NUR 420 – Leadership and Management Final
Exam | 2025/2026 Verified Questions, Correct
Answers, and Rationales
Question 1: Transformational Leadership
In a post-pandemic healthcare environment, a nurse manager implements transformational leadership by
encouraging staff to innovate telehealth protocols for remote patient monitoring. According to the 2025
American Organization for Nursing Leadership (AONL) competencies, which strategy best exemplifies
this approach?
A. Enforcing strict adherence to pre-existing workflows to minimize errors.
B. Fostering a shared vision of technology-driven care while empowering nurses to lead pilot projects.
C. Delegating all innovation tasks to an external consulting firm.
D. Prioritizing cost reduction over staff input in protocol development.
Rationale: Transformational leadership, as outlined in AONL 2025 Nurse Leader Core Competencies,
involves inspiring and intellectually stimulating followers to achieve innovative outcomes. Option B
aligns with this by promoting empowerment and vision-sharing, enhancing staff engagement and
adaptability in modern telehealth contexts, which supports strategic planning and systems thinking
competencies.
Question 2: Delegation Principles
A registered nurse (RN) on a busy medical-surgical unit delegates the task of obtaining vital signs from a
stable post-op patient to an unlicensed assistive personnel (UAP). Per the 2025 ANA Delegation
Guidelines, which of the following ensures proper delegation?
A. The RN assumes the UAP has the necessary training without verification.
B. The RN assesses the patient's stability, communicates clear expectations, and supervises the UAP's
performance.
C. The UAP independently decides the frequency of vital sign checks.
D. The RN delegates the task verbally without documenting it.
Rationale: The 2025 ANA Guidelines emphasize the "Five Rights of Delegation" (right task,
circumstance, person, direction/communication, supervision). Option B fulfills these by confirming right
assessment, communication, and supervision, upholding the RN's accountability for safe care delivery and
aligning with accountability and legal/regulatory competencies.
, Question 3: Prioritization in Crisis
During a mass casualty incident in 2026, a charge nurse must triage patients arriving via ambulance.
Using the 2026 Joint Commission Prioritization Standards, which patient should the nurse prioritize first?
A. A 45-year-old with a sprained ankle and complaints of pain.
B. A 72-year-old in respiratory distress with an oxygen saturation of 85%.
C. A 30-year-old with a superficial laceration requiring stitches.
D. A 60-year-old with stable hypertension needing medication refill.
Rationale: Prioritization follows the ABC (Airway, Breathing, Circulation) framework integrated into
2026 Joint Commission standards for emergency response. Option B addresses immediate life-threatening
respiratory compromise, demonstrating clinical judgment and resource allocation competencies essential
for nurse leaders in high-acuity scenarios.
Question 4: Ethical Decision-Making
A nurse leader faces an ethical dilemma when a team member discloses experiencing workplace
discrimination based on cultural background. Aligning with the 2025 ANA Code of Ethics Provision 1
(Respect for Human Dignity), the leader's first action should be:
A. Document the incident privately without involving the employee.
B. Conduct a confidential interview to understand the issue and initiate an equity-focused investigation
per organizational DEI policies.
C. Advise the employee to handle it informally with the colleague.
D. Report it directly to external regulatory bodies without internal review.
Rationale: The 2025 ANA Code emphasizes equity and inclusion in ethical practice. Option B promotes
dignity through active listening and systemic response, fostering a culture of safety and aligning with
ethical leadership and interpersonal communication competencies.
Question 5: Inclusive Leadership
In a diverse unit with increasing immigrant staff, a nurse manager applies inclusive leadership principles
from the 2025 AONL Diversity Framework. Which intervention best promotes psychological safety?
A. Standardizing all communication in English only.
B. Offering multilingual training sessions and anonymous feedback channels to encourage open dialogue.
Exam | 2025/2026 Verified Questions, Correct
Answers, and Rationales
Question 1: Transformational Leadership
In a post-pandemic healthcare environment, a nurse manager implements transformational leadership by
encouraging staff to innovate telehealth protocols for remote patient monitoring. According to the 2025
American Organization for Nursing Leadership (AONL) competencies, which strategy best exemplifies
this approach?
A. Enforcing strict adherence to pre-existing workflows to minimize errors.
B. Fostering a shared vision of technology-driven care while empowering nurses to lead pilot projects.
C. Delegating all innovation tasks to an external consulting firm.
D. Prioritizing cost reduction over staff input in protocol development.
Rationale: Transformational leadership, as outlined in AONL 2025 Nurse Leader Core Competencies,
involves inspiring and intellectually stimulating followers to achieve innovative outcomes. Option B
aligns with this by promoting empowerment and vision-sharing, enhancing staff engagement and
adaptability in modern telehealth contexts, which supports strategic planning and systems thinking
competencies.
Question 2: Delegation Principles
A registered nurse (RN) on a busy medical-surgical unit delegates the task of obtaining vital signs from a
stable post-op patient to an unlicensed assistive personnel (UAP). Per the 2025 ANA Delegation
Guidelines, which of the following ensures proper delegation?
A. The RN assumes the UAP has the necessary training without verification.
B. The RN assesses the patient's stability, communicates clear expectations, and supervises the UAP's
performance.
C. The UAP independently decides the frequency of vital sign checks.
D. The RN delegates the task verbally without documenting it.
Rationale: The 2025 ANA Guidelines emphasize the "Five Rights of Delegation" (right task,
circumstance, person, direction/communication, supervision). Option B fulfills these by confirming right
assessment, communication, and supervision, upholding the RN's accountability for safe care delivery and
aligning with accountability and legal/regulatory competencies.
, Question 3: Prioritization in Crisis
During a mass casualty incident in 2026, a charge nurse must triage patients arriving via ambulance.
Using the 2026 Joint Commission Prioritization Standards, which patient should the nurse prioritize first?
A. A 45-year-old with a sprained ankle and complaints of pain.
B. A 72-year-old in respiratory distress with an oxygen saturation of 85%.
C. A 30-year-old with a superficial laceration requiring stitches.
D. A 60-year-old with stable hypertension needing medication refill.
Rationale: Prioritization follows the ABC (Airway, Breathing, Circulation) framework integrated into
2026 Joint Commission standards for emergency response. Option B addresses immediate life-threatening
respiratory compromise, demonstrating clinical judgment and resource allocation competencies essential
for nurse leaders in high-acuity scenarios.
Question 4: Ethical Decision-Making
A nurse leader faces an ethical dilemma when a team member discloses experiencing workplace
discrimination based on cultural background. Aligning with the 2025 ANA Code of Ethics Provision 1
(Respect for Human Dignity), the leader's first action should be:
A. Document the incident privately without involving the employee.
B. Conduct a confidential interview to understand the issue and initiate an equity-focused investigation
per organizational DEI policies.
C. Advise the employee to handle it informally with the colleague.
D. Report it directly to external regulatory bodies without internal review.
Rationale: The 2025 ANA Code emphasizes equity and inclusion in ethical practice. Option B promotes
dignity through active listening and systemic response, fostering a culture of safety and aligning with
ethical leadership and interpersonal communication competencies.
Question 5: Inclusive Leadership
In a diverse unit with increasing immigrant staff, a nurse manager applies inclusive leadership principles
from the 2025 AONL Diversity Framework. Which intervention best promotes psychological safety?
A. Standardizing all communication in English only.
B. Offering multilingual training sessions and anonymous feedback channels to encourage open dialogue.
