NURS 497 | NURS497 Final Exam: Nursing
Capstone - WCU Updated and Latest Questions and
Correct Answers with Rationale
1. A nurse is planning to delegate tasks to an Unlicensed Assistive Personnel (UAP). Which of
the following tasks is most appropriate for the nurse to delegate?
A. Assessing a client’s surgical incision site
B. Performing an initial admission assessment
C. Measuring and recording a client’s intake and output
D. Educating a client on how to use an incentive spirometer
Correct Answer: C
Rationale: Delegating tasks correctly requires understanding the specific scope of practice
for each team member. The nurse remains accountable for the overall care provided to the
patient even when tasks are assigned to others. Assistive personnel can typically perform
routine tasks such as recording intake and output for stable patients. More complex
assessments or evaluations must be reserved for the licensed registered nurse. Proper
delegation improves efficiency while ensuring that patient safety is never compromised.
2. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first?
A. A client with pneumonia who has become suddenly confused and restless
B. A client who is post-operative and reporting a pain level of 6 out of 10
C. A client with a history of heart failure reporting slight ankle edema
D. A client who needs a dressing change for a chronic pressure ulcer
Correct Answer: A
Rationale: Prioritizing care using the ABC framework is a fundamental skill in nursing
practice. The client exhibiting sudden respiratory distress or neurological changes should
be seen first because these are high-priority concerns. Confusion and restlessness in a
pneumonia patient often indicate hypoxia which requires immediate intervention. Stable
patients with chronic conditions or expected post-operative pain can be seen after
emergent needs are addressed. This systematic approach helps the nurse manage a
complex workload effectively during a shift.
3. Which ethical principle is the nurse demonstrating when they ensure a client has all the
information needed to make a decision about their treatment?
A. Justice
B. Fidelity
,C. Nonmaleficence
D. Autonomy
Correct Answer: D
Rationale: Autonomy refers to the right of patients to make their own healthcare decisions
without outside interference. The nurse supports this principle by providing
comprehensive information and respecting the choices made by the individual. Informed
consent is a practical application of maintaining patient autonomy in a clinical setting. By
ensuring the client understands the risks and benefits, the nurse empowers them to
exercise their legal rights. This process is essential for establishing a trusting and respectful
nurse-patient relationship.
4. A nurse manager is investigating a medication error on the unit. Which action should the
manager take first as part of a quality improvement process?
A. Conduct a root cause analysis to identify system failures
B. Reprimand the nurse involved in the error
C. Implement a new policy for medication administration immediately
D. Notify the board of nursing regarding the incident
Correct Answer: A
Rationale: Quality improvement focuses on identifying and correcting systemic issues
rather than punishing individual mistakes. Conducting a root cause analysis allows the
organization to understand why an error occurred and how to prevent it. This approach
fosters a culture of safety where staff feel comfortable reporting near-misses and actual
errors. Correcting underlying process failures is more effective for long-term safety than
simply reprimanding a single worker. Through this analysis, specific changes can be made
to improve overall patient care outcomes.
5. A nurse is using the SBAR communication tool to report a change in a client’s condition to a
physician. Which information belongs in the ‘B’ (Background) section?
A. The client’s admitting diagnosis and relevant medical history
B. The nurse’s recommendation for a change in treatment
C. The client’s current vital signs and oxygen saturation
D. The nurse’s assessment of the current clinical situation
Correct Answer: A
Rationale: The SBAR tool is designed to provide structured and clear communication
between healthcare professionals. The Background component provides the context
needed to understand the current situation, such as the admitting diagnosis. Including
pertinent medical history helps the physician grasp the severity and potential causes of the
, clinical change. Without this context, the assessment and recommendations might not be
fully understood by the recipient. Consistent use of SBAR reduces the risk of
communication errors that lead to adverse patient events.
6. A nurse is caring for a client who is being discharged after a stroke. When should the nurse
ideally begin the discharge planning process?
A. At the time of the client’s admission to the hospital
B. Once the client is medically stable and out of the ICU
C. The day before the client is scheduled to leave
D. When the family asks about home care arrangements
Correct Answer: A
Rationale: Effective discharge planning should start as soon as the patient enters the
healthcare facility. Early planning allows the nurse to identify potential barriers to
recovery and coordinate necessary home resources. This proactive approach ensures a
smoother transition and reduces the likelihood of hospital readmission. By involving the
patient and family from the beginning, the nurse can tailor the education to their specific
needs. Continuous assessment throughout the stay ensures that the discharge plan remains
realistic and achievable.
7. A client refuses a scheduled dose of medication. What is the most appropriate initial action
by the nurse?
A. Document the refusal and move on to the next patient
B. Crush the medication and mix it with food without telling the client
C. Inform the client about the risks associated with not taking the medication
D. Call the physician immediately to report the non-compliance
Correct Answer: C
Rationale: When a patient refuses medication, the nurse must first explore the reasons
behind the refusal. Providing education about the purpose and risks of skipping the dose is
a critical step in the nursing process. If the patient still refuses after being informed, the
nurse must respect that choice as part of patient autonomy. The refusal must then be
documented accurately and the physician should be notified of the event. Effective
communication can often resolve misunderstandings and lead to better adherence to the
treatment plan.
8. Which of the following is a key component of evidence-based practice (EBP)?
A. Relying solely on traditional methods used on the unit
B. Following the personal preferences of the physician in charge
C. Implementing changes based on a single patient’s success
Capstone - WCU Updated and Latest Questions and
Correct Answers with Rationale
1. A nurse is planning to delegate tasks to an Unlicensed Assistive Personnel (UAP). Which of
the following tasks is most appropriate for the nurse to delegate?
A. Assessing a client’s surgical incision site
B. Performing an initial admission assessment
C. Measuring and recording a client’s intake and output
D. Educating a client on how to use an incentive spirometer
Correct Answer: C
Rationale: Delegating tasks correctly requires understanding the specific scope of practice
for each team member. The nurse remains accountable for the overall care provided to the
patient even when tasks are assigned to others. Assistive personnel can typically perform
routine tasks such as recording intake and output for stable patients. More complex
assessments or evaluations must be reserved for the licensed registered nurse. Proper
delegation improves efficiency while ensuring that patient safety is never compromised.
2. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first?
A. A client with pneumonia who has become suddenly confused and restless
B. A client who is post-operative and reporting a pain level of 6 out of 10
C. A client with a history of heart failure reporting slight ankle edema
D. A client who needs a dressing change for a chronic pressure ulcer
Correct Answer: A
Rationale: Prioritizing care using the ABC framework is a fundamental skill in nursing
practice. The client exhibiting sudden respiratory distress or neurological changes should
be seen first because these are high-priority concerns. Confusion and restlessness in a
pneumonia patient often indicate hypoxia which requires immediate intervention. Stable
patients with chronic conditions or expected post-operative pain can be seen after
emergent needs are addressed. This systematic approach helps the nurse manage a
complex workload effectively during a shift.
3. Which ethical principle is the nurse demonstrating when they ensure a client has all the
information needed to make a decision about their treatment?
A. Justice
B. Fidelity
,C. Nonmaleficence
D. Autonomy
Correct Answer: D
Rationale: Autonomy refers to the right of patients to make their own healthcare decisions
without outside interference. The nurse supports this principle by providing
comprehensive information and respecting the choices made by the individual. Informed
consent is a practical application of maintaining patient autonomy in a clinical setting. By
ensuring the client understands the risks and benefits, the nurse empowers them to
exercise their legal rights. This process is essential for establishing a trusting and respectful
nurse-patient relationship.
4. A nurse manager is investigating a medication error on the unit. Which action should the
manager take first as part of a quality improvement process?
A. Conduct a root cause analysis to identify system failures
B. Reprimand the nurse involved in the error
C. Implement a new policy for medication administration immediately
D. Notify the board of nursing regarding the incident
Correct Answer: A
Rationale: Quality improvement focuses on identifying and correcting systemic issues
rather than punishing individual mistakes. Conducting a root cause analysis allows the
organization to understand why an error occurred and how to prevent it. This approach
fosters a culture of safety where staff feel comfortable reporting near-misses and actual
errors. Correcting underlying process failures is more effective for long-term safety than
simply reprimanding a single worker. Through this analysis, specific changes can be made
to improve overall patient care outcomes.
5. A nurse is using the SBAR communication tool to report a change in a client’s condition to a
physician. Which information belongs in the ‘B’ (Background) section?
A. The client’s admitting diagnosis and relevant medical history
B. The nurse’s recommendation for a change in treatment
C. The client’s current vital signs and oxygen saturation
D. The nurse’s assessment of the current clinical situation
Correct Answer: A
Rationale: The SBAR tool is designed to provide structured and clear communication
between healthcare professionals. The Background component provides the context
needed to understand the current situation, such as the admitting diagnosis. Including
pertinent medical history helps the physician grasp the severity and potential causes of the
, clinical change. Without this context, the assessment and recommendations might not be
fully understood by the recipient. Consistent use of SBAR reduces the risk of
communication errors that lead to adverse patient events.
6. A nurse is caring for a client who is being discharged after a stroke. When should the nurse
ideally begin the discharge planning process?
A. At the time of the client’s admission to the hospital
B. Once the client is medically stable and out of the ICU
C. The day before the client is scheduled to leave
D. When the family asks about home care arrangements
Correct Answer: A
Rationale: Effective discharge planning should start as soon as the patient enters the
healthcare facility. Early planning allows the nurse to identify potential barriers to
recovery and coordinate necessary home resources. This proactive approach ensures a
smoother transition and reduces the likelihood of hospital readmission. By involving the
patient and family from the beginning, the nurse can tailor the education to their specific
needs. Continuous assessment throughout the stay ensures that the discharge plan remains
realistic and achievable.
7. A client refuses a scheduled dose of medication. What is the most appropriate initial action
by the nurse?
A. Document the refusal and move on to the next patient
B. Crush the medication and mix it with food without telling the client
C. Inform the client about the risks associated with not taking the medication
D. Call the physician immediately to report the non-compliance
Correct Answer: C
Rationale: When a patient refuses medication, the nurse must first explore the reasons
behind the refusal. Providing education about the purpose and risks of skipping the dose is
a critical step in the nursing process. If the patient still refuses after being informed, the
nurse must respect that choice as part of patient autonomy. The refusal must then be
documented accurately and the physician should be notified of the event. Effective
communication can often resolve misunderstandings and lead to better adherence to the
treatment plan.
8. Which of the following is a key component of evidence-based practice (EBP)?
A. Relying solely on traditional methods used on the unit
B. Following the personal preferences of the physician in charge
C. Implementing changes based on a single patient’s success
