,2026/2027 Galen College of Nursing NUR282 Leadership and
Nursing Management Exam 4 | Questions, Answers & Detailed
Rationales.
1. During a staffing shortage, the charge nurse must redistribute assignments. Which principle should
guide the decision?
A) Give each nurse the same number of patients.
B) Assign by room location.
C) Give the newest nurse the easiest patients regardless of skill.
D) Match patient acuity and complexity with staff competence and available resources.
Correct Answer: Match patient acuity and complexity with staff competence and available resources.
Rationale: Safe assignment depends on more than patient numbers. Leaders must consider acuity,
complexity, staff scope, experience, competencies, workload, and available support.
2. An experienced RN is caring for an unstable patient when two additional admissions arrive. What is
the charge nurse's best action?
A) Require the RN to accept both admissions.
B) Delay all admission assessments.
C) Assign the admissions to assistive personnel.
D) Rebalance assignments so the RN can focus on the unstable patient.
Correct Answer: Rebalance assignments so the RN can focus on the unstable patient.
Rationale: Assignments should be adjusted as clinical conditions change. Protecting adequate nursing
attention for an unstable patient reduces the risk of missed deterioration.
3. A novice RN is available for a new assignment. Which patient is most appropriate?
A) Stable postoperative patient with predictable needs
B) Patient in cardiogenic shock
,C) Patient requiring titrated vasoactive infusions
D) Patient with rapidly changing neurologic findings
Correct Answer: Stable postoperative patient with predictable needs
Rationale: Newly licensed nurses should generally receive stable, predictable assignments while
developing experience with prioritization and complex clinical judgment.
4. A float nurse from a medical unit is assigned to a specialty area. Before assigning a complex
therapy, the charge nurse should:
A) Verify the nurse's competency with the therapy.
B) Assume all RNs have identical specialty skills.
C) Assign the therapy based on seniority.
D) Avoid asking about previous experience.
Correct Answer: Verify the nurse's competency with the therapy.
Rationale: Licensure establishes a professional role but does not guarantee competence with every
specialty procedure. Assignment decisions should reflect demonstrated ability.
5. Several nurses report that an assignment is unsafe. What should the nurse manager do first?
A) Objectively review patient acuity, workload, and staff capability.
B) Tell staff to work faster.
C) Ignore the complaint.
D) document the concern without evaluating it.
Correct Answer: Objectively review patient acuity, workload, and staff capability.
Rationale: Staffing concerns should be evaluated against actual patient-care needs and staff
resources. If risk remains, leaders should use appropriate escalation channels.
, 6. An LPN/LVN is available to receive an assignment. Which patient is generally most appropriate?
A) Newly admitted patient requiring a comprehensive assessment
B) Stable patient requiring routine medications and treatments
C) Patient with rapidly deteriorating respiratory status
D) Patient needing initial teaching after a new diagnosis
Correct Answer: Stable patient requiring routine medications and treatments
Rationale: LPN/LVN practice commonly involves stable patients with predictable outcomes and
routine treatments, subject to applicable law and organizational policy.
7. A stable patient needs help ambulating to the bathroom. Which task is appropriate to delegate to
trained assistive personnel?
A) Assist with ambulation and report dizziness or weakness.
B) Determine whether the patient is safe to ambulate independently.
C) Evaluate orthostatic hypotension.
D) Revise the patient's fall-prevention plan.
Correct Answer: Assist with ambulation and report dizziness or weakness.
Rationale: Routine mobility assistance can be delegated for a stable patient, while assessment,
evaluation, and care planning remain nursing responsibilities.
8. After delegating routine vital signs, what remains the RN's responsibility?
A) Nothing, because the task was delegated
B) Repeating every vital sign personally
C) Reviewing abnormal results and initiating appropriate follow-up
D) Transferring accountability permanently
Nursing Management Exam 4 | Questions, Answers & Detailed
Rationales.
1. During a staffing shortage, the charge nurse must redistribute assignments. Which principle should
guide the decision?
A) Give each nurse the same number of patients.
B) Assign by room location.
C) Give the newest nurse the easiest patients regardless of skill.
D) Match patient acuity and complexity with staff competence and available resources.
Correct Answer: Match patient acuity and complexity with staff competence and available resources.
Rationale: Safe assignment depends on more than patient numbers. Leaders must consider acuity,
complexity, staff scope, experience, competencies, workload, and available support.
2. An experienced RN is caring for an unstable patient when two additional admissions arrive. What is
the charge nurse's best action?
A) Require the RN to accept both admissions.
B) Delay all admission assessments.
C) Assign the admissions to assistive personnel.
D) Rebalance assignments so the RN can focus on the unstable patient.
Correct Answer: Rebalance assignments so the RN can focus on the unstable patient.
Rationale: Assignments should be adjusted as clinical conditions change. Protecting adequate nursing
attention for an unstable patient reduces the risk of missed deterioration.
3. A novice RN is available for a new assignment. Which patient is most appropriate?
A) Stable postoperative patient with predictable needs
B) Patient in cardiogenic shock
,C) Patient requiring titrated vasoactive infusions
D) Patient with rapidly changing neurologic findings
Correct Answer: Stable postoperative patient with predictable needs
Rationale: Newly licensed nurses should generally receive stable, predictable assignments while
developing experience with prioritization and complex clinical judgment.
4. A float nurse from a medical unit is assigned to a specialty area. Before assigning a complex
therapy, the charge nurse should:
A) Verify the nurse's competency with the therapy.
B) Assume all RNs have identical specialty skills.
C) Assign the therapy based on seniority.
D) Avoid asking about previous experience.
Correct Answer: Verify the nurse's competency with the therapy.
Rationale: Licensure establishes a professional role but does not guarantee competence with every
specialty procedure. Assignment decisions should reflect demonstrated ability.
5. Several nurses report that an assignment is unsafe. What should the nurse manager do first?
A) Objectively review patient acuity, workload, and staff capability.
B) Tell staff to work faster.
C) Ignore the complaint.
D) document the concern without evaluating it.
Correct Answer: Objectively review patient acuity, workload, and staff capability.
Rationale: Staffing concerns should be evaluated against actual patient-care needs and staff
resources. If risk remains, leaders should use appropriate escalation channels.
, 6. An LPN/LVN is available to receive an assignment. Which patient is generally most appropriate?
A) Newly admitted patient requiring a comprehensive assessment
B) Stable patient requiring routine medications and treatments
C) Patient with rapidly deteriorating respiratory status
D) Patient needing initial teaching after a new diagnosis
Correct Answer: Stable patient requiring routine medications and treatments
Rationale: LPN/LVN practice commonly involves stable patients with predictable outcomes and
routine treatments, subject to applicable law and organizational policy.
7. A stable patient needs help ambulating to the bathroom. Which task is appropriate to delegate to
trained assistive personnel?
A) Assist with ambulation and report dizziness or weakness.
B) Determine whether the patient is safe to ambulate independently.
C) Evaluate orthostatic hypotension.
D) Revise the patient's fall-prevention plan.
Correct Answer: Assist with ambulation and report dizziness or weakness.
Rationale: Routine mobility assistance can be delegated for a stable patient, while assessment,
evaluation, and care planning remain nursing responsibilities.
8. After delegating routine vital signs, what remains the RN's responsibility?
A) Nothing, because the task was delegated
B) Repeating every vital sign personally
C) Reviewing abnormal results and initiating appropriate follow-up
D) Transferring accountability permanently
