NR446 Exam 1 Actual Exam Style V3 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is implementing a new EHR system and encounters resistance from staff.
Which action represents the ‘Unfreezing’ stage of Lewin’s Change Theory?
A. Sharing data showing that current paper charting leads to medication errors.
B. Providing hands-on training for the new system.
C. Updating the policy manual to include the new EHR requirements.
D. Rewarding staff who adopt the new system early.
Answer: A
Rationale: Unfreezing involves creating readiness for change by helping others realize that
the current status quo is no longer effective. By sharing data on medication errors, the
manager highlights the need for improvement and disruption of current habits. This stage
is crucial for overcoming resistance before new processes are introduced.
2. The nurse is prioritizing care for four patients. Which patient should the nurse assess first?
A. A patient with a history of heart failure who has 2+ pitting edema in both ankles.
B. A patient with COPD who has an oxygen saturation of 91% on room air.
C. A patient with asthma who is experiencing intercostal retractions and a high-pitched
wheeze.
,D. A patient who is 1 day post-appendectomy and reports pain as 6 out of 10.
Answer: C
Rationale: Airway and breathing are the highest priorities according to the ABC
framework. The patient with asthma and retractions is showing signs of acute respiratory
distress and potential airway obstruction. The other patients, while requiring care, are
currently more stable than a patient with active respiratory compromise.
3. Which task is most appropriate for the RN to delegate to an experienced Unlicensed
Assistive Personnel (UAP)?
A. Recording the intake and output for a patient on a fluid restriction.
B. Checking the residual volume of a patient’s nasogastric tube.
C. Assisting a stable patient with their first ambulation after surgery.
D. Evaluating the patient’s response to an anti-anxiety medication.
Answer: A
Rationale: Recording intake and output is a routine, non-invasive task that does not
require clinical judgment. First-time ambulation after surgery requires an assessment of
stability by the RN to ensure safety. Evaluation and gastric tube management are tasks that
fall under the RN scope of practice and cannot be delegated to UAPs.
4. A nurse manager encourages staff participation in decision-making and values the input of
every team member. Which leadership style is this?
A. Autocratic
, B. Laissez-faire
C. Democratic
D. Transactional
Answer: C
Rationale: The democratic leadership style focuses on collaboration and shared decision-
making within the team. This approach often leads to higher staff satisfaction and
engagement because employees feel their voices are heard. It contrasts with autocratic
leadership, where the leader makes all decisions without input.
5. A patient refuses to take a prescribed medication because they do not like the side effects.
The nurse respects this decision. Which ethical principle is being applied?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Answer: B
Rationale: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare. The nurse’s role is to provide information and support the
patient’s choice, even if it contradicts medical advice. This principle is fundamental to
patient-centered care and informed consent.
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is implementing a new EHR system and encounters resistance from staff.
Which action represents the ‘Unfreezing’ stage of Lewin’s Change Theory?
A. Sharing data showing that current paper charting leads to medication errors.
B. Providing hands-on training for the new system.
C. Updating the policy manual to include the new EHR requirements.
D. Rewarding staff who adopt the new system early.
Answer: A
Rationale: Unfreezing involves creating readiness for change by helping others realize that
the current status quo is no longer effective. By sharing data on medication errors, the
manager highlights the need for improvement and disruption of current habits. This stage
is crucial for overcoming resistance before new processes are introduced.
2. The nurse is prioritizing care for four patients. Which patient should the nurse assess first?
A. A patient with a history of heart failure who has 2+ pitting edema in both ankles.
B. A patient with COPD who has an oxygen saturation of 91% on room air.
C. A patient with asthma who is experiencing intercostal retractions and a high-pitched
wheeze.
,D. A patient who is 1 day post-appendectomy and reports pain as 6 out of 10.
Answer: C
Rationale: Airway and breathing are the highest priorities according to the ABC
framework. The patient with asthma and retractions is showing signs of acute respiratory
distress and potential airway obstruction. The other patients, while requiring care, are
currently more stable than a patient with active respiratory compromise.
3. Which task is most appropriate for the RN to delegate to an experienced Unlicensed
Assistive Personnel (UAP)?
A. Recording the intake and output for a patient on a fluid restriction.
B. Checking the residual volume of a patient’s nasogastric tube.
C. Assisting a stable patient with their first ambulation after surgery.
D. Evaluating the patient’s response to an anti-anxiety medication.
Answer: A
Rationale: Recording intake and output is a routine, non-invasive task that does not
require clinical judgment. First-time ambulation after surgery requires an assessment of
stability by the RN to ensure safety. Evaluation and gastric tube management are tasks that
fall under the RN scope of practice and cannot be delegated to UAPs.
4. A nurse manager encourages staff participation in decision-making and values the input of
every team member. Which leadership style is this?
A. Autocratic
, B. Laissez-faire
C. Democratic
D. Transactional
Answer: C
Rationale: The democratic leadership style focuses on collaboration and shared decision-
making within the team. This approach often leads to higher staff satisfaction and
engagement because employees feel their voices are heard. It contrasts with autocratic
leadership, where the leader makes all decisions without input.
5. A patient refuses to take a prescribed medication because they do not like the side effects.
The nurse respects this decision. Which ethical principle is being applied?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Answer: B
Rationale: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare. The nurse’s role is to provide information and support the
patient’s choice, even if it contradicts medical advice. This principle is fundamental to
patient-centered care and informed consent.
