Exam Review Questions Flashcards
Which of the following is NOT one of the 7 principles outlined for beginning practitioners by the CNO?
A. Seek help when needed
B. Work beyond the scope of practice
C. Apply critical thinking
D. Practice ethically
Correct Answer: B. Work beyond the scope of practice
Rationale: Nurses must work within their scope of practice and seek help when needed. Working beyond scope is unsafe and unprofessional.
Which principle from the CNO Code of Conduct reflects cultural humility?
A. Nurses respect client dignity
B. Nurses act with integrity
C. Nurses maintain public confidence
D. Nurses provide inclusive and culturally safe care
Correct Answer: D. Nurses provide inclusive and culturally safe care
Rationale: Cultural humility and safety are directly addressed under this principle, emphasizing equity and respect for diverse backgrounds.
According to the CNA Code of Ethics, which of the following is a regulatory purpose of the Code?
A. Provide a list of patient rights
B. Empower physicians to lead change
C. Guide nurses to self-regulate and protect the public
D. Define nurse competencies at entry to practice
Correct Answer: C. Guide nurses to self-regulate and protect the public
Rationale: The Code serves both as an aspirational guide and a regulatory tool in a self-regulating profession.
The CNA Code of Ethics promotes which of the following values?
A. Innovation and leadership
B. Risk-taking and independence
C. Justice and accountability
D. Technology and politics
Correct Answer: C. Justice and accountability
Rationale: These are two of the seven core values in the Code of Ethics, alongside dignity, safe care, and informed decision-making.
Transformational leaders do all EXCEPT:
A. Encourage shared vision
B. Promote short-term status quo
C. Inspire and motivate followers
D. Rely on intrinsic motivators
Correct Answer: B. Promote short-term status quo
Rationale: Maintaining the status quo is a trait of transactional leadership. Transformational leaders focus on long-term change and inspiration.
What is the defining trait of relational leadership?
A. Emphasis on rewards and penalties
B. Strict hierarchy
C. Relationship-building and inclusiveness
D. Sole focus on performance metrics
Correct Answer: C. Relationship-building and inclusiveness
Rationale: Relational leadership centers on trust, ethical conduct, and empowering relationships—particularly helpful in team dynamics.
According to Chaos Theory in nursing:
A. All healthcare outcomes can be predicted with precision
B. Random events rarely impact patient care
C. Small changes can lead to major effects
D. Leadership is unnecessary in unpredictable environments
Correct Answer: C. Small changes can lead to major effects
Rationale: A central idea in Chaos Theory is that minor inputs or changes can create large, unpredictable outcomes in complex systems.
What type of power stems from one’s reputation and credibility?
A. Position power
B. Expert power
C. Personal power
D. Perceived power
Correct Answer: C. Personal power
Rationale: Personal power is derived from trust and how others perceive your credibility, integrity, and reliability.
Whistleblowing is closely associated with which of the following concepts?
A. Passive compliance
B. Maintaining the status quo
C. The power of voice and advocacy
D. Personal gain and influence
Correct Answer: C. The power of voice and advocacy
Rationale: Whistleblowing uses a nurse’s voice to advocate for safe care, especially when ethical or legal violations are observed.
Which statement best reflects a political act in nursing?
A. Following hospital protocols passively
B. Prescribing based on physician order
C. Using voice and research to influence policy
D. Avoiding participation in system-level decisions
Correct Answer: C. Using voice and research to influence policy
Rationale: Political action in nursing involves advocacy, influencing decisions, and using research to shape healthcare policies.
What is one risk of excessive social media use identified in nursing practice?
A. Enhanced patient access to care
B. Improved mental health
C. Disrupted sleep patterns
D. Greater collaboration between teams
Correct Answer: C. Disrupted sleep patterns
Rationale: Excessive social media can lead to overstimulation and disrupted sleep, which in turn affect health and mental wellness.
Mobile Health (mHealth) is primarily:
A. A theory of social justice
B. A medication tracking system
C. A technology that supports health using mobile devices
D. A nursing leadership strategy
Correct Answer: C. A technology that supports health using mobile devices
Rationale: mHealth involves apps and tools on mobile devices to monitor, educate, and improve health outcomes.
Which of the following is a characteristic of effective teams in nursing?
A. Avoiding conflict at all costs
B. Individual accountability without shared goals
C. Respectful communication and collaboration
D. Strict role division and competition
Correct Answer: C. Respectful communication and collaboration
Rationale: Effective teams rely on open dialogue, shared goals, and respectful conflict resolution.
What is one outcome of intrapersonal conflict in nursing?
A. Political mobilization
B. Self-reflection and internal struggle
C. Legal consequences
D. Delegation of tasks
Correct Answer: B. Self-reflection and internal struggle
Rationale: Intrapersonal conflict is an internal tension that may lead to stress, ethical questioning, or personal growth through reflection.
Innovation in nursing practice is best described as:
A. Copying standardized tools
B. Passive application of routine methods
C. Introducing new ideas and tools to improve care
D. Avoiding risk in care delivery
Correct Answer: C. Introducing new ideas and tools to improve care
Rationale: Innovation is about implementing new methods or tools to improve patient outcomes and healthcare efficiency.
Which of the following best describes a formal leadership role in nursing?
A. A staff nurse mentoring a new graduate
B. A nurse manager overseeing unit operations
C. A student nurse helping peers study
D. A bedside nurse advocating for a patient’s medication change
correct Answer: B. A nurse manager overseeing unit operations
Rationale: Formal leadership roles involve designated positions of authority (e.g., manager, supervisor), while informal leaders influence others without a title.
A nurse takes initiative to coach a struggling colleague while not in a supervisory position. This is an example of:
A. Resistance to delegation
B. Formal mentorship
C. Informal leadership
D. Clinical overreach
Correct Answer: C. Informal leadership
Rationale: Informal leadership happens when someone, without formal authority, influences others positively — such as through peer coaching or mentorship.
Which action aligns best with the leadership principle of “Act” from the “Your Path to Nursing Leadership” framework?
A. Avoiding conflict during staff meetings
B. Completing all tasks independently without input
C. Volunteering to lead a patient safety improvement project
D. Reading about leadership but not applying the concepts
Correct Answer: C. Volunteering to lead a patient safety improvement project
Rationale: “Act” refers to applying leadership skills in real-world situations. Volunteering for projects shows active engagement and initiative.
The primary goal of reflecting on career goals, values, and past experiences in nursing is to:
A. Prepare for licensure exams
B. Strengthen pharmacology knowledge
C. Develop and clarify nursing identity
D. Memorize leadership terminology
Correct Answer: C. Develop and clarify nursing identity
Rationale: Nursing identity is built through self-reflection on values, experiences, and goals. It informs practice and professional direction.
Which statement best represents the trait of resilience in nursing leadership?
A. Avoiding risk and change
B. Giving up after initial setbacks
C. Bouncing back and adapting in challenging situations
D. Relying on others to make difficult decisions
Correct Answer: C. Bouncing back and adapting in challenging situations
Rationale: Resilience is a key trait in leadership. It involves adaptability and perseverance despite stress or failure.
What leadership trait is most closely linked to building strong team dynamics?
A. Aggressiveness
B. Empathy
C. Independence
D. Ambiguity
Correct Answer: B. Empathy
Rationale: Empathy fosters trust, collaboration, and psychological safety — all essential for strong team dynamics and leadership effectiveness.
A student nurse attends a professional development conference to improve leadership abilities. This action supports which part of leadership development?
A. Acting impulsively
B. Building technical skills only
C. Learning through ongoing education
D. Avoiding real-world challenges
Correct Answer: C. Learning through ongoing education
Rationale: Seeking knowledge through events like conferences reflects a commitment to professional growth and leadership skill enhancement.
Which of the following BEST illustrates a nurse using leadership to advocate for systemic change?
A. Reporting to work on time
B. Presenting research findings to hospital administration about patient safety concerns
C. Encouraging colleagues to take longer breaks
D. Refusing to participate in hospital improvement efforts
Correct Answer: B. Presenting research findings to hospital administration about patient safety concerns
Rationale: Advocacy and leadership intersect when nurses use evidence to promote systemic changes in policies or procedures that improve care.
A nursing student commits to asking more questions and speaking up in class to develop confidence. This action supports which leadership building block?
A. Passive learning
B. Avoiding vulnerability
C. Engaging and taking initiative
D. Memorizing textbook content
Correct Answer: C. Engaging and taking initiative
Rationale: Active engagement and initiative are foundational to developing leadership. Asking questions helps build critical thinking and confidence.
A nurse uses their relationship with a senior physician to gain support for implementing a new patient safety protocol. What type of power is this?
A. Connection power
B. Expert power
C. Perceived power
D. Position power
Correct Answer: A. Connection power
Rationale: Connection power comes from relationships or associations with individuals in influential positions.
What is the best example of a nurse engaging in innovation?
A. Learning a policy word-for-word
B. Creating a new bedside handover tool to improve communication
C. Avoiding new projects to focus on routine care
D. Repeating standard care procedures without feedback
Correct Answer: B. Creating a new bedside handover tool to improve communication
Rationale: Innovation involves developing and implementing new methods or tools to enhance nursing practice and patient outcomes.
A nurse feels guilty for not speaking up about unsafe care. They continue to carry this emotional weight. What term best describes this?
A. Moral residue
B. Intrapersonal conflict
C. Whistleblowing
D. Emotional detachment
Correct Answer: A. Moral residue
Rationale: Moral residue refers to lingering feelings of guilt or regret after failing to act according to one’s ethical values.
Which leadership style is least effective in promoting change in a rapidly evolving healthcare environment?
A. Transactional leadership
B. Transformational leadership
C. Relational leadership
D. Collaborative leadership
Correct Answer: A. Transactional leadership
Rationale: Transactional leadership maintains the status quo and uses incentives for compliance, making it less effective for complex or adaptive change.
Which of the following is MOST important when building a culturally safe nursing practice?
A. Understanding that patients must adjust to the dominant culture
B. Enforcing uniform procedures for all patients
C. Practicing cultural humility and adapting care respectfully
D. Assuming all patients share similar values
Correct Answer: C. Practicing cultural humility and adapting care respectfully
Rationale: Culturally safe practice means acknowledging and respecting the patient’s cultural identity while providing inclusive, non-judgmental care.
Which of the following is an example of intrapersonal conflict?
A. A nurse disagrees with a colleague over scheduling
B. A manager debates with an external vendor
C. A nurse struggles internally with whether to report a mistake
D. Two departments clash over budget allocations
Correct Answer: C. A nurse struggles internally with whether to report a mistake
Rationale: Intrapersonal conflict happens within the individual, involving personal dilemmas or ethical struggles.
A student nurse joins a nursing advocacy organization. What is the MOST likely benefit of this action?
A. Increased income
B. Better clinical grades
C. Greater opportunity to influence health policy
D. Reduced patient contact
Correct Answer: C. Greater opportunity to influence health policy
Rationale: Advocacy organizations empower nurses to use their collective voice to advocate for change, especially in healthcare policy and social justice.
Which of the following best reflects the CNA value of accountability?
A. Documenting care accurately and owning mistakes
B. Ignoring patient concerns to save time
C. Delegating all tasks without supervision
D. Relying solely on written protocols
Correct Answer: A. Documenting care accurately and owning mistakes
Rationale: Accountability includes being responsible for one’s actions and decisions in nursing care, including documentation and transparency.
What is the primary purpose of the CNO’s Entry-to-Practice Competencies?
A. To standardize hospital budgets
B. To outline expectations for nurses beginning their practice
C. To manage physician responsibilities
D. To promote global nursing travel
Correct Answer: B. To outline expectations for nurses beginning their practice
Rationale: The CNO’s Entry-to-Practice Competencies guide newly licensed nurses in providing safe, ethical, and competent care within scope.
A student nurse is encouraged to reflect on their leadership progress and plan for future development. This activity supports which of the following?
A. Avoidance of failure
B. Continuous growth as a nurse leader
C. Limiting responsibility
D. Learning from only past mistakes
Correct Answer: B. Continuous growth as a nurse leader
Rationale: Leadership development is an ongoing journey that includes reflection, learning, and taking initiative to grow professionally.
A nurse who consistently mentors junior staff and promotes teamwork on the unit is demonstrating which nursing role?
A. Advocate
B. Educator
C. Leader
D. Coordinator
Correct Answer: C. Leader
Rationale: Leaders influence others, guide professional growth, and support collaboration—all of which this nurse is doing through mentorship and team support.
What action BEST aligns with the CNA value of promoting justice?
A. Providing care only to insured patients
B. Advocating for equitable healthcare access for marginalized groups
C. Prioritizing fast discharges to manage costs
D. Refusing to work with patients from different backgrounds
Correct Answer: B. Advocating for equitable healthcare access for marginalized groups
Rationale: Justice in nursing involves addressing health inequities and promoting fair, accessible care for all populations.
Which of the following BEST demonstrates nursing as a political act, according to the CNA?
A. Avoiding discussions about controversial healthcare topics
B. Refusing to vote in healthcare policy decisions
C. Using research and voice to influence healthcare reform
D. Ignoring policy changes in the workplace
Correct Answer: C. Using research and voice to influence healthcare reform
Rationale: Nursing is political because nurses are in a unique position to use evidence and advocacy to influence healthcare policies and systems.
Which of the following reflects the clinician role of a registered nurse?
A. Coordinating staff schedules
B. Delivering safe, evidence-informed care to patients
C. Lobbying for political change
D. Teaching at a nursing school
Correct Answer: B. Delivering safe, evidence-informed care to patients
Rationale: The clinician role focuses on direct care, clinical judgment, and ensuring safety and quality in nursing practice.
A nurse who makes ethical decisions, respects confidentiality, and upholds the integrity of the profession is practicing as a:
A. Collaborator
B. Scholar
C. Professional
D. Coordinator
Correct Answer: C. Professional
Rationale: The professional role includes acting with integrity, ethical responsibility, and accountability for maintaining public trust.
A nurse actively listens to a patient’s concerns and communicates with compassion. Which professional competency is being demonstrated?
A. Advocate
B. Communicator
C. Leader
D. Coordinator
Correct Answer: B. Communicator
Rationale: Being a strong communicator involves listening, empathy, clarity, and building therapeutic relationships with patients and families.
A nurse working in a team environment mediates a disagreement between coworkers to improve collaboration. This is an example of:
A. Interpersonal conflict
B. Passive leadership
C. Conflict resolution
D. Power assertion
Correct Answer: C. Conflict resolution
Rationale: Conflict resolution involves addressing disagreements constructively to support team functioning and communication.
Which of the following BEST describes informed decision-making in the context of the CNA Code of Ethics?
A. Telling patients what to do
B. Encouraging patients to follow hospital policies
C. Respecting the patient’s right to make their own healthcare choices
D. Providing limited information to avoid confusion
Correct Answer: C. Respecting the patient’s right to make their own healthcare choices
Rationale: Informed decision-making centers on patient autonomy and requires nurses to support and respect patient choices after providing appropriate information.
A student nurse chooses to volunteer on a hospital quality improvement committee. This reflects which step in the leadership journey?
A. Avoid
B. Reflect
C. Learn
D. Act
Correct Answer: D. Act
Rationale: Taking initiative to apply leadership skills in practice (e.g., joining a committee) is part of the “Act” step in developing as a nurse leader.
What is the role of the Coordinator in nursing?
A. Providing bedside care
B. Collaborating to organize and manage patient care plans
C. Teaching in academic settings
D. Advocating in legal disputes
Correct Answer: B. Collaborating to organize and manage patient care plans
Rationale: Coordinators work across disciplines to ensure the patient’s care plan is organized, comprehensive, and timely.
A nurse uses West and Farr’s concept of innovation by doing which of the following?
A. Avoiding new tools until tested in other hospitals
B. Applying outdated methods to ensure consistency
C. Introducing a creative charting method that reduces errors
D. Waiting for management to initiate change
Correct Answer: C. Introducing a creative charting method that reduces errors
Rationale: Innovation involves the intentional use of new ideas or methods to benefit practice, improve care, and solve problems.
A student nurse begins journaling about their values, past clinical experiences, and career goals. This activity supports:
A. Time management
B. Building clinical skills
C. Developing their nursing identity
D. Avoiding leadership stress
Correct Answer: C. Developing their nursing identity
Rationale: Reflecting on personal and professional experiences helps students understand who they are and what kind of nurse they want to become.
Which nurse is demonstrating the educator role?
A. A nurse assigning tasks on the unit
B. A nurse mentoring a student about safe medication practices
C. A nurse filing shift reports to management
D. A nurse performing bedside care independently
Correct Answer: B. A nurse mentoring a student about safe medication practices
Rationale: The educator role includes teaching, coaching, and guiding others, especially students and peers, in the clinical setting.
What concept best explains a nurse leader’s ability to tolerate opposing views and build psychological safety in their team?
A. Relational leadership
B. Transactional leadership
C. Expert power
D. Delegation theory
Correct Answer: A. Relational leadership
Rationale: Relational leaders value inclusivity, ethical engagement, and open communication, fostering safe environments for discussion and growth.
A nurse advocates for policy change to support the use of mobile health (mHealth) tools in underserved communities. This demonstrates:
A. Resistance to technology
B. The nurse’s educator role
C. Health promotion through leadership and advocacy
D. Limiting patient access to care
Correct Answer: C. Health promotion through leadership and advocacy
Rationale: The nurse is advocating for equitable access to technology-based care, demonstrating leadership, innovation, and health promotion.
A newly graduated nurse is unsure whether to follow a physician’s order that appears to conflict with the patient’s clearly stated wishes. The nurse feels torn between following protocol and respecting the patient’s autonomy. What is the BEST action the nurse should take?
A. Carry out the physician’s order without question to avoid conflict
B. Refuse the order and immediately file a formal complaint
C. Consult with the healthcare team or a clinical supervisor before acting
D. Document the situation and do nothing unless the patient complains
Correct Answer: C. Consult with the healthcare team or a clinical supervisor before acting
Rationale:
This question is tricky because all the options reflect possible reactions — but only one reflects safe, ethical, and collaborative practice.
A is unsafe and disregards patient-centered care.
B may be appropriate later, but not as a first step without clarification.
D involves documentation, but passivity is not the best initial action.
C is correct because it respects the nurse’s ethical responsibility to advocate for the patient while also ensuring interprofessional communication and guidance before proceeding.
A nurse notices a colleague frequently rushing medication administration and skipping patient identification checks. What is the most appropriate initial response?
A. Ignore the situation unless a patient is harmed
B. Immediately report the colleague to the nurse manager
C. Approach the colleague privately to express concern and clarify observations
D. Confront the colleague publicly to prevent further incidents
Correct Answer: C. Approach the colleague privately to express concern and clarify observations
Rationale:
The nurse has an ethical obligation to advocate for patient safety while respecting professionalism and peer communication.
A is unsafe and avoids accountability.
B might be necessary later, but not the first step unless the risk is immediate.
D undermines trust and is unprofessional.
C allows for clarification, addresses the issue constructively, and supports safe practice.
A nurse leader wants to influence a policy change but holds no formal leadership position. What form of power should they leverage to gain support?
A. Position power
B. Personal power
C. Coercive power
D. Delegated authority
Correct Answer: B. Personal power
Rationale:
Even without formal authority, personal power—rooted in credibility, trust, and integrity—can significantly influence outcomes.
A isn’t available without a title.
C involves force or pressure, which is unethical.
D refers to tasks assigned by someone in authority, not a source of influence here.
A hospital introduces a policy that limits RN advocacy activities to scheduled education sessions only. A nurse believes this restricts their ethical responsibility. What is the best response?
A. Comply with the policy without concern
B. Submit a formal letter challenging the policy to the hospital board
C. Seek clarification through a professional nursing association or regulatory body
D. Organize a protest with other nurses
Correct Answer: C. Seek clarification through a professional nursing association or regulatory body
Rationale:
This is a tough ethical-policy tension. Nurses are ethically bound to advocate at all times—not just during scheduled sessions.
A ignores ethical obligations.
B could be appropriate but should follow clarification first.
D may escalate without first seeking professional guidance.
C is the most informed and ethical approach.
A newly graduated nurse is unsure whether to follow a physician’s order that appears to conflict with the patient’s clearly stated wishes. The nurse feels torn between following protocol and respecting the patient’s autonomy. What is the BEST action the nurse should take?
A. Carry out the physician’s order without question to avoid conflict
B. Refuse the order and immediately file a formal complaint
C. Consult with the healthcare team or a clinical supervisor before acting
D. Document the situation and do nothing unless the patient complains
Correct Answer: C
Rationale: The nurse must prioritize patient advocacy and ethical care. Consulting the team promotes collaboration and ensures both patient wishes and clinical protocol are respected.
A nurse notices a colleague frequently rushing medication administration and skipping patient identification checks. What is the most appropriate initial response?
A. Ignore the situation unless a patient is harmed
B. Immediately report the colleague to the nurse manager
C. Approach the colleague privately to express concern and clarify observations
D. Confront the colleague publicly to prevent further incidents
Correct Answer: C
Rationale: Addressing the issue privately first encourages professional dialogue, peer accountability, and potentially resolves the issue without escalation.
A nurse leader wants to influence a policy change but holds no formal leadership position. What form of power should they leverage to gain support?
A. Position power
B. Personal power
C. Coercive power
D. Delegated authority
Correct Answer: B
💡 Rationale: Personal power—built through trust, integrity, and credibility—can be influential even without formal authority.
A hospital introduces a policy that limits RN advocacy activities to scheduled education sessions only. A nurse believes this restricts their ethical responsibility. What is the best response?
A. Comply with the policy without concern
B. Submit a formal letter challenging the policy to the hospital board
C. Seek clarification through a professional nursing association or regulatory body
D. Organize a protest with other nurses
Correct Answer: C
💡 Rationale: Seeking clarification through professional bodies ensures the nurse acts with both advocacy and professional integrity before taking further steps.
A nurse is working with a patient from a cultural background that includes extended family in all decision-making. The patient is alert and competent. What is the BEST response by the nurse?
A. Only speak to the patient and disregard the family
B. Ask the physician to handle the conversation instead
C. Include the family if the patient requests, while ensuring the patient’s autonomy is respected
D. Tell the family they cannot be involved in decisions
Correct Answer: C. Include the family if the patient requests, while ensuring the patient’s autonomy is respected
💡 Rationale: Respecting cultural values and family roles is essential, but the patient’s autonomy must be prioritized. Involving family is appropriate if the patient consents.
A nurse leader is preparing for a team meeting on a new patient safety policy. What is the MOST effective way to promote participation and shared ownership?
A. Deliver the policy changes as final decisions
B. Assign the team tasks without discussion
C. Encourage open feedback and include team input in the implementation process
D. Schedule the meeting after work hours for better attendance
Correct Answer: C. Encourage open feedback and include team input in the implementation process
💡 Rationale: Engaging the team in decision-making builds ownership, improves compliance, and promotes relational leadership.
uring a team huddle, a senior nurse dismisses a junior colleague’s safety concern. What leadership strategy should the charge nurse use?
A. Ignore it to avoid disrupting workflow
B. Schedule separate meetings with both nurses
C. Address the behavior respectfully in the moment and reinforce a culture of psychological safety
D. Report the senior nurse immediately for bullying
Correct Answer: C. Address the behavior respectfully in the moment and reinforce a culture of psychological safety
💡 Rationale: Psychological safety is critical. Addressing the issue calmly but immediately models leadership and supports open communication.
Which example BEST demonstrates how a nurse fulfills the advocate role?
A. Calling a patient’s family to confirm a discharge plan
B. Informing the manager that a patient feels unheard and is fearful about a treatment
C. Administering a scheduled medication on time
D. Avoiding difficult conversations that may upset the patient
Correct Answer: B. Informing the manager that a patient feels unheard and is fearful about a treatment
💡 Rationale: Advocacy means speaking up for the patient’s needs, especially when their concerns aren’t being addressed or respected.
Which action BEST reflects a nurse applying critical thinking in clinical practice?
A. Administering medications exactly as written without questioning
B. Looking up a new order and clarifying it with the provider if unsure
C. Completing tasks as quickly as possible to manage time
D. Avoiding discussions with the interprofessional team
Correct Answer: B. Looking up a new order and clarifying it with the provider if unsure
💡 Rationale: Critical thinking includes questioning unclear orders, using evidence, and making safe, informed decisions to prevent errors.
T/F: Nurses are only accountable for tasks they personally complete.
False (They are also responsible for what they delegate.)
T/F: Culturally safe care requires the nurse to be the expert in the client’s culture
False (It requires cultural humility, not expertise.)
T/F: Transactional leadership is highly effective for solving adaptive problems.
False
T/F: Advocacy in nursing includes influencing policy and political engagement.
True
T/F: The CNA Code of Ethics is only aspirational and not enforceable
False
The “unfreezing” phase in Lewin’s Change Theory involves:
A. Making the change permanent
B. Establishing urgency and motivation for change
C. Implementing the change
D. Delegating tasks
Answer: B
Which theory emphasizes small random changes leading to large-scale effects?
A. Diffusion of Innovation
B. Chaos Theory
C. Transactional Theory
D. Lippitt’s Change Theory
Answer: B
Transformational leaders are best suited to:
A. Enforce compliance through penalties
B. Handle routine day-to-day tasks
C. Inspire and motivate followers through shared vision
D. Avoid emotional involvement with staff
Answer: C
According to the CNA Code of Ethics, nurses must promote:
A. Personal judgment above institutional policies
B. Health and well-being
C. Physician-led care
D. Financial efficiency
Answer: B
A transformational nurse leader is most likely to:
A. Focus solely on policy adherence
B. Inspire staff through a shared vision and empowerment
C. Rely on rewards to ensure compliance
D. Avoid personal involvement in team dynamics
Answer: B
B – Transformational leaders inspire and empower others through a shared vision. They promote long-term change and motivation from within, not just performance.
Which characteristic best defines transactional leadership?
A. Shared vision and innovation
B. Managing daily operations through rewards and penalties
C. Focus on team empowerment and inclusivity
D. Embracing chaos and ambiguity in leadership
Answer: B
B – Transactional leaders rely on a system of rewards and punishments to maintain structure and meet expectations, rather than fostering innovation.
A relational nurse leader would most likely:
A. Prioritize deadlines over team relationships
B. Focus on top-down directives
C. Build trust and psychological safety in the team
D. Manage performance through disciplinary action
Answer: C
Relational leadership emphasizes psychological safety, collaboration, and building strong interpersonal relationships to enhance team performance.
Which leadership style is most effective in solving structured and routine problems?
A. Transformational
B. Transactional
C. Laissez-faire
D. Relational
Answer: D
Relational leadership is best for clear and structured problems. It focuses on ethics, inclusivity, and collaboration—especially in predictable settings.
What leadership approach involves seeing problems as adaptive and requiring cultural and organizational transformation?
A. Transactional
B. Transformational
C. Autocratic
D. Democratic
Answer: B
Transformational leaders tackle complex, ambiguous problems that require organizational and cultural change by inspiring others.
In Kotter’s 8-step model, which is the FIRST step in leading change?
A. Create a vision
B. Empower others
C. Establish urgency
D. Communicate the plan
C – Kotter’s first step is to create a sense of urgency to motivate others and lay the groundwork for change.
According to Lewin’s model, what is the purpose of the “refreezing” stage?
A. Evaluate results
B. Sustain and stabilize the change
C. Resist regression
D. Introduce a new vision
B “Refreezing” stabilizes the new practices and embeds them into the culture or routine to prevent regression.
Which stage of Rogers’ Diffusion of Innovation involves the individual weighing the pros and cons of the innovation?
A. Knowledge
B. Persuasion
C. Decision
D. Confirmation
In the decision phase, individuals evaluate the advantages and disadvantages of the change before adopting it.
What does “unfreezing” mean in Lewin’s model?
A. Creating policies
B. Encouraging resistance
C. Preparing the organization for change
D. Communicating new roles
C : Unfreezing” prepares individuals by helping them see the need for change and breaking old habits or mindsets.
In Diffusion of Innovation, the people most resistant to adopting change are called:
A. Early adopters
B. Laggards
C. Innovators
D. Opinion leaders
Laggards are the last to adopt new practices. They resist change until it becomes the norm or necessary.
Advocacy in nursing means:
A. Only reporting unethical behavior
B. Supporting individual patient decisions
C. Using evidence and voice to influence policy and care
D. Following institutional rules without question
C – Advocacy is more than supporting individuals—it’s about using voice and evidence to influence systems and policy for greater equity.
According to the CNA, advocacy includes all EXCEPT:
A. Political engagement
B. Mobilizing evidence
C. Promoting injustice
D. Speaking out against inequity
Advocacy cannot promote injustice. It must be rooted in ethical practice, promoting fairness and equity.
Nurses acting as change agents must first:
A. Wait for a physician to lead
B. Identify and assess the need for change
C. Avoid conflict with leadership
D. Work independently without collaboration
Change agents start by assessing the need for change. This foundation is essential before action or implementation.
A nurse advocating for improved mental health access in a rural community is practicing:
A. Managerial delegation
B. Ethical compliance
C. Policy-level advocacy
D. Conflict avoidance
Policy-level advocacy addresses systemic issues such as access, equity, and health infrastructure, especially for underserved areas.
One barrier to advocacy in nursing is:
A. Understanding of systems
B. Strong nursing numbers
C. Lack of political unity and funding
D. Patient-centered care
Nurses often face barriers like fragmented political efforts and insufficient funding for lobbying, which hinders advocacy efforts.
What is the main benefit of RN prescribing in Canada?
A. Reduces nursing autonomy
B. Delays treatment
C. Expands access to care, especially in underserved areas
D. Eliminates NP roles
RN prescribing helps reduce treatment delays and expands care in underserved areas, especially for minor conditions.
In which Canadian province is RN prescribing currently under review?
A. Alberta
B. Ontario
C. British Columbia
D. Nova Scotia
As of the latest update, Ontario is reviewing RN prescribing, whereas other provinces have already started or piloted it.
A key challenge of RN prescribing is:
A. Increased patient satisfaction
B. Overlap with NP roles and role confusion
C. Reduced healthcare costs
D. More time with clients
Confusion between RN and NP roles is a major challenge, especially if scope, responsibilities, and public understanding aren’t clear.
RN prescribing typically covers minor ailments such as UTIs, contraception, and smoking cessation, not complex conditions.
Which condition is commonly addressed by RN prescribing frameworks?
A. Cancer
B. Heart disease
C. Minor ailments like UTIs and smoking cessation
D. Complex chronic disease
Safe and effective RN prescribing relies on regulation, training, and clear role definitions to protect patients and practitioners
Which of the following is NOT part of the CNO’s Code of Conduct?
A. Respect client dignity
B. Work respectfully with healthcare team
C. Maximize hospital profits
D. Maintain public confidence in nursing
Maximizing profits is not part of the CNO Code. The Code focuses on safety, dignity, integrity, and collaboration.
Practicing cultural humility supports which CNO principle?
A. Professional autonomy
B. Providing inclusive and culturally safe care
C. Personal judgment
D. Minimizing team communication
C. Practicing cultural humility helps ensure inclusive and culturally safe care, which is central to the Code.
A nurse who acts with integrity in the client’s best interest is adhering to:
A. Organizational loyalty
B. CNA privacy standards
C. CNO Code of Conduct
D. Transactional leadership
C. Acting in the client’s best interest is a cornerstone of the CNO Code of Conduct and professional nursing ethics.
Public confidence in nursing is maintained by:
A. Avoiding change
B. Adhering to the CNO Code of Conduct
C. Following physician orders without question
D. Limiting client input
B. Adhering to professional standards, such as the Code of Conduct, helps maintain public trust in the nursing profession.
The CNO Code of Conduct emphasizes:
A. Political neutrality
B. Legal representation
C. Culturally safe and competent care
D. Managerial control
C. Culturally competent and safe care ensures clients are respected, valued, and treated without discrimination.
Which of the following is a key element of whistleblowing?
A. Avoiding legal support
B. Working anonymously only
C. Using voice and power to report unsafe practices
D. Waiting for change to happen naturally
C. Whistleblowing is the act of using your voice and professional standing to report unsafe or unethical practices, often tied to power dynamics.
What is the first step when a nurse considers whistleblowing?
A. Speak to media
B. Notify the union
C. Report through organizational channels
D. Resign from the position
C The first step is to report concerns internally through established organizational procedures before going outside.
Whistleblowing is important because:
A. It protects employers
B. It maintains nursing silence
C. It holds systems accountable and protects public safety
D. It avoids confrontation
C: Whistleblowing plays a crucial role in holding organizations accountable and ensuring public and patient safety.
Developing a strong nursing identity involves:
A. Mimicking senior staff behavior
B. Defining personal values and leadership style
C. Avoiding responsibility
D. Ignoring change
B Nursing identity develops through understanding one’s values, leadership style, and professional goals—not imitation.
Inclusive leadership means:
A. Enforcing strict hierarchy
B. Making decisions without input
C. Valuing diverse perspectives and engaging others in solutions
D. Avoiding discussions on race or culture
C: Inclusive leadership involves engaging team members, respecting diverse views, and making collaborative decisions.
Emotional intelligence includes all EXCEPT:
A. Self-awareness
B. Empathy
C. Impulsiveness
D. Social skills
C : Impulsiveness is the opposite of emotional intelligence, which includes self-regulation, empathy, and interpersonal skills.
A nurse with strong emotional intelligence would:
A. Avoid feedback
B. Lash out under pressure
C. Reflect and regulate emotional reactions
D. Ignore team dynamics
C : Emotionally intelligent nurses recognize their emotions and regulate their responses, especially under pressure.
Which of the following is a social determinant of health?
A. Lab results
B. Blood pressure
C. Income and social status
D. Age
C Income and social status are recognized by Health Canada and WHO as core social determinants of health.
Nurses should assess social determinants because they:
A. Are part of medical history only
B. Influence access, recovery, and risk for illness
C. Are optional in care planning
D. Do not apply to hospital settings
B. Social determinants shape access, adherence, and recovery; therefore, they must be considered in nursing assessments.
Relational leaders support inclusive care by:
A. Working independently
B. Valuing relationships and creating psychological safety
C. Limiting discussions with clients
D. Focusing on hierarchy
B. Relational leaders build trust and safety by emphasizing respect, inclusiveness, and team collaboration.
Which of the following best describes the role of a nurse leader as an advocate?
A. Providing direct bedside care
B. Enforcing hospital policy without question
C. Using frontline experience and data to influence health policy
D. Avoiding political discussions in healthcare
Correct Answer: C
Rationale: Nurse leaders are expected to translate frontline knowledge into policy by advocating for improvements in healthcare systems. Advocacy is a political act.
A nurse leader challenges the perception that nurses are “just workers” by emphasizing their professional autonomy. This is an example of:
A. Task delegation
B. Role confusion
C. Value-based leadership
D. Transactional management
Correct Answer: C
Rationale: Value-based leadership involves highlighting the ethical, professional, and societal value of nursing beyond task-oriented roles.
Which of the following is a primary challenge associated with whistleblowing?
A. Increased compensation
B. Overwhelming public support
C. Fear of retaliation and professional isolation
D. Guaranteed legal protection in all workplaces
Correct Answer: C
Rationale: Fear of retaliation, job loss, and being ostracized are common barriers that prevent nurses from reporting unethical or unsafe practices.
What is one effective strategy to overcome challenges related to whistleblowing?
A. Ignoring systemic issues until someone else reports them
B. Reporting to media before internal channels
C. Educating oneself on legal rights and protections
D. Working in isolation to avoid conflict
Correct Answer: C
Rationale: Education on whistleblower protections and legal rights empowers nurses to speak up safely and effectively.
Which of the following actions best reflects a nurse leader’s plan to move forward as an advocate?
A. Remaining neutral in political discussions to avoid controversy
B. Attending conferences only for clinical skill development
C. Speaking out on staffing shortages and collaborating with professional organizations
D. Avoiding union involvement
Correct Answer: C
Rationale: Effective advocacy includes speaking up, uniting with others, and influencing policy and system-level changes.
A nurse leader joins a hospital committee to influence inclusive policy changes. This action demonstrates:
A. Passive resistance
B. Role confusion
C. Political disengagement
D. Active leadership and advocacy
Correct Answer: D
Rationale: Participating in decision-making bodies is a key advocacy strategy that gives nurses a voice in shaping policy.
T/F: One barrier to whistleblowing is lack of knowledge about legal protections.
✅ True
Rationale: Many nurses are unsure about their rights or how to report issues safely, which hinders whistleblowing efforts.
Why is collective power important in addressing whistleblowing challenges?
A. It guarantees anonymity
B. It strengthens credibility and reduces individual risk
C. It eliminates institutional power dynamics
D. It allows nurses to avoid documentation
Correct Answer: B
Rationale: Working collectively helps validate concerns, protect individuals, and give weight to reports on systemic issues.
Which example best shows a nurse leader mentoring new nurses in advocacy?
A. Teaching them only clinical skills
B. Encouraging them to avoid conflict
C. Guiding them on how to navigate ethical dilemmas in political contexts
D. Discouraging participation in union events
Correct Answer: C
Rationale: Mentorship should include how to recognize and respond to ethical and political challenges, not just clinical practice.
T/F: Advocacy in nursing is limited to patient care and does not include influencing health policy.
❌ False
Rationale: Advocacy includes influencing policy, promoting equity, and engaging in political action to support patients and the profession.
T/F: Collaborating with unions and nursing organizations can support safe and effective advocacy.
✅ True
Rationale: These groups provide resources, legal support, and collective power to strengthen nurses’ voices.
T/F: Speaking out about unsafe conditions is outside the scope of a nurse leader’s responsibilities.
❌ False
Rationale: Nurse leaders are expected to address safety, advocate for fair conditions, and lead systemic change.
T/F: Building alliances with other professionals and organizations increases the impact of nursing advocacy.
True
Rationale: Cross-sector collaboration strengthens advocacy efforts and fosters comprehensive, systemic change.
T/F: Political engagement by nurses helps shape more inclusive and equitable healthcare systems.
True
Rationale: When nurses participate in policy-making, they bring the patient voice and frontline knowledge to the table, influencing equity and access.
A nurse leader challenges outdated scheduling practices by proposing a flexible, app-based staffing pilot program. This is an example of:
A. Transactional leadership
B. Managing the status quo
C. Innovation through design thinking
D. Reducing accountability in the workplace
Correct Answer: C
Rationale: This reflects the use of creative problem-solving to reframe and improve work-life balance, which is central to design thinking and innovative leadership.
What is the first step in using design thinking in nursing innovation?
A. Create a detailed business case
B. Empathize with patients and staff to understand real needs
C. Jump straight to implementing solutions
D. Collect budget approval from stakeholders
Correct Answer: B
Rationale: Design thinking begins with empathy—understanding the lived experiences of patients or staff to define the core problem before jumping to solutions.
Which leadership action best promotes a culture of innovation on a healthcare team?
A. Discouraging new ideas to maintain consistency
B. Hosting monthly idea huddles to encourage team creativity
C. Avoiding risks to ensure compliance with policy
D. Criticizing failures to prevent repeated mistakes
Correct Answer: B
Rationale: Hosting informal innovation spaces fosters psychological safety, shared creativity, and idea-sharing—key to building a culture of innovation.
Which of the following best demonstrates nurse entrepreneurship?
A. Following policies without question
B. Inventing a new wearable device with a biomedical engineer
C. Reporting for the same shift model every week
D. Delegating tasks only to regulated professionals
Correct Answer: B
Rationale: Entrepreneurship involves creating or co-developing new tools or technologies to meet patient needs—like nurse-engineer collaborations.
According to the CNO, nurses are expected to engage in which of the following related to informatics?
A. Avoid using mobile health tools
B. Use computers only for charting
C. Strengthen competence in nursing informatics
D. Focus solely on verbal communication
Correct Answer: C
Rationale: CNO Entry-to-Practice Competency #9.4 emphasizes the importance of building informatics competency, including the use of emerging technologies.
A nurse leader celebrates a colleague’s idea that didn’t succeed but sparked new discussion. This demonstrates:
A. Passive leadership
B. Innovation avoidance
C. Risk-taking and learning culture
D. Poor decision-making
Correct Answer: C
Rationale: Celebrating failure as part of growth is essential in creating an environment where innovation can thrive.
What is a key consideration when implementing digital health technologies?
A. Reducing collaboration
B. Increasing the workload
C. Ensuring ethical standards, consent, and confidentiality
D. Prioritizing cost over patient care
Correct Answer: C
Rationale: When adopting technology in nursing, it’s essential to prioritize ethics, confidentiality, and informed consent to protect patient rights.
Which informatics tool is best suited for real-time care coordination and documentation?
A. Telemarketing systems
B. Social media apps
C. Electronic health records (eHealth)
D. Voice memos
Correct Answer: C
Rationale: eHealth technologies like electronic medical records (EMRs) support care documentation and communication across healthcare teams.
Which of the following best describes “innovation” in nursing according to Kelly & Young (2017)?
A. Implementation of a new task
B. Invention + Adoption + Diffusion
C. Risk avoidance + Time management
D. Process repetition without change
Correct Answer: B
Rationale: Innovation involves creating new ideas (invention), using them (adoption), and spreading them across systems (diffusion).
A nurse co-designs a digital discharge checklist with patients and IT staff. This reflects:
A. Isolated practice
B. Hierarchical decision-making
C. Interdisciplinary innovation
D. Traditional care planning
Correct Answer: C
Rationale: Engaging with multiple professionals—including patients—is key to interdisciplinary collaboration in innovative projects
T/F: Divergent thinking involves encouraging unconventional ideas and brainstorming freely.
True
Rationale: Divergent thinking supports creativity and innovation by welcoming diverse and out-of-the-box solutions.
T/F: Design thinking starts with analyzing hospital budgets.
❌ False
Rationale: It starts with empathy—understanding the user experience (e.g., patients, staff) to frame the right problem.
T/F: Psychological safety helps teams feel confident sharing ideas without fear of judgment.
True
Rationale: A psychologically safe environment encourages innovation and honest communication, especially during trial-and-error.
T/F: One of the main expectations of nurses is to ignore emerging technologies unless trained formally.
False
Rationale: Nurses are expected to identify, analyze, and adapt to emerging technologies, even if it requires ongoing professional development.
