions b. Providing clinical leadership and ensuring quality for the patient’s care c. Guiding the patient in an effort to provide high-quality managed care d. Guiding the patient and family through their various interactions with the health-care system Team Building EHR - When implementing new EHRs, there should be adequate training for staff and the appropriate budget to accommodate for the new technology Effective Communication Strategies - Keep a calm demeanor - Have inviting body language - Make eye contact - Allow for privacy - Be respectful of physical boundaries - Pay attention to nonverbal communication, this can take precedent when it is not congruent with verbal communication - Different genders may communicate differently; take this into account Group Roles - Initiator: starts the group, initiates tasks and projects - Information seeker: gathers info, research - Information giver: disseminates new information to the group - Opinion seeker: does surveys, gathers group opinions - Elaborator: makes ideas come to life - Coordinator: coordinates group activities - Orienteer: teaches new members how to be a part of the group - Evaluator: evaluates group success - Energizer/encourager: keeps the group motivated - Gatekeeper: ensures everyone is a part of decision making, keeps people from going on tangents - Aggressor: aggressive communication style, may be argumentative - Blocker: stops group progress, always has something negative to say - Recognition seeker: needs constant praise for their work - Self-confessor: uses the group to explore or talk about non-group related, personal things - Playboy: does not care about the group and is very vocal about it. Can be cynical and overly playful/nonchalant The nurse-manager is sitting on a practice committee and has adopted the role of gatekeeper. What action should the manager perform in this role? a. Acknowledge and praise each member’s contributions. b. Mediate, harmonize, and resolve conflict when it arises. c. Facilitate and promote participation by all group members. d. Record the group’s process and provide feedback to the group. A member of a work group that the nurse-manager leads is aloof and dismissive of the group’s role. The member has occasionally made jokes during serious discussions and seems skeptical that the group will meet its goals. What role is this member playing? a. Blocker b. Playboy c. Dominator d. Recognition seeker Grapevine communication - Informal, haphazard, and random communication that does not follow chain of command - To combat this, try to understand why chain of command is not being followed and re-educate team members Direction of communication - Upward: from staff to manager - Downward: from manager to staff - Horizontal: between co-workers of the same level Assertive communication - To be direct, open and honest when speaking but NOT aggressive or rude A nurse-manager has a reputation as being an assertive communicator. How does this manager most likely communicate? a. Through confrontation and intimidation b. In an unfeminine way that is clear and direct c. Directly and honestly, while respecting the rights of others d. In a clear, but occasionally offensive, manner Group Formation - Forming – team gets to know each other - Storming – interpersonal conflict arises as people’s true nature comes out and boundaries are pushed - Norming – differences are resolved, people start to agree and recognize each other’s strengths - Performing – team is in sync and performs to full potential A nurse-manager has recently established a “best practice committee” at the clinic. Which behavior by the committee members suggests that it is in the “storming” stage? a. Members attempt to impress each other with their credentials. b. The short- and long-term goals for the group are agreed upon. c. Group members achieve their stated goals. d. The members receive their instructions and mandate from the manager. Barriers to effective communication - Internal o Personal characteristics like stubbornness, aggressive communication styles, lack of respect, poor listening ability, facial expression, body language, incongruence between verbal and nonverbal communication - External o Changes in the environment, location, culture of the organization, chains of command, etc... Which principle should guide the nurse-manager’s use of nonverbal communication? a. It is generally consistent across cultures, unlike verbal communication. b. It supersedes verbal communication when the two are incongruent. c. Nonverbal communication should be minimized because it confuses the receiver regarding the true intent of the message. d. Nonverbal communication is a significant part of the communication exchange only when it is not congruent with the verbal exchange. Feedback from a nurse-manager’s peers suggests that the manager’s faceto-face communication is often ineffective. The manager should consider what potential cause of this problem? a. Incongruence between the manager’s verbal and nonverbal messages b. Ineffective listening skills on the part of subordinates and colleagues c. Inadequate formal training on communication skills d. Career stagnation by the nurse-manager A nurse-manager is communicating with a subordinate. What component of this communication would be considered as part of the external climate? a. The clarity of the message b. The subordinate’s personality c. The culture of the organization d. The manager’s stress level Collective Bargaining Grievances: complaints filed by employees - Should be handled by HR or a third party that is NOT involved in the conflict. Should not be handled directly by a manger, especially if the manager is involved in the issue A nurse filed a grievance against the employer and the matter has proceeded to arbitration. What is true about this employee’s grievance? a. Arbitration is likely the initial step in resolving the grievance. b. A neutral third party will impose a solution to the grievance. c. The grievance took place at a public health-care organization. d. The employer is likely trying to avert a strike. Age Discrimination in Employment Act - Individuals cannot be discriminated against by their age as long as they are able to perform the job up to the appropriate standards - Removed maximum age limits on jobs Which statement concerning the 1967 and 1987 Age Discrimination and Employment Acts is true? a. Maximum age restrictions were lifted for almost all job categories. b. Employees can be forced to retire at age 70 years if their health is poor. c. Underage minors can be employed up to 20 hours per week. d. Individuals seeking retirement before the age of 60 years may be exempt from company pension plans. A nurse has over four decades of work experience and is weighing the benefits of retiring versus continuing to work. How will the Age Discrimination in Employment Act affect this nurse? a. The nurse may continue to work but must forfeit job security. b. The nurse will be required to retire once he or she turns 70 years. c. The nurse will be required to retire once he or she turns 65 years. d. The nurse may retire, or continue to work, as long as he or she is capable of performing the job. Equal Pay Act of 1963: made it so men and women should be paid the exact same as long as they are: - Performing the same amount of responsibility, performing the same skills, use the same amount of effort, and work under the same working conditions A senior manager is ensuring that organizational policies for compensation align with the Equal Pay Act of 1963. What domains of work should the manager examine? Select all that apply. a. The potential for promotion or advancement in the job b. The working conditions associated with the job c. The amount of responsibility that the job carries d. The effort that is required to perform the job e. The level of job satisfaction associated with the job f. The skill that is needed to perform the job Charge nurse vs. Supervisor - There has been debate on whether charge nurses can be considered supervisors. This classification is based on how often the nurse in question spends time as regular staff versus actually being a charge nurse. A situation has occurred in a health-care organization where it is important to determine whether a particular nurse is categorized as a “staff nurse” or as a supervisor. What criterion should be used to make this differentiation? a. The nurse’s position in the hierarchy of the unit based on years of experienced b. The nurse position on the organization’s salary scale c. The nurse’s level of influence on his or her peers and colleagues d. The percentage of time that the nurse spends as charge nurse versus giving direct client care Affirmative action - Program used to extend jobs to underemployed groups based on race or gender An affirmative action plan has been established in the jurisdiction where a nurse works. The nurse should understand what characteristic of this program? a. The terms of the plan are laid out in United States Equal Employment Opportunity legislation. b. It aims to prevent workplace discrimination on the basis of age or sexual orientation. c. It actively seeks members of underemployed groups to fill job vacancies. d. Few affirmative action programs still exist because they encourage reverse discrimination. Labor Standards: ensures that working conditions are up to code and safe for employees - Includes things like safety standards, certain number of hours the employee should work and when it is considered overtime or unsafe, and the way pay is determined/sent out - Labor laws also prevent employers from retaliating against employees who are a part of a union or strike During orientation to a new job, a nurse is reviewing the relevance of labor standards to the new position. What aspects of the job will these standards affect? Select all that apply. a. The number of hours that the nurse will work b. The nurse’s right to a safe workplace c. The way the nurse’s salary is determined and paid d. The nurse’s continuing education requirements e. The nurse’s accountability to his or her supervisor The managers of a clinic have been accused of creating an unpleasant work schedule and increased workload for a nurse who helped lead an unsuccessful union drive. How should the managers’ actions be best interpreted? a. Creating schedules and work assignment are valid management roles. b. These actions are violations of labor relations law. c. Management is within its rights but in violation of ethics standards. d. These actions are criminal offenses. Unions - From the nurse’s perspective o Can be helpful in collective bargaining o Can show united front to fight for better working conditions, pay, and benefits o Managers are not a part of the union o Unions form when managers are insensitive to employee needs - From the manager’s perspective o Can be disruptive to the normal flow of how decisions are made o It is in the best interest of management for unions NOT to exist o Ways to prevent union formation  Pay attention to staff needs, implement shared decisionmaking models, keep up with competitive wages and benefits A nurse executive wants to decrease the chances of unionization of the nursing service department. To accomplish this goal, where should financial and energy resources best be directed? a. Publicizing the potential cost and harm of unionization b. Increasing the quality and amount of equipment available to nurses c. Implementing a shared decision-making model in the department d. Emphasizing the identity of nursing as a “helping” profession that prioritizes others’ needs One of the nurses comes to the manager and reports, “I didn’t receive overtime pay when I acted as ambulance support last week. Our union contract says that we’re supposed to. Will you please follow up and see that I get the overtime on my next check?” What is this an example of? a. An issue around the implementation of a contract b. An employee contributing to a toxic workplace setting c. A formal grievance about a contract d. A problem that needs to be reported to the director of nursing immediately What event tends to be the primary reason for an increase in the numbers of unions being formed? a. Salaries are not keeping pace with the economy. b. Organizations are insensitive to employees’ needs. c. There is an economic downturn. d. Jobs are scarce. Quality Improvement Leapfrog Group - Computerized physician ordering system that helps reduce medical errors A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines? a. Replacing practical nurses with registered nurses whenever possible b. Eliminating the use of high-risk medications and increasing the role of pharmacists c. Purchasing a computerized physician–provider order entry system d. Converting shared rooms to single-occupant rooms Quality improvement is like the nursing process - You must first determine the criteria, collect data to see if those criteria are being met, then perform corrective action as necessary to meet the criteria A novice nurse-manager is a member of a team that will oversee quality control in a health-care organization. What action should the nurse and the other members off the team perform first? a. Take corrective action to address standards that are known to be challenging. b. Collect the essential data that will give a general overview of performance data. c. Determine the specific criteria and standards by which quality will be measured. d. Assign tasks between the team members to address identified standards. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) - Survey given to patients after discharge - Asks them questions about their hospital stay, the staff, and their overall experience A nurse-manager and several colleagues are reviewing the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These results will allow the team to make what assessment? a. The root causes of adverse incidents b. Clients’ perspectives on the care they received c. Consumers’ health outcomes at 3 and 6 months after discharge d. Clients’ health status at admission versus at discharge Clinical Practice Guidelines: a guide and set of interventions for providers to follow that is based on EBP and professional expertise A nurse-manager has referred staff members to a clinical practice guideline (CPG) that addresses the prevention of pressure ulcers. What is a characteristic of this CPG? a. The CPG will lay out the criteria that the health-care organization must meet in order to be reimbursed for treating a client’s pressure ulcer. b. It will describe interventions for nurses to follow in an effort to provide evidence-based care. c. It will describe the treatment for pressure ulcers that is provided at the best performing organizations. d. The CPG will summarize the etiology and diagnosis of pressure ulcers. Qualitative vs. Quantitative variables - Qualitative: surveys and opinions of patients - Quantitative: numerical data like readmission rates A nurse-manager is participating in a hospital’s quality control efforts and is collating data sources. What data source should the manager identify as a qualitative source? a. The hospital’s rate of nosocomial infections b. The hospital’s readmission rate c. Results of interviews with discharged clients d. The previous year’s budget for continuing education initiatives Nursing Specific Outcomes: patient related outcomes that are specifically affected by nursing care Lean Manufacturing: technology and machinery that promotes the most costeffective method of functioning that effectively utilizes resources to cut down on costs During a quality improvement initiative, the leadership of a health-care organization has worked with senior managers to implement the principles of Lean Manufacturing. This initiative will focus on what factor? a. Identifying sentinel events b. Identifying and preventing waste c. Engaging all staff members d. Performing root cause analysis of errors