Exam 1: NUR 204/ NUR204 (Latest 2025/ 2026 Update) Leadership and
Management Guide| Questions & Answers| Grade A| 100% Correct (Verified
Solutions)- Fortis
Question 1
A nurse manager is overseeing a busy medical-surgical unit. Which leadership style is most
effective when a "code blue" is called and immediate, decisive action is required?
A) Democratic
B) Laissez-faire
C) Authoritarian
D) Transformational
E) Transactional
Correct Answer: C) Authoritarian
Rationale: Authoritarian (or autocratic) leadership is characterized by individual control
over all decisions with little input from group members. While often viewed negatively in
routine settings, it is the most effective style during emergency situations (like a cardiac
arrest) because it allows for rapid decision-making and clear, direct orders that ensure life-
saving tasks are performed without delay.
Question 2
A Registered Nurse (RN) is delegating tasks to an Assistive Personnel (AP). Which task is
appropriate for the RN to delegate?
A) Performing an initial admission assessment on a stable patient.
B) Evaluating a patient’s response to pain medication administered 30 minutes ago.
C) Assisting a stable patient with ambulation for the first time post-surgery.
D) Monitoring the vital signs of a patient who just returned from a high-risk procedure.
E) Performing a clean-catch urine specimen collection on a stable patient.
Correct Answer: E) Performing a clean-catch urine specimen collection on a stable patient.
Rationale: Delegation is governed by the "Five Rights." An RN can delegate tasks that are
repetitive, non-invasive, and do not require nursing judgment to an AP. Collecting a urine
specimen is a technical, stable task. Initial assessments (A), evaluations (B), and monitoring
unstable or high-risk patients (D) require the specialized knowledge and judgment of an
RN. Assisting with the first ambulation post-surgery (C) is usually reserved for the RN to
assess for orthostatic hypotension.
Question 3
Which component of Lewin’s Change Theory involves the stage where the nurse manager
creates awareness of the need for change and builds a sense of urgency among staff?
A) Moving
B) Refreezing
C) Unfreezing
, 2
D) Transforming
E) Transitioning
Correct Answer: C) Unfreezing
Rationale: Lewin’s Change Theory consists of three stages. Unfreezing is the first stage,
where the leader helps the group become ready to change by identifying a problem and
demonstrating that the current "status quo" is no longer effective. Moving is the
implementation phase, and Refreezing is the final phase where the change is integrated into
the permanent culture of the unit.
Question 4
A nurse is assigned to four patients. Using the prioritization principle of "survival potential,"
which patient should the nurse see first?
A) A patient with a broken leg reporting pain of 8/10.
B) A patient with a chronic cough and a temperature of 101.2°F.
C) A patient who just had a seizure and is currently in the postictal state.
D) A patient with a suspected tension pneumothorax exhibiting tracheal deviation.
E) A patient requesting a discharge summary so they can leave the hospital.
Correct Answer: D) A patient with a suspected tension pneumothorax exhibiting tracheal
deviation.
Rationale: Priority should always follow ABCs (Airway, Breathing, Circulation). A tension
pneumothorax is a life-threatening "Breathing" emergency that can lead to obstructive
shock. This patient requires immediate intervention (needle decompression/chest tube) to
survive. The seizure patient (C) is the second priority, followed by the acute pain (A) and
the fever (B).
Question 5
A nurse manager is utilizing a "Transactional" leadership style. Which action best exemplifies
this style?
A) Inspiring the staff to achieve a shared vision of excellence.
B) Mentoring a new nurse to help them reach their personal career goals.
C) Offering a financial bonus to any nurse who works an extra weekend shift.
D) Collaborating with the team to develop a new unit-based protocol.
E) Allowing staff to make their own schedules with zero management oversight.
Correct Answer: C) Offering a financial bonus to any nurse who works an extra weekend
shift.
Rationale: Transactional leadership is based on a "quid pro quo" or exchange. The leader
motivates subordinates by offering rewards for performance or threatening punishment for
failure. Inspiring a vision (A) is Transformational. Allowing total freedom (E) is Laissez-
faire.
, 3
Question 6
A nurse is concerned about the legal implications of "battery." Which action by the nurse
constitutes battery?
A) Threatening to insert a nasogastric tube if the patient does not eat.
B) Discussing a patient's diagnosis in the hospital cafeteria with a colleague.
C) Administering an injection to a competent patient who has explicitly refused it.
D) Failing to check a patient’s identification band before giving medication.
E) Leaving a patient in soiled linens for an entire shift.
Correct Answer: C) Administering an injection to a competent patient who has explicitly
refused it.
Rationale: Battery is the intentional and wrongful physical contact with a person without
their consent that entails injury or offensive touching. Performing a procedure or giving a
medication after a patient has refused is battery. Threatening to do so (A) is assault.
Discussing private info (B) is a HIPAA violation. Failing to check ID (D) is
negligence/malpractice.
Question 7
What is the primary goal of the Quality Improvement (QI) process in a healthcare facility?
A) To identify and fire the individual responsible for a medical error.
B) To reduce the hospital's operational costs by cutting staff.
C) To improve patient outcomes by identifying and correcting system-wide problems.
D) To ensure that every nurse has a Master's degree.
E) To increase the number of patients seen per day in the emergency room.
Correct Answer: C) To improve patient outcomes by identifying and correcting system-wide
problems.
Rationale: Quality Improvement is a systematic, data-driven approach to improving the
quality of care. Unlike traditional "quality assurance," which often looks for individual
blame, QI focuses on system processes and how they can be refined to prevent errors and
improve the overall standard of care.
Question 8
A Registered Nurse is delegating to a Licensed Practical Nurse (LPN). Which task is within the
LPN’s scope of practice?
A) Developing the initial plan of care for a patient with new-onset heart failure.
B) Administering an IV bolus dose of a high-risk medication like Heparin.
C) Providing teaching to a patient about a new prescription for Lisinopril.
D) Monitoring a patient’s breath sounds and reinforcing previous teaching.
E) Assessing a patient who just returned from surgery with a sudden drop in blood pressure.
Management Guide| Questions & Answers| Grade A| 100% Correct (Verified
Solutions)- Fortis
Question 1
A nurse manager is overseeing a busy medical-surgical unit. Which leadership style is most
effective when a "code blue" is called and immediate, decisive action is required?
A) Democratic
B) Laissez-faire
C) Authoritarian
D) Transformational
E) Transactional
Correct Answer: C) Authoritarian
Rationale: Authoritarian (or autocratic) leadership is characterized by individual control
over all decisions with little input from group members. While often viewed negatively in
routine settings, it is the most effective style during emergency situations (like a cardiac
arrest) because it allows for rapid decision-making and clear, direct orders that ensure life-
saving tasks are performed without delay.
Question 2
A Registered Nurse (RN) is delegating tasks to an Assistive Personnel (AP). Which task is
appropriate for the RN to delegate?
A) Performing an initial admission assessment on a stable patient.
B) Evaluating a patient’s response to pain medication administered 30 minutes ago.
C) Assisting a stable patient with ambulation for the first time post-surgery.
D) Monitoring the vital signs of a patient who just returned from a high-risk procedure.
E) Performing a clean-catch urine specimen collection on a stable patient.
Correct Answer: E) Performing a clean-catch urine specimen collection on a stable patient.
Rationale: Delegation is governed by the "Five Rights." An RN can delegate tasks that are
repetitive, non-invasive, and do not require nursing judgment to an AP. Collecting a urine
specimen is a technical, stable task. Initial assessments (A), evaluations (B), and monitoring
unstable or high-risk patients (D) require the specialized knowledge and judgment of an
RN. Assisting with the first ambulation post-surgery (C) is usually reserved for the RN to
assess for orthostatic hypotension.
Question 3
Which component of Lewin’s Change Theory involves the stage where the nurse manager
creates awareness of the need for change and builds a sense of urgency among staff?
A) Moving
B) Refreezing
C) Unfreezing
, 2
D) Transforming
E) Transitioning
Correct Answer: C) Unfreezing
Rationale: Lewin’s Change Theory consists of three stages. Unfreezing is the first stage,
where the leader helps the group become ready to change by identifying a problem and
demonstrating that the current "status quo" is no longer effective. Moving is the
implementation phase, and Refreezing is the final phase where the change is integrated into
the permanent culture of the unit.
Question 4
A nurse is assigned to four patients. Using the prioritization principle of "survival potential,"
which patient should the nurse see first?
A) A patient with a broken leg reporting pain of 8/10.
B) A patient with a chronic cough and a temperature of 101.2°F.
C) A patient who just had a seizure and is currently in the postictal state.
D) A patient with a suspected tension pneumothorax exhibiting tracheal deviation.
E) A patient requesting a discharge summary so they can leave the hospital.
Correct Answer: D) A patient with a suspected tension pneumothorax exhibiting tracheal
deviation.
Rationale: Priority should always follow ABCs (Airway, Breathing, Circulation). A tension
pneumothorax is a life-threatening "Breathing" emergency that can lead to obstructive
shock. This patient requires immediate intervention (needle decompression/chest tube) to
survive. The seizure patient (C) is the second priority, followed by the acute pain (A) and
the fever (B).
Question 5
A nurse manager is utilizing a "Transactional" leadership style. Which action best exemplifies
this style?
A) Inspiring the staff to achieve a shared vision of excellence.
B) Mentoring a new nurse to help them reach their personal career goals.
C) Offering a financial bonus to any nurse who works an extra weekend shift.
D) Collaborating with the team to develop a new unit-based protocol.
E) Allowing staff to make their own schedules with zero management oversight.
Correct Answer: C) Offering a financial bonus to any nurse who works an extra weekend
shift.
Rationale: Transactional leadership is based on a "quid pro quo" or exchange. The leader
motivates subordinates by offering rewards for performance or threatening punishment for
failure. Inspiring a vision (A) is Transformational. Allowing total freedom (E) is Laissez-
faire.
, 3
Question 6
A nurse is concerned about the legal implications of "battery." Which action by the nurse
constitutes battery?
A) Threatening to insert a nasogastric tube if the patient does not eat.
B) Discussing a patient's diagnosis in the hospital cafeteria with a colleague.
C) Administering an injection to a competent patient who has explicitly refused it.
D) Failing to check a patient’s identification band before giving medication.
E) Leaving a patient in soiled linens for an entire shift.
Correct Answer: C) Administering an injection to a competent patient who has explicitly
refused it.
Rationale: Battery is the intentional and wrongful physical contact with a person without
their consent that entails injury or offensive touching. Performing a procedure or giving a
medication after a patient has refused is battery. Threatening to do so (A) is assault.
Discussing private info (B) is a HIPAA violation. Failing to check ID (D) is
negligence/malpractice.
Question 7
What is the primary goal of the Quality Improvement (QI) process in a healthcare facility?
A) To identify and fire the individual responsible for a medical error.
B) To reduce the hospital's operational costs by cutting staff.
C) To improve patient outcomes by identifying and correcting system-wide problems.
D) To ensure that every nurse has a Master's degree.
E) To increase the number of patients seen per day in the emergency room.
Correct Answer: C) To improve patient outcomes by identifying and correcting system-wide
problems.
Rationale: Quality Improvement is a systematic, data-driven approach to improving the
quality of care. Unlike traditional "quality assurance," which often looks for individual
blame, QI focuses on system processes and how they can be refined to prevent errors and
improve the overall standard of care.
Question 8
A Registered Nurse is delegating to a Licensed Practical Nurse (LPN). Which task is within the
LPN’s scope of practice?
A) Developing the initial plan of care for a patient with new-onset heart failure.
B) Administering an IV bolus dose of a high-risk medication like Heparin.
C) Providing teaching to a patient about a new prescription for Lisinopril.
D) Monitoring a patient’s breath sounds and reinforcing previous teaching.
E) Assessing a patient who just returned from surgery with a sudden drop in blood pressure.
