NR 446 Nursing Leadership Exam 4 Study Guide 2026 |Chamberlain
College
1. A nurse is delegating tasks to an Assistive Personnel (AP). Which task is
appropriate for the nurse to delegate?
A. Evaluating a client’s response to pain medication
B. Assisting a client with a sitz bath
C. Teaching a client how to use an incentive spirometer
D. Assessing a client’s skin breakdown
Answer: B
Rationale: Assisting a client with hygiene and ADLs, such as a sitz bath, is within the scope
of practice for an AP. Evaluation, teaching, and assessment require the judgment of a
licensed nurse.
2. A nurse manager is using transformational leadership. Which behavior is
characteristic of this style?
A. Rewarding staff for meeting specific productivity goals
B. Focusing on day-to-day operations and maintenance
C. Empowering staff to participate in decision-making and vision
D. Correcting staff errors immediately to maintain standards
Answer: C
Rationale: Transformational leaders focus on inspiring and empowering staff to contribute
to a shared vision, whereas transactional leaders focus on tasks and rewards.
,3. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a 10-cm abdominal incision needing a dressing change
B. A client who is 2 days postoperative and reporting a pain level of 4 on a scale of 0 to 10
C. A client who had a hip arthroplasty and is reporting sudden shortness of breath
D. A client who is scheduled for discharge in 2 hours and needs prescriptions
Answer: C
Rationale: Shortness of breath indicates a potential pulmonary embolism or respiratory
distress, which is an airway/breathing priority over stable postoperative care or discharge
planning.
4. A nurse is planning a presentation about conflict resolution. Which style
involves both parties giving up something to reach a solution?
A. Competing
B. Collaborating
C. Compromising
D. Smoothing
Answer: C
Rationale: Compromising is the ‘lose-lose’ or ‘give-and-take’ strategy where both parties
sacrifice something to reach a middle-ground agreement.
5. Which of the following describes the ethical principle of veracity?
A. The duty to do no harm to the client
B. The duty to be fair to all clients
C. The right of the client to make their own decisions
D. The obligation to tell the truth
Answer: D
Rationale: Veracity refers to the nurse’s obligation to be truthful and honest with clients
and colleagues.
, 6. A nurse manager is implementing a new policy. According to Lewin’s Change
Theory, which stage involves creating awareness of the need for change?
A. Unfreezing
B. Refreezing
C. Moving
D. Stabilizing
Answer: A
Rationale: Unfreezing is the initial stage where the leader creates motivation for change by
identifying the problem and preparing the staff.
7. A nurse is providing care to a client who refuses a blood transfusion for
religious reasons. Which ethical principle is the nurse supporting?
A. Justice
B. Fidelity
C. Beneficence
D. Autonomy
Answer: D
Rationale: Autonomy is the right of the individual to make their own healthcare decisions,
even if those decisions differ from the provider’s recommendations.
8. A nurse forgets to administer a scheduled dose of an anticoagulant, and the
client later develops a deep vein thrombosis. This is an example of which legal
concept?
A. Battery
B. Assault
C. Negligence
D. False imprisonment
Answer: C
College
1. A nurse is delegating tasks to an Assistive Personnel (AP). Which task is
appropriate for the nurse to delegate?
A. Evaluating a client’s response to pain medication
B. Assisting a client with a sitz bath
C. Teaching a client how to use an incentive spirometer
D. Assessing a client’s skin breakdown
Answer: B
Rationale: Assisting a client with hygiene and ADLs, such as a sitz bath, is within the scope
of practice for an AP. Evaluation, teaching, and assessment require the judgment of a
licensed nurse.
2. A nurse manager is using transformational leadership. Which behavior is
characteristic of this style?
A. Rewarding staff for meeting specific productivity goals
B. Focusing on day-to-day operations and maintenance
C. Empowering staff to participate in decision-making and vision
D. Correcting staff errors immediately to maintain standards
Answer: C
Rationale: Transformational leaders focus on inspiring and empowering staff to contribute
to a shared vision, whereas transactional leaders focus on tasks and rewards.
,3. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a 10-cm abdominal incision needing a dressing change
B. A client who is 2 days postoperative and reporting a pain level of 4 on a scale of 0 to 10
C. A client who had a hip arthroplasty and is reporting sudden shortness of breath
D. A client who is scheduled for discharge in 2 hours and needs prescriptions
Answer: C
Rationale: Shortness of breath indicates a potential pulmonary embolism or respiratory
distress, which is an airway/breathing priority over stable postoperative care or discharge
planning.
4. A nurse is planning a presentation about conflict resolution. Which style
involves both parties giving up something to reach a solution?
A. Competing
B. Collaborating
C. Compromising
D. Smoothing
Answer: C
Rationale: Compromising is the ‘lose-lose’ or ‘give-and-take’ strategy where both parties
sacrifice something to reach a middle-ground agreement.
5. Which of the following describes the ethical principle of veracity?
A. The duty to do no harm to the client
B. The duty to be fair to all clients
C. The right of the client to make their own decisions
D. The obligation to tell the truth
Answer: D
Rationale: Veracity refers to the nurse’s obligation to be truthful and honest with clients
and colleagues.
, 6. A nurse manager is implementing a new policy. According to Lewin’s Change
Theory, which stage involves creating awareness of the need for change?
A. Unfreezing
B. Refreezing
C. Moving
D. Stabilizing
Answer: A
Rationale: Unfreezing is the initial stage where the leader creates motivation for change by
identifying the problem and preparing the staff.
7. A nurse is providing care to a client who refuses a blood transfusion for
religious reasons. Which ethical principle is the nurse supporting?
A. Justice
B. Fidelity
C. Beneficence
D. Autonomy
Answer: D
Rationale: Autonomy is the right of the individual to make their own healthcare decisions,
even if those decisions differ from the provider’s recommendations.
8. A nurse forgets to administer a scheduled dose of an anticoagulant, and the
client later develops a deep vein thrombosis. This is an example of which legal
concept?
A. Battery
B. Assault
C. Negligence
D. False imprisonment
Answer: C
