Page 1 of 168
NSG 4100 EXAM 4 /ACTUAL NSG 4100
EXAM 4 , PREP QUESTIONS & LATEST
UPDATED STUDY GUIDE ACCURATE EXAM
2026/2027 COMPLETE REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED
VERSION |GUARANTEED PASS
1. A nurse manager is implementing shared governance on a
medical-surgical unit. Which outcome indicates that shared
governance is functioning effectively?
A) The manager makes all scheduling decisions.
B) Staff nurses vote on unit practice guidelines.
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C) Physicians approve all nursing protocols.
D) The charge nurse assigns all patient loads.
Answer: B) Staff nurses vote on unit practice guidelines.
Rationale: Shared governance empowers staff to participate
in decision-making about practice, policy, and quality
improvement. Voting on guidelines reflects active staff
engagement.
2. During a code blue, the charge nurse directs staff to specific
roles. Which leadership style is being used?
A) Laissez-faire
B) Democratic
C) Autocratic
D) Transformational
Answer: C) Autocratic
Rationale: In emergencies, rapid, directive decision-making is
essential. Autocratic leadership provides clear, immediate
commands.
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3. A staff nurse frequently arrives late and leaves early. What
is the nurse manager’s best first action?
A) Terminate the nurse immediately.
B) Discuss the issue privately with the nurse.
C) Report the nurse to human resources.
D) Ignore the behavior unless it affects patient care.
Answer: B) Discuss the issue privately with the nurse.
Rationale: The initial step in addressing performance issues is
a private, non-punitive conversation to understand the problem
and set expectations.
4. Which cost is considered a fixed cost in a nursing unit
budget?
A) Overtime pay
B) Salaries for full-time RNs
C) IV tubing supplies
D) Agency nurse fees
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Answer: B) Salaries for full-time RNs
Rationale: Fixed costs do not change with patient volume.
Salaries are fixed; supplies, overtime, and agency fees are
variable.
5. Staff complain that assignments are unfair. What is the
manager’s best response?
A) “Work it out among yourselves.”
B) Post the assignment grid with acuity levels.
C) Assign based only on seniority.
D) Ignore until a formal complaint is filed.
Answer: B) Post the assignment grid with acuity levels.
Rationale: Transparency in assignments, showing patient acuity
and staff skills, reduces perceptions of unfairness.
6. A nurse manager is using transformational leadership.
Which behavior is typical?
A) Rewarding staff for following rules
B) Inspiring staff to achieve a shared vision
NSG 4100 EXAM 4 /ACTUAL NSG 4100
EXAM 4 , PREP QUESTIONS & LATEST
UPDATED STUDY GUIDE ACCURATE EXAM
2026/2027 COMPLETE REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED
VERSION |GUARANTEED PASS
1. A nurse manager is implementing shared governance on a
medical-surgical unit. Which outcome indicates that shared
governance is functioning effectively?
A) The manager makes all scheduling decisions.
B) Staff nurses vote on unit practice guidelines.
,Page 2 of 168
C) Physicians approve all nursing protocols.
D) The charge nurse assigns all patient loads.
Answer: B) Staff nurses vote on unit practice guidelines.
Rationale: Shared governance empowers staff to participate
in decision-making about practice, policy, and quality
improvement. Voting on guidelines reflects active staff
engagement.
2. During a code blue, the charge nurse directs staff to specific
roles. Which leadership style is being used?
A) Laissez-faire
B) Democratic
C) Autocratic
D) Transformational
Answer: C) Autocratic
Rationale: In emergencies, rapid, directive decision-making is
essential. Autocratic leadership provides clear, immediate
commands.
,Page 3 of 168
3. A staff nurse frequently arrives late and leaves early. What
is the nurse manager’s best first action?
A) Terminate the nurse immediately.
B) Discuss the issue privately with the nurse.
C) Report the nurse to human resources.
D) Ignore the behavior unless it affects patient care.
Answer: B) Discuss the issue privately with the nurse.
Rationale: The initial step in addressing performance issues is
a private, non-punitive conversation to understand the problem
and set expectations.
4. Which cost is considered a fixed cost in a nursing unit
budget?
A) Overtime pay
B) Salaries for full-time RNs
C) IV tubing supplies
D) Agency nurse fees
, Page 4 of 168
Answer: B) Salaries for full-time RNs
Rationale: Fixed costs do not change with patient volume.
Salaries are fixed; supplies, overtime, and agency fees are
variable.
5. Staff complain that assignments are unfair. What is the
manager’s best response?
A) “Work it out among yourselves.”
B) Post the assignment grid with acuity levels.
C) Assign based only on seniority.
D) Ignore until a formal complaint is filed.
Answer: B) Post the assignment grid with acuity levels.
Rationale: Transparency in assignments, showing patient acuity
and staff skills, reduces perceptions of unfairness.
6. A nurse manager is using transformational leadership.
Which behavior is typical?
A) Rewarding staff for following rules
B) Inspiring staff to achieve a shared vision
