NR 446 Nursing Leadership: Prioritization & Time Management
Practice Pack 2026 |Chamberlain College
1. A nurse is assigned to four patients. Which patient should the nurse assess
first?
A. A patient with a history of heart failure reporting 2+ pitting edema.
B. A patient with asthma who is experiencing increased wheezing and restlessness.
C. A patient who is 2 days post-operative and requesting pain medication.
D. A patient receiving a blood transfusion who has a slight headache.
Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, the patient with
asthma exhibiting wheezing and restlessness is showing signs of respiratory distress and
must be prioritized.
2. Which of the following tasks should the registered nurse (RN) delegate to the
Unlicensed Assistive Personnel (UAP)?
A. Changing the dressing on a newly placed central venous catheter.
B. Feeding a patient who has recently developed dysphagia.
C. Evaluating the effectiveness of a PRN analgesic.
D. Collecting a clean-catch urine specimen from a stable patient.
Answer: D
Rationale: UAPs can perform routine tasks on stable patients, such as specimen collection.
Feeding patients with dysphagia, evaluating medication effects, and central line dressing
changes require clinical judgment or specialized skill.
,3. An RN is prioritizing care for four patients. Which task should be performed
last?
A. Administering a scheduled antibiotic for a patient with sepsis.
B. Calling the provider about a patient’s low potassium level.
C. Updating a patient’s discharge plan for next week.
D. Completing a dressing change on a stable patient with a pressure ulcer.
Answer: C
Rationale: Discharge planning for a future date is the lowest priority when compared to
clinical treatments (antibiotics), critical lab values (potassium), or physical care (dressing
change).
4. A nurse manager is using Lewin’s Change Theory to implement a new EHR
system. Which action represents the ‘Unfreezing’ stage?
A. Providing training sessions for all staff members.
B. Identifying the need for change and building awareness of the problem.
C. Establishing the new EHR as the permanent standard of care.
D. Monitoring the usage of the new system and providing feedback.
Answer: B
Rationale: Unfreezing involves creating the motivation for change and identifying the need
for it. Training is part of ‘Moving’, and making it permanent is ‘Refreezing’.
5. Which leadership style is characterized by the leader making all decisions
without consulting the staff?
A. Democratic
B. Laissez-faire
C. Transformational
D. Autocratic
Answer: D
, Rationale: Autocratic leadership involves centralized decision-making with little input
from others. This style is often used in emergency situations.
6. An RN is assigning tasks to a Licensed Practical Nurse (LPN). Which task is
appropriate for the LPN?
A. Initial assessment of a patient admitted with chest pain.
B. Administering IV push medications to a patient in the ICU.
C. Developing a nursing care plan for a patient with a new diagnosis.
D. Reinforcing teaching about diabetic foot care to a stable patient.
Answer: D
Rationale: LPNs can reinforce teaching previously provided by the RN. Initial assessments,
care plan development, and high-risk IV push meds are typically reserved for the RN.
7. A nurse is using the SBAR tool to communicate with a provider. Which
statement represents the ‘B’ (Background)?
A. The patient has a history of COPD and was admitted for pneumonia.
B. The patient is experiencing sudden shortness of breath.
C. I think the patient may need a stat chest X-ray.
D. The patient’s current oxygen saturation is 88% on room air.
Answer: A
Rationale: Background (B) provides the clinical history and context of the patient’s
admission. ‘A’ is Situation, ‘D’ is Assessment, and ‘C’ is Recommendation.
8. Which strategy is most effective for a nurse to manage time during a busy
shift?
A. Clustering nursing activities when visiting a patient’s room.
B. Waiting to document all care until the end of the shift.
C. Performing all low-priority tasks first to get them out of the way.
D. Refusing to delegate any tasks to ensure they are done correctly.
Answer: A
Practice Pack 2026 |Chamberlain College
1. A nurse is assigned to four patients. Which patient should the nurse assess
first?
A. A patient with a history of heart failure reporting 2+ pitting edema.
B. A patient with asthma who is experiencing increased wheezing and restlessness.
C. A patient who is 2 days post-operative and requesting pain medication.
D. A patient receiving a blood transfusion who has a slight headache.
Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, the patient with
asthma exhibiting wheezing and restlessness is showing signs of respiratory distress and
must be prioritized.
2. Which of the following tasks should the registered nurse (RN) delegate to the
Unlicensed Assistive Personnel (UAP)?
A. Changing the dressing on a newly placed central venous catheter.
B. Feeding a patient who has recently developed dysphagia.
C. Evaluating the effectiveness of a PRN analgesic.
D. Collecting a clean-catch urine specimen from a stable patient.
Answer: D
Rationale: UAPs can perform routine tasks on stable patients, such as specimen collection.
Feeding patients with dysphagia, evaluating medication effects, and central line dressing
changes require clinical judgment or specialized skill.
,3. An RN is prioritizing care for four patients. Which task should be performed
last?
A. Administering a scheduled antibiotic for a patient with sepsis.
B. Calling the provider about a patient’s low potassium level.
C. Updating a patient’s discharge plan for next week.
D. Completing a dressing change on a stable patient with a pressure ulcer.
Answer: C
Rationale: Discharge planning for a future date is the lowest priority when compared to
clinical treatments (antibiotics), critical lab values (potassium), or physical care (dressing
change).
4. A nurse manager is using Lewin’s Change Theory to implement a new EHR
system. Which action represents the ‘Unfreezing’ stage?
A. Providing training sessions for all staff members.
B. Identifying the need for change and building awareness of the problem.
C. Establishing the new EHR as the permanent standard of care.
D. Monitoring the usage of the new system and providing feedback.
Answer: B
Rationale: Unfreezing involves creating the motivation for change and identifying the need
for it. Training is part of ‘Moving’, and making it permanent is ‘Refreezing’.
5. Which leadership style is characterized by the leader making all decisions
without consulting the staff?
A. Democratic
B. Laissez-faire
C. Transformational
D. Autocratic
Answer: D
, Rationale: Autocratic leadership involves centralized decision-making with little input
from others. This style is often used in emergency situations.
6. An RN is assigning tasks to a Licensed Practical Nurse (LPN). Which task is
appropriate for the LPN?
A. Initial assessment of a patient admitted with chest pain.
B. Administering IV push medications to a patient in the ICU.
C. Developing a nursing care plan for a patient with a new diagnosis.
D. Reinforcing teaching about diabetic foot care to a stable patient.
Answer: D
Rationale: LPNs can reinforce teaching previously provided by the RN. Initial assessments,
care plan development, and high-risk IV push meds are typically reserved for the RN.
7. A nurse is using the SBAR tool to communicate with a provider. Which
statement represents the ‘B’ (Background)?
A. The patient has a history of COPD and was admitted for pneumonia.
B. The patient is experiencing sudden shortness of breath.
C. I think the patient may need a stat chest X-ray.
D. The patient’s current oxygen saturation is 88% on room air.
Answer: A
Rationale: Background (B) provides the clinical history and context of the patient’s
admission. ‘A’ is Situation, ‘D’ is Assessment, and ‘C’ is Recommendation.
8. Which strategy is most effective for a nurse to manage time during a busy
shift?
A. Clustering nursing activities when visiting a patient’s room.
B. Waiting to document all care until the end of the shift.
C. Performing all low-priority tasks first to get them out of the way.
D. Refusing to delegate any tasks to ensure they are done correctly.
Answer: A
