NUR 219 LEADERSHIP AND MANAGEMENT EXAM GUIDE WITH
QUESTIONS AND CORRECT ANSWERS 2026 Q&A
A nurse manager is attempting to implement a new evidence-based
practice protocol on her unit. Which leadership style would be MOST
effective for gaining staff buy-in and ensuring successful
implementation?
A. Autocratic leadership
B. Transformational leadership
C. Laissez-faire leadership
D. Transactional leadership
Correct Answer: B
Explanation: Transformational leadership inspires and motivates staff
through vision, intellectual stimulation, and individualized
consideration, making it most effective for change management and
evidence-based practice implementation. Autocratic leadership (A)
excludes staff input, laissez-faire (C) lacks direction, and transactional
(D) focuses on rewards/punishments rather than intrinsic motivation.
During a shift report, a nurse discovers that a medication error occurred
2 hours ago but was not documented. The patient received the wrong
dose but is currently stable. What is the FIRST action the nurse manager
should take?
A. Document the error in the incident reporting system
B. Assess the patient for any adverse effects
C. Meet with the staff nurse to discuss the error
D. Notify the physician and pharmacy immediately
Correct Answer: B
,Explanation: Patient safety is the priority. The FIRST action is to assess
the patient for harm before any documentation or confrontation. After
assessment, the nurse should notify the physician (D), document the
incident (A), and then meet with the staff nurse (C) for education and
corrective action.
A charge nurse needs to delegate tasks for a 12-hour shift on a medical-
surgical unit. Which task is MOST appropriate to delegate to an
experienced licensed practical nurse (LPN)?
A. Admission assessment of a newly admitted patient with chest pain
B. Administration of IV push morphine to a postoperative patient
C. Administration of oral antibiotics to a stable patient with pneumonia
D. Development of a discharge teaching plan for a diabetic patient
Correct Answer: C
Explanation: LPNs can administer oral medications to stable patients. IV
push medications (B) require RN-level knowledge, admission
assessments (A) are RN responsibilities, and discharge planning (D)
involves complex teaching requiring RN scope. The LPN's role is focused
on stable patients with predictable outcomes.
A nurse manager notices that two staff nurses have a persistent conflict
affecting unit morale. The conflict involves personality differences and
communication breakdowns. Which conflict resolution strategy should
the manager employ FIRST?
A. Mediation by involving a neutral third party
B. Arbitration with a binding decision
C. Collaboration to find a win-win solution
,D. Separation of the two nurses on different shifts
Correct Answer: C
Explanation: Collaboration (problem-solving) is the most effective first
approach for interpersonal conflicts as it addresses the root cause and
strengthens relationships. Mediation (A) is used when direct
collaboration fails. Arbitration (B) is authoritative and may damage
relationships. Separation (D) avoids the problem rather than resolving
it.
According to Hersey and Blanchard's Situational Leadership Theory,
which leadership style is MOST appropriate for a newly graduated nurse
who is competent but lacks confidence?
A. Telling (high task, low relationship)
B. Selling (high task, high relationship)
C. Participating (low task, high relationship)
D. Delegating (low task, low relationship)
Correct Answer: B
Explanation: A new graduate with some competence but low confidence
is at the "decisive beginner" or "disillusioned learner" stage, requiring
high task direction and high relationship support (selling style). Telling
(A) is for beginners with no competence. Participating (C) is for capable
but hesitant performers. Delegating (D) is for highly competent,
confident performers.
A hospital is transitioning from a functional nursing model to a primary
nursing model. Which outcome should the nurse manager EXPECT from
this change?
, A. Decreased cost of patient care
B. Increased nurse autonomy and accountability
C. Reduced need for charge nurses
D. Decreased documentation requirements
Correct Answer: B
Explanation: Primary nursing increases nurse autonomy and
accountability as one RN assumes 24-hour responsibility for a patient's
care plan. Costs typically increase (A) due to higher RN staffing. Charge
nurses are still needed (C). Documentation often increases (D) due to
comprehensive care planning responsibilities.
During a budget meeting, the finance director informs the nurse
manager that the unit must reduce staffing costs by 10% without
compromising patient safety. Which strategy demonstrates effective
cost containment while maintaining quality?
A. Reducing the number of RNs and replacing them with unlicensed
assistive personnel
B. Implementing flexible staffing based on patient acuity and census
C. Eliminating all continuing education funds for staff
D. Reducing supply costs by 20% across all patient care areas
Correct Answer: B
Explanation: Flexible/acuity-based staffing aligns resources with patient
needs, reducing costs while maintaining safety. Replacing RNs with UAP
(A) compromises care quality. Eliminating education (C) increases errors
long-term. Reducing supplies by 20% (D) may impact patient care and is
not targeted.
QUESTIONS AND CORRECT ANSWERS 2026 Q&A
A nurse manager is attempting to implement a new evidence-based
practice protocol on her unit. Which leadership style would be MOST
effective for gaining staff buy-in and ensuring successful
implementation?
A. Autocratic leadership
B. Transformational leadership
C. Laissez-faire leadership
D. Transactional leadership
Correct Answer: B
Explanation: Transformational leadership inspires and motivates staff
through vision, intellectual stimulation, and individualized
consideration, making it most effective for change management and
evidence-based practice implementation. Autocratic leadership (A)
excludes staff input, laissez-faire (C) lacks direction, and transactional
(D) focuses on rewards/punishments rather than intrinsic motivation.
During a shift report, a nurse discovers that a medication error occurred
2 hours ago but was not documented. The patient received the wrong
dose but is currently stable. What is the FIRST action the nurse manager
should take?
A. Document the error in the incident reporting system
B. Assess the patient for any adverse effects
C. Meet with the staff nurse to discuss the error
D. Notify the physician and pharmacy immediately
Correct Answer: B
,Explanation: Patient safety is the priority. The FIRST action is to assess
the patient for harm before any documentation or confrontation. After
assessment, the nurse should notify the physician (D), document the
incident (A), and then meet with the staff nurse (C) for education and
corrective action.
A charge nurse needs to delegate tasks for a 12-hour shift on a medical-
surgical unit. Which task is MOST appropriate to delegate to an
experienced licensed practical nurse (LPN)?
A. Admission assessment of a newly admitted patient with chest pain
B. Administration of IV push morphine to a postoperative patient
C. Administration of oral antibiotics to a stable patient with pneumonia
D. Development of a discharge teaching plan for a diabetic patient
Correct Answer: C
Explanation: LPNs can administer oral medications to stable patients. IV
push medications (B) require RN-level knowledge, admission
assessments (A) are RN responsibilities, and discharge planning (D)
involves complex teaching requiring RN scope. The LPN's role is focused
on stable patients with predictable outcomes.
A nurse manager notices that two staff nurses have a persistent conflict
affecting unit morale. The conflict involves personality differences and
communication breakdowns. Which conflict resolution strategy should
the manager employ FIRST?
A. Mediation by involving a neutral third party
B. Arbitration with a binding decision
C. Collaboration to find a win-win solution
,D. Separation of the two nurses on different shifts
Correct Answer: C
Explanation: Collaboration (problem-solving) is the most effective first
approach for interpersonal conflicts as it addresses the root cause and
strengthens relationships. Mediation (A) is used when direct
collaboration fails. Arbitration (B) is authoritative and may damage
relationships. Separation (D) avoids the problem rather than resolving
it.
According to Hersey and Blanchard's Situational Leadership Theory,
which leadership style is MOST appropriate for a newly graduated nurse
who is competent but lacks confidence?
A. Telling (high task, low relationship)
B. Selling (high task, high relationship)
C. Participating (low task, high relationship)
D. Delegating (low task, low relationship)
Correct Answer: B
Explanation: A new graduate with some competence but low confidence
is at the "decisive beginner" or "disillusioned learner" stage, requiring
high task direction and high relationship support (selling style). Telling
(A) is for beginners with no competence. Participating (C) is for capable
but hesitant performers. Delegating (D) is for highly competent,
confident performers.
A hospital is transitioning from a functional nursing model to a primary
nursing model. Which outcome should the nurse manager EXPECT from
this change?
, A. Decreased cost of patient care
B. Increased nurse autonomy and accountability
C. Reduced need for charge nurses
D. Decreased documentation requirements
Correct Answer: B
Explanation: Primary nursing increases nurse autonomy and
accountability as one RN assumes 24-hour responsibility for a patient's
care plan. Costs typically increase (A) due to higher RN staffing. Charge
nurses are still needed (C). Documentation often increases (D) due to
comprehensive care planning responsibilities.
During a budget meeting, the finance director informs the nurse
manager that the unit must reduce staffing costs by 10% without
compromising patient safety. Which strategy demonstrates effective
cost containment while maintaining quality?
A. Reducing the number of RNs and replacing them with unlicensed
assistive personnel
B. Implementing flexible staffing based on patient acuity and census
C. Eliminating all continuing education funds for staff
D. Reducing supply costs by 20% across all patient care areas
Correct Answer: B
Explanation: Flexible/acuity-based staffing aligns resources with patient
needs, reducing costs while maintaining safety. Replacing RNs with UAP
(A) compromises care quality. Eliminating education (C) increases errors
long-term. Reducing supplies by 20% (D) may impact patient care and is
not targeted.
