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Nursing Leadership and Management · Nursing Management Practice Test

Full Question & Rationale Repository

Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A nurse manager notices that the unit's central-line infection rate rose after a change in dressing supplies.

What is the most appropriate next action?

A. Stop reporting infections until the rate improves
B. Switch supplies again without reviewing the data
C. Partner with infection prevention to verify the trend and review product, technique and process changes
D. Assume the rise is random and take no action
E. Immediately blame the nurse who changed the first dressing

Expert Explanatory Rationale

Correct Answer: C. Partner with infection prevention to verify the trend and review product, technique and process changes

The trend should be verified and investigated collaboratively before a corrective intervention is selected.

Question 2 of 15

Case excerpt

A nurse is asked to precept a new graduate while carrying a full assignment of high-acuity patients.

Which management decision best protects learning and patient care?

A. Review the preceptor's workload and adjust the assignment to allow safe supervision
B. Tell the new graduate to observe only and sign off competencies
C. Add the new graduate's patients to the preceptor's assignment without adjustment
D. Assign precepting to the busiest nurse because of seniority
E. Cancel all orientation documentation

Expert Explanatory Rationale

Correct Answer: A. Review the preceptor's workload and adjust the assignment to allow safe supervision

Precepting requires time for supervision and feedback; workload should reflect this responsibility.

Question 3 of 15

Case excerpt

A hospital plans to close a low-volume outpatient service. The nurse manager is asked to provide an operational recommendation.

Which information should be included?

A. Only the current month's revenue
B. The manager's personal preference
C. The number of rooms in the clinic
D. The distance from the manager's office
E. Patient access, outcomes, demand trends, alternative services, workforce effects and financial impact

Expert Explanatory Rationale

Correct Answer: E. Patient access, outcomes, demand trends, alternative services, workforce effects and financial impact

Service decisions require a balanced review of access, quality, demand, alternatives and resource implications.

Question 4 of 15

Case excerpt

A patient safety committee has limited time and receives 40 improvement proposals.

Which proposal should be prioritized first?

A. A proposal requiring no measurement
B. A proposal addressing a high-severity hazard with evidence of frequent exposure and a feasible control
C. A proposal that benefits only staff convenience
D. A proposal submitted by the most senior employee
E. A proposal with the most attractive presentation

Expert Explanatory Rationale

Correct Answer: B. A proposal addressing a high-severity hazard with evidence of frequent exposure and a feasible control

Risk-based prioritization considers severity, likelihood or exposure, and the feasibility of reducing harm.

Question 5 of 15

Case excerpt

A nurse manager receives an anonymous report that a staff member is diverting controlled medication.

What should the manager do?

A. Tell the entire unit who made the report
B. Follow the organization's diversion response process, protect patients and preserve objective information
C. Search the employee's personal belongings without authorization
D. Confront the employee publicly at shift change
E. Ignore the report because it is anonymous

Expert Explanatory Rationale

Correct Answer: B. Follow the organization's diversion response process, protect patients and preserve objective information

Suspected diversion requires a formal, confidential response that protects patients and follows policy and law.

Question 6 of 15

Case excerpt

A leader is reviewing whether a new bedside mobility program has unintended consequences.

Which balancing measure is most relevant?

A. Number of emails sent about the program
B. The cost of printing patient leaflets alone
C. Increase in patient fatigue, near falls or staff injury during assisted mobility
D. Number of mobility posters on the walls
E. Attendance at the launch meeting

Expert Explanatory Rationale

Correct Answer: C. Increase in patient fatigue, near falls or staff injury during assisted mobility

Balancing measures detect potential harms or trade-offs caused by an improvement intervention.

Question 7 of 15

Case excerpt

A nurse manager learns that a staff member's professional license has expired.

Which action is required before the employee continues licensed nursing duties?

A. Wait until the next performance review
B. Change the employee's job title but keep the same duties
C. Ask a coworker to cosign all documentation
D. Verify current authorization with the relevant licensing authority and follow employment policy
E. Allow practice while the renewal application is pending in every circumstance

Expert Explanatory Rationale

Correct Answer: D. Verify current authorization with the relevant licensing authority and follow employment policy

The organization must verify current licensure and ensure the employee does not perform duties requiring an inactive license.

Question 8 of 15

Case excerpt

A manager is preparing to implement a revised restraint-reduction protocol.

Which group should be included in the implementation planning?

A. Bedside nurses, providers, rehabilitation staff, patients or advocates and quality or safety partners
B. Only the purchasing department
C. Only the vendor supplying restraint products
D. Only the nurse manager
E. Only employees who have never used restraints

Expert Explanatory Rationale

Correct Answer: A. Bedside nurses, providers, rehabilitation staff, patients or advocates and quality or safety partners

Interprofessional and patient perspectives help make restraint-reduction practices clinically appropriate and workable.

Question 9 of 15

Case excerpt

A nurse manager is developing a plan to reduce alarm fatigue in a step-down unit.

In the situation involving a nurse manager is developing a plan to reduce alarm fatigue in a step-down unit, which actions are appropriate? Select all that apply.

A. Maintain equipment and sensor placement
B. Review alarm data and identify nonactionable alarm sources
C. Ensure staff know escalation expectations for critical alarms
D. Set patient-specific parameters according to clinical assessment and policy
E. Silence alarms permanently to reduce noise
F. Evaluate alarm burden after changes

Expert Explanatory Rationale

Correct Answer: A. Maintain equipment and sensor placement; B. Review alarm data and identify nonactionable alarm sources; C. Ensure staff know escalation expectations for critical alarms; D. Set patient-specific parameters according to clinical assessment and policy; F. Evaluate alarm burden after changes

Alarm improvement requires data, appropriate parameters, staff knowledge, equipment reliability and ongoing evaluation.

Question 10 of 15

Case excerpt

A staff nurse reports that a colleague is bullying a newly hired nurse during orientation.

Which leadership responses are appropriate? Select all that apply.

A. Reinforce behavioral expectations with the team
B. Listen to the report and document objective details
C. Dismiss the report as normal initiation
D. Take steps to protect the new nurse from continued mistreatment
E. Check whether the new nurse needs support or a different preceptor
F. Follow the organization's reporting and investigation process

Expert Explanatory Rationale

Correct Answer: A. Reinforce behavioral expectations with the team; B. Listen to the report and document objective details; D. Take steps to protect the new nurse from continued mistreatment; E. Check whether the new nurse needs support or a different preceptor; F. Follow the organization's reporting and investigation process

A leader responds promptly, protects the employee, follows fair procedures and reinforces professional standards.

Question 11 of 15

Case excerpt

A quality team is designing a project to improve timely antibiotic administration for patients with suspected sepsis.

Which data should be collected? Select all that apply.

A. Only the number of antibiotic doses stocked
B. Patient outcomes relevant to the project
C. Proportion of eligible cases meeting the target interval
D. Balancing measures for inappropriate antibiotic use
E. Time from recognition to antibiotic administration
F. Reasons for delay, such as access or order-entry barriers

Expert Explanatory Rationale

Correct Answer: B. Patient outcomes relevant to the project; C. Proportion of eligible cases meeting the target interval; D. Balancing measures for inappropriate antibiotic use; E. Time from recognition to antibiotic administration; F. Reasons for delay, such as access or order-entry barriers

Time-based process data, delay reasons, balancing measures and outcomes are needed to judge improvement.

Question 12 of 15

Case excerpt

A nurse leader is reviewing whether staff education on blood transfusion reactions has improved readiness.

Which evaluation methods are useful? Select all that apply.

A. Staff feedback about unclear steps
B. Audit of escalation and reaction-management processes
C. Scenario-based competency assessment
D. Observation of required bedside checks
E. Attendance alone as proof of competence
F. Review of response documentation after simulations or events

Expert Explanatory Rationale

Correct Answer: A. Staff feedback about unclear steps; B. Audit of escalation and reaction-management processes; C. Scenario-based competency assessment; D. Observation of required bedside checks; F. Review of response documentation after simulations or events

Competence is better assessed through demonstrated knowledge and practice than attendance alone.

Question 13 of 15

Case excerpt

A nurse manager is planning a response to a prolonged power outage affecting medication refrigerators.

Which actions should be included? Select all that apply.

A. Communicate the contingency plan to affected clinical areas
B. Monitor and document storage temperatures
C. Use approved backup power or transfer arrangements
D. Consult pharmacy about product stability and disposition
E. Use medications without checking excursion guidance
F. Identify affected temperature-sensitive stock

Expert Explanatory Rationale

Correct Answer: A. Communicate the contingency plan to affected clinical areas; B. Monitor and document storage temperatures; C. Use approved backup power or transfer arrangements; D. Consult pharmacy about product stability and disposition; F. Identify affected temperature-sensitive stock

The response protects medication integrity through temperature monitoring, approved storage alternatives and pharmacy guidance.

Question 14 of 15

Case excerpt

A manager has 52 nursing hours available for a weekend shift. The acuity-based staffing plan requires 60 hours.

How many additional nursing hours are needed to meet the plan?

Expert Explanatory Rationale

Correct Answer: 8

60 required hours minus 52 available hours equals 8 hours.

Question 15 of 15

Case excerpt

A unit is introducing a new policy for handling critical laboratory results.

Place the implementation steps in the correct order.

A. Publish the approved procedure and contact list
B. Define critical-result responsibilities and escalation timeframes
C. Audit acknowledgement and escalation after launch
D. Train staff and test the communication pathway

Expert Explanatory Rationale

Correct Answer: B. Define critical-result responsibilities and escalation timeframes; A. Publish the approved procedure and contact list; D. Train staff and test the communication pathway; C. Audit acknowledgement and escalation after launch

The process begins with clear responsibilities, then communication tools and training, followed by an audit.

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