NUR 210/NUR210 Exam 2 V1 | Transition
to Practice - Capstone Q&A with Rationale
| Fortis College
1. A nurse manager is implementing a new electronic documentation system. Which action by
the manager best demonstrates the ‘unfreezing’ stage of Lewin’s Change Theory?
A. Providing hands-on training sessions for all staff members.
B. Rewarding staff who successfully transition to the new system early.
C. Discussing the limitations of the current paper-based system with the staff.
D. Updating the facility’s policy and procedure manual to reflect the change.
Correct Answer: C
Expert Explanation: The unfreezing stage involves creating readiness for change by
helping individuals understand why the current status quo is no longer effective. By
discussing the limitations of the existing system, the manager creates a sense of necessity
for the new system. This stage is critical for overcoming resistance before the actual
transition occurs.
2. Which task should a registered nurse (RN) delegate to an unlicensed assistive personnel
(UAP)?
A. Evaluating a client’s response to pain medication administered one hour ago.
B. Assisting a stable client with their first ambulation after surgery.
,C. Obtaining a set of vital signs on a client returning from the cardiac catheterization lab.
D. Performing a straight catheterization on a client with urinary retention.
Correct Answer: B
Expert Explanation: Assisting a stable client with ambulation is within the scope of
practice for a UAP as it is a routine task with predictable outcomes. Evaluation of
medication effectiveness and post-procedural vital signs require clinical judgment and
assessment skills reserved for the RN. Invasive procedures like catheterization are
generally reserved for licensed personnel in most acute care settings.
3. An RN is caring for four clients. Which client should the nurse assess first after receiving the
change-of-shift report?
A. A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
B. A client with pneumonia who has a new onset of confusion and restlessness.
C. A client who is 2 days postoperative following a cholecystectomy and reports pain as
6/10.
D. A client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of
90% on room air.
Correct Answer: B
Expert Explanation: New onset confusion and restlessness are early signs of hypoxia and
require immediate assessment using the ABC (Airway, Breathing, Circulation) framework.
The other clients, while requiring care, exhibit symptoms that are either expected for their
, condition or not immediately life-threatening. Prioritization must always address acute
changes in neurological or respiratory status first.
4. A nurse is involved in a conflict with a colleague regarding the division of labor on the unit.
The nurse decides to use the ‘compromising’ strategy. Which action reflects this approach?
A. Agreeing to take one extra admission if the colleague agrees to perform all scheduled
dressing changes.
B. Telling the colleague exactly how the tasks will be divided without input.
C. Ignoring the issue and hoping the colleague notices the workload imbalance.
D. Submitting a formal complaint to the nurse manager about the colleague’s performance.
Correct Answer: A
Expert Explanation: Compromising involves both parties giving up something to reach a
mutually acceptable solution. By trading one task for another, both nurses adjust their
expectations to resolve the conflict fairly. This strategy is effective when both sides have
equal power or when a quick middle-ground solution is needed.
5. Which leadership style is most effective for a nurse manager to use during a code blue
situation?
A. Laissez-faire leadership
B. Democratic leadership
C. Transformational leadership
to Practice - Capstone Q&A with Rationale
| Fortis College
1. A nurse manager is implementing a new electronic documentation system. Which action by
the manager best demonstrates the ‘unfreezing’ stage of Lewin’s Change Theory?
A. Providing hands-on training sessions for all staff members.
B. Rewarding staff who successfully transition to the new system early.
C. Discussing the limitations of the current paper-based system with the staff.
D. Updating the facility’s policy and procedure manual to reflect the change.
Correct Answer: C
Expert Explanation: The unfreezing stage involves creating readiness for change by
helping individuals understand why the current status quo is no longer effective. By
discussing the limitations of the existing system, the manager creates a sense of necessity
for the new system. This stage is critical for overcoming resistance before the actual
transition occurs.
2. Which task should a registered nurse (RN) delegate to an unlicensed assistive personnel
(UAP)?
A. Evaluating a client’s response to pain medication administered one hour ago.
B. Assisting a stable client with their first ambulation after surgery.
,C. Obtaining a set of vital signs on a client returning from the cardiac catheterization lab.
D. Performing a straight catheterization on a client with urinary retention.
Correct Answer: B
Expert Explanation: Assisting a stable client with ambulation is within the scope of
practice for a UAP as it is a routine task with predictable outcomes. Evaluation of
medication effectiveness and post-procedural vital signs require clinical judgment and
assessment skills reserved for the RN. Invasive procedures like catheterization are
generally reserved for licensed personnel in most acute care settings.
3. An RN is caring for four clients. Which client should the nurse assess first after receiving the
change-of-shift report?
A. A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
B. A client with pneumonia who has a new onset of confusion and restlessness.
C. A client who is 2 days postoperative following a cholecystectomy and reports pain as
6/10.
D. A client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of
90% on room air.
Correct Answer: B
Expert Explanation: New onset confusion and restlessness are early signs of hypoxia and
require immediate assessment using the ABC (Airway, Breathing, Circulation) framework.
The other clients, while requiring care, exhibit symptoms that are either expected for their
, condition or not immediately life-threatening. Prioritization must always address acute
changes in neurological or respiratory status first.
4. A nurse is involved in a conflict with a colleague regarding the division of labor on the unit.
The nurse decides to use the ‘compromising’ strategy. Which action reflects this approach?
A. Agreeing to take one extra admission if the colleague agrees to perform all scheduled
dressing changes.
B. Telling the colleague exactly how the tasks will be divided without input.
C. Ignoring the issue and hoping the colleague notices the workload imbalance.
D. Submitting a formal complaint to the nurse manager about the colleague’s performance.
Correct Answer: A
Expert Explanation: Compromising involves both parties giving up something to reach a
mutually acceptable solution. By trading one task for another, both nurses adjust their
expectations to resolve the conflict fairly. This strategy is effective when both sides have
equal power or when a quick middle-ground solution is needed.
5. Which leadership style is most effective for a nurse manager to use during a code blue
situation?
A. Laissez-faire leadership
B. Democratic leadership
C. Transformational leadership
