,NSG 4800 Final Exam | Questions & Verified
Answers | 2026 Edition | Galen College
1. A nurse manager is implementing shared governance on a medical-surgical unit. Which action best
reflects this leadership model?
A) The nurse manager makes all staffing and scheduling decisions independently
B) Staff nurses have authority over clinical practice standards and quality improvement
C) Physicians are given voting rights on all nursing unit policies
D) The hospital CEO selects members for all unit-based committees
Correct Answer: Staff nurses have authority over clinical practice standards and quality improvement
Rationale: Shared governance empowers staff nurses to have control over their practice, including the
development of clinical policies, quality improvement initiatives, and professional standards. This model
distributes decision-making authority to those who provide direct patient care, fostering professional
autonomy and accountability.
2. A charge nurse notes an increase in medication errors on the night shift. Using a just culture
approach, which action should the nurse take first?
A) Terminate the nurse who made the most recent error
B) Review systems and processes that may contribute to errors
C) Implement mandatory re-education for all night shift staff
D) Write a formal warning for all nurses involved in errors
Correct Answer: Review systems and processes that may contribute to errors
Rationale: A just culture distinguishes between human error, at-risk behavior, and reckless behavior,
focusing first on system analysis. The first step is to analyze the systems and processes that may have
contributed to the errors, rather than immediately blaming individuals.
,3. A charge nurse is faced with a decision about staffing assignments and seeks input from the team
before making the final decision. This leadership style is best described as:
A) Autocratic
B) Democratic (participative)
C) Laissez-faire
D) Transactional
Correct Answer: Democratic (participative)
Rationale: Democratic leadership involves the leader including team members in the decision-making
process, though the leader retains final authority. This style fosters collaboration, improves morale, and
often leads to better-informed decisions.
4. A newly licensed nurse is struggling to organize their workload and complete tasks on time. The
nurse's preceptor should first:
A) Assign the nurse to fewer patients
B) Work alongside the nurse to model prioritization and time management strategies
C) Report the nurse to the manager for incompetence
D) Allow the nurse to figure it out independently
Correct Answer: Work alongside the nurse to model prioritization and time management strategies
Rationale: Coaching and modeling are effective strategies for developing a new nurse's skills. The
preceptor should provide guidance, demonstrate effective techniques, and offer constructive feedback
in real time.
5. Which of the following tasks can a registered nurse safely delegate to an unlicensed assistive
personnel (UAP)?
A) Assessing a client's pain level
B) Performing a sterile dressing change
C) Measuring and recording vital signs
, D) Providing discharge teaching about wound care
Correct Answer: Measuring and recording vital signs
Rationale: UAPs can perform routine, standardized tasks that do not require clinical judgment, such as
measuring vital signs, recording intake and output, and assisting with activities of daily living.
Assessment, sterile procedures, and teaching are within the RN's scope of practice.
6. The nurse is caring for four clients. Which client should the nurse assess first?
A) A client with COPD who has an oxygen saturation of 92% on 2L NC
B) A client with heart failure who has 2+ pitting edema in the lower extremities
C) A client post-cardiac catheterization who reports new back pain and has a pulsating mass at the groin
site
D) A client with diabetes who has a blood glucose of 180 mg/dL
Correct Answer: A client post-cardiac catheterization who reports new back pain and has a pulsating
mass at the groin site
Rationale: New back pain and a pulsating mass at the catheter insertion site after cardiac catheterization
may indicate retroperitoneal bleeding or a pseudoaneurysm—a life-threatening emergency. This
requires immediate assessment and intervention.
7. A new graduate nurse is experiencing reality shock. Which statement best describes this
phenomenon?
A) The excitement of starting a new job and learning new skills
B) The discrepancy between the values taught in school and the actual work environment
C) A period of orientation where preceptors guide the new nurse
D) The process of completing advanced certifications
Correct Answer: The discrepancy between the values taught in school and the actual work environment
Answers | 2026 Edition | Galen College
1. A nurse manager is implementing shared governance on a medical-surgical unit. Which action best
reflects this leadership model?
A) The nurse manager makes all staffing and scheduling decisions independently
B) Staff nurses have authority over clinical practice standards and quality improvement
C) Physicians are given voting rights on all nursing unit policies
D) The hospital CEO selects members for all unit-based committees
Correct Answer: Staff nurses have authority over clinical practice standards and quality improvement
Rationale: Shared governance empowers staff nurses to have control over their practice, including the
development of clinical policies, quality improvement initiatives, and professional standards. This model
distributes decision-making authority to those who provide direct patient care, fostering professional
autonomy and accountability.
2. A charge nurse notes an increase in medication errors on the night shift. Using a just culture
approach, which action should the nurse take first?
A) Terminate the nurse who made the most recent error
B) Review systems and processes that may contribute to errors
C) Implement mandatory re-education for all night shift staff
D) Write a formal warning for all nurses involved in errors
Correct Answer: Review systems and processes that may contribute to errors
Rationale: A just culture distinguishes between human error, at-risk behavior, and reckless behavior,
focusing first on system analysis. The first step is to analyze the systems and processes that may have
contributed to the errors, rather than immediately blaming individuals.
,3. A charge nurse is faced with a decision about staffing assignments and seeks input from the team
before making the final decision. This leadership style is best described as:
A) Autocratic
B) Democratic (participative)
C) Laissez-faire
D) Transactional
Correct Answer: Democratic (participative)
Rationale: Democratic leadership involves the leader including team members in the decision-making
process, though the leader retains final authority. This style fosters collaboration, improves morale, and
often leads to better-informed decisions.
4. A newly licensed nurse is struggling to organize their workload and complete tasks on time. The
nurse's preceptor should first:
A) Assign the nurse to fewer patients
B) Work alongside the nurse to model prioritization and time management strategies
C) Report the nurse to the manager for incompetence
D) Allow the nurse to figure it out independently
Correct Answer: Work alongside the nurse to model prioritization and time management strategies
Rationale: Coaching and modeling are effective strategies for developing a new nurse's skills. The
preceptor should provide guidance, demonstrate effective techniques, and offer constructive feedback
in real time.
5. Which of the following tasks can a registered nurse safely delegate to an unlicensed assistive
personnel (UAP)?
A) Assessing a client's pain level
B) Performing a sterile dressing change
C) Measuring and recording vital signs
, D) Providing discharge teaching about wound care
Correct Answer: Measuring and recording vital signs
Rationale: UAPs can perform routine, standardized tasks that do not require clinical judgment, such as
measuring vital signs, recording intake and output, and assisting with activities of daily living.
Assessment, sterile procedures, and teaching are within the RN's scope of practice.
6. The nurse is caring for four clients. Which client should the nurse assess first?
A) A client with COPD who has an oxygen saturation of 92% on 2L NC
B) A client with heart failure who has 2+ pitting edema in the lower extremities
C) A client post-cardiac catheterization who reports new back pain and has a pulsating mass at the groin
site
D) A client with diabetes who has a blood glucose of 180 mg/dL
Correct Answer: A client post-cardiac catheterization who reports new back pain and has a pulsating
mass at the groin site
Rationale: New back pain and a pulsating mass at the catheter insertion site after cardiac catheterization
may indicate retroperitoneal bleeding or a pseudoaneurysm—a life-threatening emergency. This
requires immediate assessment and intervention.
7. A new graduate nurse is experiencing reality shock. Which statement best describes this
phenomenon?
A) The excitement of starting a new job and learning new skills
B) The discrepancy between the values taught in school and the actual work environment
C) A period of orientation where preceptors guide the new nurse
D) The process of completing advanced certifications
Correct Answer: The discrepancy between the values taught in school and the actual work environment
