NURS 497 | NURS497 Exam 4: Nursing Capstone -
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse manager is implementing a new electronic health record system using Lewin’s
Change Theory. During the ‘unfreezing’ stage, which action is most appropriate?
A. Providing hands-on training sessions for all staff members
B. Sharing data regarding the high error rate of the current paper-based system
C. Evaluating the overall effectiveness of the new system after one month
D. Developing a rewards system for early adopters of the technology
Correct Answer: B
Rationale: The unfreezing stage involves creating readiness for change by helping others
realize that the current status quo is no longer effective. By sharing data on errors, the
manager highlights the need for improvement and motivates staff to move toward a new
process. Training occurs during the moving or change stage rather than the unfreezing
phase. Rewards are typically part of the refreezing stage to solidify new behaviors in the
workplace. This strategic approach ensures that staff are psychologically prepared for the
transition to a new system.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN) on a busy medical-surgical
unit. Which task is most appropriate for the RN to delegate to the LPN?
A. Administering the first dose of an IV antibiotic for a patient with sepsis
B. Performing a sterile dressing change on a stable post-operative wound
C. Developing a discharge teaching plan for a patient with a new colostomy
D. Conducting the initial admission assessment for a patient with chest pain
Correct Answer: B
Rationale: LPNs are trained to perform specific technical skills such as sterile dressing
changes for patients who are clinically stable. Initial assessments and the development of
teaching plans are strictly the responsibility of the registered nurse. Furthermore, the first
dose of high-risk IV medications often requires RN monitoring for potential immediate
reactions. Delegation must always be based on the scope of practice and the complexity of
the patient’s condition. Proper delegation allows the RN to focus on more complex nursing
judgments and clinical assessments.
,3. A nurse is caring for an older adult patient who refuses life-saving surgery despite
understanding the risks. Which ethical principle is the nurse upholding by supporting the
patient’s decision?
A. Autonomy
B. Non-maleficence
C. Beneficence
D. Justice
Correct Answer: A
Rationale: Autonomy refers to the right of a patient to make their own decisions regarding
their medical care. Even if the nurse believes the surgery is beneficial, the patient’s right to
refuse must be respected. Beneficence focuses on doing good for the patient, while non-
maleficence is the duty to do no harm. Justice involves the fair distribution of resources and
treatment among all patients. Recognizing autonomy is a cornerstone of ethical nursing
practice in complex clinical environments.
4. In a mass casualty incident, a nurse uses the START triage system. Which patient should be
tagged with a ‘red’ tag?
A. A patient with a minor forearm laceration who is walking around the scene
B. A patient with a massive head injury who is not breathing after airway opening
C. A patient with a compound fracture of the femur and a pulse of 110 bpm
D. A patient with an open chest wound and a respiratory rate of 34 breaths per minute
Correct Answer: D
Rationale: The red tag indicates immediate priority for patients with life-threatening
injuries who are likely to survive with rapid intervention. A respiratory rate greater than
30 breaths per minute is a primary indicator for a red tag under START protocols. Walking
patients are tagged green, and those who are not breathing after basic airway maneuvers
are tagged black. Compound fractures with stable vital signs are typically tagged as yellow
for delayed care. Rapid triage is essential in disaster scenarios to maximize the number of
lives saved by medical teams.
5. A nurse manager notices a conflict between two nurses regarding the scheduling of holiday
shifts. The manager asks both nurses to meet and find a solution that satisfies both their
needs. Which conflict resolution strategy is being used?
A. Avoiding
B. Competing
C. Compromising
D. Collaborating
, Correct Answer: D
Rationale: Collaboration is a ‘win-win’ strategy where both parties work together to find a
solution that meets all concerns. Unlike compromising, which involves both parties giving
something up, collaboration seeks to fully satisfy both sides. Avoiding involves ignoring the
conflict, while competing is a power-oriented approach where one side wins at the expense
of the other. The manager’s encouragement of mutual problem-solving points directly to a
collaborative leadership style. This approach fosters a positive work environment and
improves team cohesion over the long term.
6. A nurse is preparing to administer blood to a patient and realizes the blood type on the bag
does not match the patient’s records. What is the first action the nurse should take?
A. Return the blood to the laboratory and do not administer it
B. Document the error in the patient’s electronic health record
C. Call the blood bank to report the discrepancy immediately
D. Double-check the patient’s wristband with another registered nurse
Correct Answer: A
Rationale: The primary safety priority is to prevent the administration of incompatible
blood to the patient. Returning the blood immediately ensures that a fatal transfusion
reaction does not occur during the procedure. While reporting and documenting are
necessary steps, they follow the immediate action of securing the incorrect blood product.
Checking with another nurse is part of the standard protocol, but once a mismatch is
identified, the process must stop. Safety protocols for blood administration are rigid to
protect patients from high-risk medical errors.
7. A hospital is performing a Root Cause Analysis (RCA) after a sentinel event. What is the
primary purpose of an RCA?
A. To identify which individual staff member is responsible for the error
B. To update the hospital’s public safety rating on national databases
C. To provide evidence for legal defense in case of a malpractice lawsuit
D. To determine the underlying system failures that led to the event
Correct Answer: D
Rationale: The goal of a Root Cause Analysis is to look beyond individual human error to
find systemic flaws. By identifying process failures, the organization can implement
changes to prevent the event from occurring again in the future. RCA is a non-punitive
process that focuses on patient safety and quality improvement across the entire facility. It
does not aim to blame individuals but rather to strengthen the environment of care. This
approach is fundamental to creating a culture of safety within complex healthcare
organizations.
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse manager is implementing a new electronic health record system using Lewin’s
Change Theory. During the ‘unfreezing’ stage, which action is most appropriate?
A. Providing hands-on training sessions for all staff members
B. Sharing data regarding the high error rate of the current paper-based system
C. Evaluating the overall effectiveness of the new system after one month
D. Developing a rewards system for early adopters of the technology
Correct Answer: B
Rationale: The unfreezing stage involves creating readiness for change by helping others
realize that the current status quo is no longer effective. By sharing data on errors, the
manager highlights the need for improvement and motivates staff to move toward a new
process. Training occurs during the moving or change stage rather than the unfreezing
phase. Rewards are typically part of the refreezing stage to solidify new behaviors in the
workplace. This strategic approach ensures that staff are psychologically prepared for the
transition to a new system.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN) on a busy medical-surgical
unit. Which task is most appropriate for the RN to delegate to the LPN?
A. Administering the first dose of an IV antibiotic for a patient with sepsis
B. Performing a sterile dressing change on a stable post-operative wound
C. Developing a discharge teaching plan for a patient with a new colostomy
D. Conducting the initial admission assessment for a patient with chest pain
Correct Answer: B
Rationale: LPNs are trained to perform specific technical skills such as sterile dressing
changes for patients who are clinically stable. Initial assessments and the development of
teaching plans are strictly the responsibility of the registered nurse. Furthermore, the first
dose of high-risk IV medications often requires RN monitoring for potential immediate
reactions. Delegation must always be based on the scope of practice and the complexity of
the patient’s condition. Proper delegation allows the RN to focus on more complex nursing
judgments and clinical assessments.
,3. A nurse is caring for an older adult patient who refuses life-saving surgery despite
understanding the risks. Which ethical principle is the nurse upholding by supporting the
patient’s decision?
A. Autonomy
B. Non-maleficence
C. Beneficence
D. Justice
Correct Answer: A
Rationale: Autonomy refers to the right of a patient to make their own decisions regarding
their medical care. Even if the nurse believes the surgery is beneficial, the patient’s right to
refuse must be respected. Beneficence focuses on doing good for the patient, while non-
maleficence is the duty to do no harm. Justice involves the fair distribution of resources and
treatment among all patients. Recognizing autonomy is a cornerstone of ethical nursing
practice in complex clinical environments.
4. In a mass casualty incident, a nurse uses the START triage system. Which patient should be
tagged with a ‘red’ tag?
A. A patient with a minor forearm laceration who is walking around the scene
B. A patient with a massive head injury who is not breathing after airway opening
C. A patient with a compound fracture of the femur and a pulse of 110 bpm
D. A patient with an open chest wound and a respiratory rate of 34 breaths per minute
Correct Answer: D
Rationale: The red tag indicates immediate priority for patients with life-threatening
injuries who are likely to survive with rapid intervention. A respiratory rate greater than
30 breaths per minute is a primary indicator for a red tag under START protocols. Walking
patients are tagged green, and those who are not breathing after basic airway maneuvers
are tagged black. Compound fractures with stable vital signs are typically tagged as yellow
for delayed care. Rapid triage is essential in disaster scenarios to maximize the number of
lives saved by medical teams.
5. A nurse manager notices a conflict between two nurses regarding the scheduling of holiday
shifts. The manager asks both nurses to meet and find a solution that satisfies both their
needs. Which conflict resolution strategy is being used?
A. Avoiding
B. Competing
C. Compromising
D. Collaborating
, Correct Answer: D
Rationale: Collaboration is a ‘win-win’ strategy where both parties work together to find a
solution that meets all concerns. Unlike compromising, which involves both parties giving
something up, collaboration seeks to fully satisfy both sides. Avoiding involves ignoring the
conflict, while competing is a power-oriented approach where one side wins at the expense
of the other. The manager’s encouragement of mutual problem-solving points directly to a
collaborative leadership style. This approach fosters a positive work environment and
improves team cohesion over the long term.
6. A nurse is preparing to administer blood to a patient and realizes the blood type on the bag
does not match the patient’s records. What is the first action the nurse should take?
A. Return the blood to the laboratory and do not administer it
B. Document the error in the patient’s electronic health record
C. Call the blood bank to report the discrepancy immediately
D. Double-check the patient’s wristband with another registered nurse
Correct Answer: A
Rationale: The primary safety priority is to prevent the administration of incompatible
blood to the patient. Returning the blood immediately ensures that a fatal transfusion
reaction does not occur during the procedure. While reporting and documenting are
necessary steps, they follow the immediate action of securing the incorrect blood product.
Checking with another nurse is part of the standard protocol, but once a mismatch is
identified, the process must stop. Safety protocols for blood administration are rigid to
protect patients from high-risk medical errors.
7. A hospital is performing a Root Cause Analysis (RCA) after a sentinel event. What is the
primary purpose of an RCA?
A. To identify which individual staff member is responsible for the error
B. To update the hospital’s public safety rating on national databases
C. To provide evidence for legal defense in case of a malpractice lawsuit
D. To determine the underlying system failures that led to the event
Correct Answer: D
Rationale: The goal of a Root Cause Analysis is to look beyond individual human error to
find systemic flaws. By identifying process failures, the organization can implement
changes to prevent the event from occurring again in the future. RCA is a non-punitive
process that focuses on patient safety and quality improvement across the entire facility. It
does not aim to blame individuals but rather to strengthen the environment of care. This
approach is fundamental to creating a culture of safety within complex healthcare
organizations.
