NR 447 Leadership & Management Final 2026/2027
COMPLETE ACCURATE TEST EXAM ACTUAL
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED SOLUTIONS)
|ALREADY GRADED A+||NEWEST VERSION |BEST
DOCUMENT FOR EXAM
1. A charge nurse is making assignments on a medical-surgical unit. Which patient should
be assigned to the most experienced nurse?
a. A client 1 day post-appendectomy requesting discharge teaching
b. A client with stable heart failure receiving daily furosemide
c. A client with uncontrolled diabetes admitted with DKA and Kussmaul respirations
d. A client with a UTI receiving oral antibiotics
Correct Answer: C
Expert Rationale:
Diabetic ketoacidosis (DKA) is an acute, life-threatening condition requiring frequent
assessment of airway, electrolytes, and acid-base balance. The most experienced nurse should
manage unstable, high-acuity patients. Options A, B, and D are more stable and appropriate for
less experienced staff.
NCLEX focus: prioritization, client acuity
DIF: Application
REF: Leadership/Delegation Principles
OBJ: Prioritize client assignments based on acuity
TOP: Safe and Effective Care Environment
2. A nurse is delegating tasks to assistive personnel (AP). Which task is appropriate?
a. Assessing pain level in a postoperative client
b. Teaching a client how to use an incentive spirometer
c. Obtaining vital signs on a stable client
d. Evaluating a wound for signs of infection
Correct Answer: C
Expert Rationale:
,AP can perform non-invasive, routine tasks such as obtaining vital signs on stable clients.
Assessment, teaching, and evaluation require licensed nursing judgment.
NCLEX focus: delegation
DIF: Knowledge
REF: Delegation Rules
OBJ: Identify appropriate tasks for AP
TOP: Management of Care
3. A nurse notices a coworker documenting vital signs not actually taken. What is the
priority action?
a. Report the behavior to the nurse manager immediately
b. Confront the coworker in front of staff
c. Ignore the behavior unless it continues
d. Document the incident in the chart
Correct Answer: A
Expert Rationale:
Falsification of documentation is an ethical and legal violation requiring immediate reporting
through the chain of command. Direct confrontation or ignoring the issue is inappropriate.
NCLEX focus: ethics/legal issues
DIF: Application
REF: Professional Conduct
OBJ: Identify appropriate reporting actions
TOP: Ethical Practice
4. A nurse is prioritizing care for four clients. Which should be seen first?
a. Client requesting pain medication for chronic back pain
b. Client with asthma reporting mild wheezing after exercise
c. Client with chest pain and ST elevation on ECG
d. Client scheduled for discharge in 1 hour
Correct Answer: C
Expert Rationale:
Chest pain with ST elevation indicates possible myocardial infarction requiring immediate
intervention. This is life-threatening and highest priority.
NCLEX focus: ABCs, priority setting
DIF: Analysis
REF: Cardiovascular Emergencies
OBJ: Prioritize acute cardiac conditions
TOP: Physiological Integrity
, 5. A nurse is managing a unit with limited staff. Which action demonstrates effective
resource allocation?
a. Assigning all stable clients to RN staff
b. Sending all AP home early
c. Matching patient acuity with nurse skill level
d. Delaying admissions until staffing improves
Correct Answer: C
Expert Rationale:
Effective staffing requires balancing client acuity with nurse competency to ensure safe care
delivery.
NCLEX focus: leadership, staffing
DIF: Application
REF: Staffing Principles
OBJ: Apply staffing strategies
TOP: Management of Care
6. A nurse is caring for a client who refuses treatment due to religious beliefs. What is the
nurse’s priority?
a. Document refusal and respect the client’s decision
b. Notify the provider immediately
c. Educate the client about risks repeatedly
d. Ask family to convince the client
Correct Answer: A
Expert Rationale:
Clients have the right to refuse treatment even if it conflicts with medical advice. The nurse
must respect autonomy and document refusal.
NCLEX focus: ethics, client rights
DIF: Application
REF: Informed Consent
OBJ: Respect client autonomy
TOP: Ethical Practice
7. A nurse is preparing a disaster triage plan. Which client is tagged as “red”?
a. Minor laceration requiring sutures
b. Open fracture with uncontrolled bleeding
c. Closed head injury with stable vitals
d. Sprained ankle
, Correct Answer: B
Expert Rationale:
“Red” indicates immediate life-saving intervention. Active uncontrolled bleeding is life-
threatening but potentially survivable with intervention.
NCLEX focus: disaster management
DIF: Application
REF: Emergency Preparedness
OBJ: Apply triage principles
TOP: Safety and Infection Control
8. A nurse is resolving conflict between staff members. What is the best initial action?
a. Ignore the conflict
b. Encourage private discussion between parties
c. Report both staff members
d. Assign them to different units permanently
Correct Answer: B
Expert Rationale:
Conflict resolution begins with direct communication between parties to promote problem-
solving. Escalation is not first-line unless unresolved.
NCLEX focus: leadership, communication
DIF: Application
REF: Conflict Management
OBJ: Resolve workplace conflict
TOP: Management of Care
9. A nurse is delegating care to an LPN. Which task is appropriate?
a. Initial assessment of a new admission
b. Administering oral medications to stable clients
c. Developing care plans
d. Evaluating discharge teaching
Correct Answer: B
Expert Rationale:
LPNs can administer medications to stable clients but cannot perform initial assessments or
evaluations.
NCLEX focus: delegation
DIF: Knowledge
REF: Scope of Practice
COMPLETE ACCURATE TEST EXAM ACTUAL
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED SOLUTIONS)
|ALREADY GRADED A+||NEWEST VERSION |BEST
DOCUMENT FOR EXAM
1. A charge nurse is making assignments on a medical-surgical unit. Which patient should
be assigned to the most experienced nurse?
a. A client 1 day post-appendectomy requesting discharge teaching
b. A client with stable heart failure receiving daily furosemide
c. A client with uncontrolled diabetes admitted with DKA and Kussmaul respirations
d. A client with a UTI receiving oral antibiotics
Correct Answer: C
Expert Rationale:
Diabetic ketoacidosis (DKA) is an acute, life-threatening condition requiring frequent
assessment of airway, electrolytes, and acid-base balance. The most experienced nurse should
manage unstable, high-acuity patients. Options A, B, and D are more stable and appropriate for
less experienced staff.
NCLEX focus: prioritization, client acuity
DIF: Application
REF: Leadership/Delegation Principles
OBJ: Prioritize client assignments based on acuity
TOP: Safe and Effective Care Environment
2. A nurse is delegating tasks to assistive personnel (AP). Which task is appropriate?
a. Assessing pain level in a postoperative client
b. Teaching a client how to use an incentive spirometer
c. Obtaining vital signs on a stable client
d. Evaluating a wound for signs of infection
Correct Answer: C
Expert Rationale:
,AP can perform non-invasive, routine tasks such as obtaining vital signs on stable clients.
Assessment, teaching, and evaluation require licensed nursing judgment.
NCLEX focus: delegation
DIF: Knowledge
REF: Delegation Rules
OBJ: Identify appropriate tasks for AP
TOP: Management of Care
3. A nurse notices a coworker documenting vital signs not actually taken. What is the
priority action?
a. Report the behavior to the nurse manager immediately
b. Confront the coworker in front of staff
c. Ignore the behavior unless it continues
d. Document the incident in the chart
Correct Answer: A
Expert Rationale:
Falsification of documentation is an ethical and legal violation requiring immediate reporting
through the chain of command. Direct confrontation or ignoring the issue is inappropriate.
NCLEX focus: ethics/legal issues
DIF: Application
REF: Professional Conduct
OBJ: Identify appropriate reporting actions
TOP: Ethical Practice
4. A nurse is prioritizing care for four clients. Which should be seen first?
a. Client requesting pain medication for chronic back pain
b. Client with asthma reporting mild wheezing after exercise
c. Client with chest pain and ST elevation on ECG
d. Client scheduled for discharge in 1 hour
Correct Answer: C
Expert Rationale:
Chest pain with ST elevation indicates possible myocardial infarction requiring immediate
intervention. This is life-threatening and highest priority.
NCLEX focus: ABCs, priority setting
DIF: Analysis
REF: Cardiovascular Emergencies
OBJ: Prioritize acute cardiac conditions
TOP: Physiological Integrity
, 5. A nurse is managing a unit with limited staff. Which action demonstrates effective
resource allocation?
a. Assigning all stable clients to RN staff
b. Sending all AP home early
c. Matching patient acuity with nurse skill level
d. Delaying admissions until staffing improves
Correct Answer: C
Expert Rationale:
Effective staffing requires balancing client acuity with nurse competency to ensure safe care
delivery.
NCLEX focus: leadership, staffing
DIF: Application
REF: Staffing Principles
OBJ: Apply staffing strategies
TOP: Management of Care
6. A nurse is caring for a client who refuses treatment due to religious beliefs. What is the
nurse’s priority?
a. Document refusal and respect the client’s decision
b. Notify the provider immediately
c. Educate the client about risks repeatedly
d. Ask family to convince the client
Correct Answer: A
Expert Rationale:
Clients have the right to refuse treatment even if it conflicts with medical advice. The nurse
must respect autonomy and document refusal.
NCLEX focus: ethics, client rights
DIF: Application
REF: Informed Consent
OBJ: Respect client autonomy
TOP: Ethical Practice
7. A nurse is preparing a disaster triage plan. Which client is tagged as “red”?
a. Minor laceration requiring sutures
b. Open fracture with uncontrolled bleeding
c. Closed head injury with stable vitals
d. Sprained ankle
, Correct Answer: B
Expert Rationale:
“Red” indicates immediate life-saving intervention. Active uncontrolled bleeding is life-
threatening but potentially survivable with intervention.
NCLEX focus: disaster management
DIF: Application
REF: Emergency Preparedness
OBJ: Apply triage principles
TOP: Safety and Infection Control
8. A nurse is resolving conflict between staff members. What is the best initial action?
a. Ignore the conflict
b. Encourage private discussion between parties
c. Report both staff members
d. Assign them to different units permanently
Correct Answer: B
Expert Rationale:
Conflict resolution begins with direct communication between parties to promote problem-
solving. Escalation is not first-line unless unresolved.
NCLEX focus: leadership, communication
DIF: Application
REF: Conflict Management
OBJ: Resolve workplace conflict
TOP: Management of Care
9. A nurse is delegating care to an LPN. Which task is appropriate?
a. Initial assessment of a new admission
b. Administering oral medications to stable clients
c. Developing care plans
d. Evaluating discharge teaching
Correct Answer: B
Expert Rationale:
LPNs can administer medications to stable clients but cannot perform initial assessments or
evaluations.
NCLEX focus: delegation
DIF: Knowledge
REF: Scope of Practice
