Nurse Executive,
Advanced Certification
(NEA-BC®) Exam
1. A nurse executive wants to improve interdisciplinary collaboration across units.
Which strategy is MOST effective?
A. Require weekly staff meetings on every unit
B. Implement structured interprofessional bedside rounds
C. Have nurse managers report communication issues monthly
D. Add collaboration to performance evaluations
Answer: B
Rationale: Structured interprofessional bedside rounds directly improve
communication, align care goals, and reduce fragmentation.
2. The organization is transitioning to a shared governance model. What is the FIRST
step?
A. Develop bylaws for the shared governance councils
B. Assess staff readiness and organizational culture
C. Train unit representatives on decision-making
D. Establish the professional practice council
Answer: B
,Rationale: Assessing readiness ensures shared governance structures are built on a
realistic understanding of culture, barriers, and facilitators.
3. The nurse executive wants to evaluate leadership succession planning. Which
metric is MOST relevant?
A. Overtime hours
B. Nurse vacancy rate
C. Internal promotion rate
D. Patient satisfaction scores
Answer: C
Rationale: Internal promotion rate directly reflects the effectiveness of succession
planning.
4. A nurse manager reports high turnover among new graduate nurses. Which
intervention BEST supports retention?
A. Increased staffing ratios
B. Competency-based orientation with mentorship
C. Quarterly discipline-based workshops
D. Mandatory overtime reduction
Answer: B
Rationale: Mentorship plus competency-based orientation strengthens confidence
and reduces early turnover.
5. Which financial statement should a nurse executive use to analyze organizational
profitability?
A. Balance sheet
B. Operating budget
,C. Income statement
D. Cash flow projection
Answer: C
Rationale: The income statement (profit & loss) shows revenues, expenses, and net
profit.
6. A health system is implementing a new EHR. What is the nurse executive’s primary
responsibility?
A. Select technical configurations
B. Ensure nursing workflow integration and usability
C. Train the IT team
D. Approve vendor contract pricing
Answer: B
Rationale: Nurse executives safeguard that the EHR aligns with clinical workflow and
supports patient safety and quality.
7. Which outcome BEST indicates a healthy work environment?
A. Low capital expenses
B. High productivity standards
C. Low nurse burnout and moral distress
D. Mandatory cross-training
Answer: C
Rationale: Burnout and moral distress are leading indicators of culture, staffing
adequacy, and work environment health.
8. A chief nursing officer (CNO) wants to reduce hospital-acquired pressure injuries
(HAPIs). What is the MOST appropriate leadership approach?
, A. Delegate responsibility to wound care nurses
B. Create a multidisciplinary performance improvement team
C. Implement staff penalties for incomplete assessments
D. Require daily skin audits on all units
Answer: B
Rationale: Multidisciplinary teams address system-level factors (equipment,
workflow, education, accountability).
9. A nurse leader uses transformational leadership. Which behavior demonstrates
this style?
A. Enforcing policy compliance
B. Using transactional rewards
C. Inspiring staff with a shared vision
D. Increasing staff oversight
Answer: C
Rationale: Transformational leaders motivate, inspire, and empower employees
through a shared vision.
10. The CNO must justify adding FTEs based on workload. Which tool is MOST
appropriate?
A. Balanced scorecard
B. Patient acuity system
C. Employee engagement survey
D. Daily productivity tracking
Answer: B
Advanced Certification
(NEA-BC®) Exam
1. A nurse executive wants to improve interdisciplinary collaboration across units.
Which strategy is MOST effective?
A. Require weekly staff meetings on every unit
B. Implement structured interprofessional bedside rounds
C. Have nurse managers report communication issues monthly
D. Add collaboration to performance evaluations
Answer: B
Rationale: Structured interprofessional bedside rounds directly improve
communication, align care goals, and reduce fragmentation.
2. The organization is transitioning to a shared governance model. What is the FIRST
step?
A. Develop bylaws for the shared governance councils
B. Assess staff readiness and organizational culture
C. Train unit representatives on decision-making
D. Establish the professional practice council
Answer: B
,Rationale: Assessing readiness ensures shared governance structures are built on a
realistic understanding of culture, barriers, and facilitators.
3. The nurse executive wants to evaluate leadership succession planning. Which
metric is MOST relevant?
A. Overtime hours
B. Nurse vacancy rate
C. Internal promotion rate
D. Patient satisfaction scores
Answer: C
Rationale: Internal promotion rate directly reflects the effectiveness of succession
planning.
4. A nurse manager reports high turnover among new graduate nurses. Which
intervention BEST supports retention?
A. Increased staffing ratios
B. Competency-based orientation with mentorship
C. Quarterly discipline-based workshops
D. Mandatory overtime reduction
Answer: B
Rationale: Mentorship plus competency-based orientation strengthens confidence
and reduces early turnover.
5. Which financial statement should a nurse executive use to analyze organizational
profitability?
A. Balance sheet
B. Operating budget
,C. Income statement
D. Cash flow projection
Answer: C
Rationale: The income statement (profit & loss) shows revenues, expenses, and net
profit.
6. A health system is implementing a new EHR. What is the nurse executive’s primary
responsibility?
A. Select technical configurations
B. Ensure nursing workflow integration and usability
C. Train the IT team
D. Approve vendor contract pricing
Answer: B
Rationale: Nurse executives safeguard that the EHR aligns with clinical workflow and
supports patient safety and quality.
7. Which outcome BEST indicates a healthy work environment?
A. Low capital expenses
B. High productivity standards
C. Low nurse burnout and moral distress
D. Mandatory cross-training
Answer: C
Rationale: Burnout and moral distress are leading indicators of culture, staffing
adequacy, and work environment health.
8. A chief nursing officer (CNO) wants to reduce hospital-acquired pressure injuries
(HAPIs). What is the MOST appropriate leadership approach?
, A. Delegate responsibility to wound care nurses
B. Create a multidisciplinary performance improvement team
C. Implement staff penalties for incomplete assessments
D. Require daily skin audits on all units
Answer: B
Rationale: Multidisciplinary teams address system-level factors (equipment,
workflow, education, accountability).
9. A nurse leader uses transformational leadership. Which behavior demonstrates
this style?
A. Enforcing policy compliance
B. Using transactional rewards
C. Inspiring staff with a shared vision
D. Increasing staff oversight
Answer: C
Rationale: Transformational leaders motivate, inspire, and empower employees
through a shared vision.
10. The CNO must justify adding FTEs based on workload. Which tool is MOST
appropriate?
A. Balanced scorecard
B. Patient acuity system
C. Employee engagement survey
D. Daily productivity tracking
Answer: B
