NR 446 Nursing Leadership Final Exam Practice 2026 |Chamberlain
College
1. A nurse manager is known for making decisions independently without
consulting the staff. Which leadership style is this nurse demonstrating?
A. Transformational
B. Autocratic
C. Democratic
D. Laissez-faire
Answer: B
Rationale: Autocratic leadership involves the leader making decisions without input from
the group, often used in emergency situations.
2. Which task is most appropriate for a nurse to delegate to an unlicensed
assistive personnel (UAP)?
A. Assessing a new admission’s skin integrity
B. Administering an oral medication
C. Assisting a stable patient with ambulation
D. Teaching a patient how to use an incentive spirometer
Answer: C
Rationale: UAPs can perform routine tasks for stable patients such as ADLs and
ambulation. Assessment, medication, and teaching are nursing responsibilities.
,3. According to Maslow’s Hierarchy of Needs, which patient should the nurse
see first?
A. A patient requesting a PRN pain medication
B. A patient who is experiencing shortness of breath
C. A patient who is lonely and wants to talk
D. A patient who needs discharge instructions
Answer: B
Rationale: Physiological needs like breathing (Airway, Breathing, Circulation) always take
priority over safety, social, or esteem needs.
4. In the SBAR communication tool, the ‘B’ stands for:
A. Briefing
B. Basics
C. Behavior
D. Background
Answer: D
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation,
which provides a structured way to relay patient information.
5. A nurse respects a patient’s decision to refuse a life-saving blood transfusion
due to religious beliefs. Which ethical principle is the nurse upholding?
A. Justice
B. Beneficence
C. Autonomy
D. Nonmaleficence
Answer: C
Rationale: Autonomy is the right of the patient to make their own healthcare decisions
even if the provider disagrees.
, 6. What is the primary focus of transformational leadership?
A. Empowering others to achieve a shared vision
B. Maintaining the status quo through rewards and punishments
C. Focusing strictly on task completion
D. Avoiding involvement in staff issues
Answer: A
Rationale: Transformational leaders inspire and motivate followers to go beyond
expectations and focus on a shared vision for the future.
7. During a conflict, one nurse agrees to give up their holiday shift in exchange
for a weekend off later. This is an example of:
A. Compromising
B. Avoiding
C. Competing
D. Collaborating
Answer: A
Rationale: Compromising involves each party giving up something to reach a mutually
acceptable agreement.
8. Which of the following is an example of a sentinel event?
A. A patient falling without injury
B. A medication error that does not reach the patient
C. A patient suicide in a 24-hour facility
D. A delay in physical therapy services
Answer: C
Rationale: A sentinel event is an unexpected occurrence involving death or serious
physical or psychological injury.
College
1. A nurse manager is known for making decisions independently without
consulting the staff. Which leadership style is this nurse demonstrating?
A. Transformational
B. Autocratic
C. Democratic
D. Laissez-faire
Answer: B
Rationale: Autocratic leadership involves the leader making decisions without input from
the group, often used in emergency situations.
2. Which task is most appropriate for a nurse to delegate to an unlicensed
assistive personnel (UAP)?
A. Assessing a new admission’s skin integrity
B. Administering an oral medication
C. Assisting a stable patient with ambulation
D. Teaching a patient how to use an incentive spirometer
Answer: C
Rationale: UAPs can perform routine tasks for stable patients such as ADLs and
ambulation. Assessment, medication, and teaching are nursing responsibilities.
,3. According to Maslow’s Hierarchy of Needs, which patient should the nurse
see first?
A. A patient requesting a PRN pain medication
B. A patient who is experiencing shortness of breath
C. A patient who is lonely and wants to talk
D. A patient who needs discharge instructions
Answer: B
Rationale: Physiological needs like breathing (Airway, Breathing, Circulation) always take
priority over safety, social, or esteem needs.
4. In the SBAR communication tool, the ‘B’ stands for:
A. Briefing
B. Basics
C. Behavior
D. Background
Answer: D
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation,
which provides a structured way to relay patient information.
5. A nurse respects a patient’s decision to refuse a life-saving blood transfusion
due to religious beliefs. Which ethical principle is the nurse upholding?
A. Justice
B. Beneficence
C. Autonomy
D. Nonmaleficence
Answer: C
Rationale: Autonomy is the right of the patient to make their own healthcare decisions
even if the provider disagrees.
, 6. What is the primary focus of transformational leadership?
A. Empowering others to achieve a shared vision
B. Maintaining the status quo through rewards and punishments
C. Focusing strictly on task completion
D. Avoiding involvement in staff issues
Answer: A
Rationale: Transformational leaders inspire and motivate followers to go beyond
expectations and focus on a shared vision for the future.
7. During a conflict, one nurse agrees to give up their holiday shift in exchange
for a weekend off later. This is an example of:
A. Compromising
B. Avoiding
C. Competing
D. Collaborating
Answer: A
Rationale: Compromising involves each party giving up something to reach a mutually
acceptable agreement.
8. Which of the following is an example of a sentinel event?
A. A patient falling without injury
B. A medication error that does not reach the patient
C. A patient suicide in a 24-hour facility
D. A delay in physical therapy services
Answer: C
Rationale: A sentinel event is an unexpected occurrence involving death or serious
physical or psychological injury.
