ANCC NPD-BC Exam Questions

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21.

In an effort to improve patient satisfaction and care quality, a nurse leader decides to adopt an affiliative leadership style. Which action should the leader prioritize to achieve these goals?

  • The leader should prioritize creating a nurturing work environment instead of focusing on productivity metrics.

  • The leader should focus on rigorous enforcement of care standards and immediate correction of any deviations.

  • The leader should set highly ambitious care quality goals for the team to achieve within a short timeframe.

  • The leader should provide frequent, supporting feedback to team members regarding their performance and how it can be improved.

Correct answer: The leader should prioritize creating a nurturing work environment instead of focusing on productivity metrics.

Affiliative leadership emphasizes creating a caring and supportive work environment. Prioritizing a nurturing environment where team members feel valued and understood can lead to improved satisfaction and care quality. A pure affiliative leadership style will not focus on productivity metrics, but will instead take the position that providing a caring and supportive work environment will ultimately improve productivity and performance.

Rigorous enforcement of standards is more characteristic of a coercive or pacesetting leadership style, rather than the supportive and nurturing approach of affiliative leadership. Setting highly ambitious goals within a short timeframe is more aligned with a pacesetting leadership style, focusing on results rather than the emotional well-being of the team. While offering supportive feedback can be associated with affiliative leadership, frequent coaching is not as aligned with an affiliative leadership style as creating a nurturing work environment.

22.

Which of the following comprehensively explains adult learning in healthcare?

  • There is no single theory or model that comprehensively explains adult learning.

  • Behavioral learning theory

  • Adult learning theory

  • Health belief model

Correct answer: There is no single theory or model that comprehensively explains adult learning.

No single theory or model can comprehensively explain adult learning in healthcare. It is important for nurses to understand all major learning theories and employ techniques and principles from each of them depending on the particular situation.

Behavioral learning theory, adult learning theory, and the health belief model are all important learning theories or models that nurses should be familiar with, however, none of these will comprehensively explain adult learning in healthcare.

23.

A patient requires a procedure that the nurse has never performed before. Which ethical principle most obligates the nurse to seek additional guidance or refer the patient to a more experienced colleague?

  • Nonmaleficence

  • Autonomy

  • Beneficence

  • Fidelity

Correct answer: Nonmaleficence

Nonmaleficence is the principle that obligates healthcare professionals to avoid causing harm, which includes refraining from performing procedures or treatments for which they are not adequately trained or experienced.

Autonomy pertains to the patient's right to make decisions, not the nurse's competency. Beneficence is about doing good, but the specific obligation to avoid causing harm is addressed by nonmaleficence. Fidelity involves keeping promises and being trustworthy, it's not the primary principle at stake when it comes to competence in performing procedures.

24.

During a public health crisis, a nurse must decide how to allocate limited resources to a large number of patients. According to deontological ethics, what should be the primary consideration in decision-making?

  • Adhering to established guidelines for fair and impartial resource allocation.

  • Maximizing the total well-being of the greatest number of people.

  • Allocating resources based on the social status or contribution of the patients.

  • Distributing resources based on the personal relationship with the patients.

Correct answer: Adhering to established guidelines for fair and impartial resource allocation.

Deontological ethics emphasizes the importance of following moral rules and duties, in this case, adhering to established guidelines for fair and ethical distribution of resources.

Maximizing well-being relates more to utilitarian principles than to deontological ethics. Deontology focuses on the adherence to duty and moral rules, not on social status or contribution. Personal relationships should not influence the allocation of resources according to deontological ethics, which values impartial adherence to ethical principles.

25.

Core measures in a hospital setting are used to do which of the following?

  • Evaluate patient care quality and safety based on specific criteria.

  • Measure the core functions and processes of the hospital.

  • Evaluate the performance of each employee individually.

  • Assess the efficiency of the IT department.

Correct answer: Evaluate patient care quality and safety based on specific criteria.

Core measures are evidence-based criteria used to evaluate the quality and safety of patient care. Core measures evaluate processes and outcomes directly impacting the patient, but they are not used to measure the functions and processes of the hospital in general. Core measures evaluate patient care quality, not employee performance unless it pertains to their performance in meeting the core measure.

While important, the IT department's efficiency is not what core measures are designed to assess.

26.

In evaluating a patient's understanding of their new medication regimen, a nurse should do which of the following?

  • Use open-ended questions to assess the patient's understanding.

  • Assess comprehension by noting if the patient nods in agreement.

  • Rely on written materials to confirm understanding.

  • Avoid correcting misconceptions to maintain the patient's confidence.

Correct answer: Use open-ended questions to assess the patient's understanding.

Open-ended questions allow the patient to express their understanding in their own words, revealing any misconceptions.

Nodding may not indicate true understanding; it can be a social or cultural cue rather than a sign of comprehension. Written materials alone may not ensure comprehension, especially in patients beginning a new treatment regimen. Addressing and correcting misconceptions is crucial for patient safety and comprehension.

27.

In a professional development session on managing aggressive behavior in psychiatric patients, the nurse educator wants to evaluate the nurses’ ability to de-escalate potentially violent situations. Which activity should the educator use?

  • A role-play exercise where nurses practice de-escalation techniques in simulated scenarios.

  • A discussion on the theoretical models of aggression.

  • A review of hospital policies on the use of restraints and seclusion.

  • A written test covering the signs and symptoms of escalating aggressive behavior.

Correct answer: A role-play exercise where nurses practice de-escalation techniques in simulated scenarios.

Role-play exercises simulate real-life scenarios, allowing the educator to assess the nurses’ ability to apply de-escalation techniques effectively.

Theoretical discussions provide background knowledge but do not assess practical de-escalation skills. Reviewing policies is important but does not assess the nurses’ ability to apply de-escalation techniques in practice. Written tests assess knowledge recall but do not measure the practical application and evaluation of de-escalation techniques in a dynamic setting.

28.

When planning a continuing education program on managing diabetic ketoacidosis, the nursing professional development practitioner ensures that the program can accommodate nurses with different levels of experience. This consideration is most important for meeting which standard?

  • Addressing diverse learning needs

  • Ensuring content validity

  • Facilitating learner engagement

  • Promoting inter-professional learning

Correct answer: Addressing diverse learning needs

Addressing diverse learning needs ensures that the program is inclusive and relevant for nurses at different stages in their careers, aligning with the standard of providing education that meets the specific needs of the audience.

Ensuring content validity is important but not directly related to accommodating different levels of experience. Facilitating learner engagement is important but is a broader concept than addressing specific learning needs. Promoting inter-professional learning is beneficial but not specifically about accommodating varying levels of nursing experience.

29.

When initiating a new project to improve patient handover processes between departments, what is the first step in managing this project effectively?

  • Identifying champions and key stakeholders for the project.

  • Identifying and securing funding opportunities for the project.

  • Setting strict timelines for each phase of the project.

  • Developing a detailed action plan.

Correct answer: Identifying champions and key stakeholders for the project.

Identifying champions and stakeholders is the correct first step because their support is critical for the project's success from the outset.

While securing funding is important, understanding who the project's champions and key stakeholders are is crucial for initial buy-in and will support efforts to secure funding. Setting timelines is necessary for project management but they should come after identifying key personnel who will drive and support the project. An action plan is vital but should be developed with input from champions and stakeholders to ensure it addresses all necessary areas effectively.

30.

In the context of information management policies, what is the significance of an audit trail in a healthcare setting?

  • It provides a record of all access to and actions taken on patient data.

  • It tracks changes in system configurations and software updates.

  • It monitors any financial transactions made by employees.

  • It evaluates the clinical outcomes of patients over time.

Correct answer: It provides a record of all access to and actions taken on patient data.

In the context of information management policies, an audit provides a record of all access to and actions taken on patient data. It is essential for tracking who accessed or modified patient data and is crucial for security and compliance.

While tracking changes in system configurations and software updates is important, this description is not primarily related to auditing in the context of information management policies. An audit trail in the context of information management policies is not the same as a financial audit. Clinical outcomes are not the focus of an audit trail in the context of information management policies.

31.

When educating an elderly patient with hearing and vision impairment about managing hypertension at home, what should the nurse prioritize to enhance the patient's readiness to learn?

  • Ensure a quiet environment and use tactile teaching methods when possible.

  • Speak loudly and provide written materials in large print.

  • Rely on family members to convey the information after the session.

  • Present the information quickly to reduce the cognitive load on the patient.

Correct answer: Ensure a quiet environment and use tactile teaching methods when possible.

Reducing auditory distractions and using tactile methods can help overcome sensory barriers and facilitate learning.

While speaking loudly and providing written materials in large print may address sensory impairments, they may not fully cater to the patient's learning needs and are not related to enhancing readiness to learn. Involving family is important, but the patient's direct engagement and understanding are also crucial when possible. Quick presentation can overwhelm the patient, especially considering their sensory impairments.

32.

In a situation where a new, complex medical protocol is being introduced, which action by an authoritarian nurse leader is most expected?

  • The nurse leader provides detailed instructions on the new protocol, expects strict adherence, and monitors implementation closely.

  • The nurse leader organizes a series of workshops and encourages the staff to collaboratively learn and practice the new protocol.

  • The nurse leader encourages the staff to research and understand the new protocol independently and integrate their findings into practice.

  • The nurse leader facilitates a discussion forum where staff can express their opinions and concerns about the new protocol.

Correct answer: The nurse leader provides detailed instructions on the new protocol, expects strict adherence, and monitors implementation closely.

An authoritarian leadership style dictates adherence unilaterally instead of seeking input or diverse views.

Authoritarian leaders are less likely to encourage collaborative learning, preferring to instruct and direct learning in a structured manner. They also typically do not encourage independent research or integration but prefer to maintain control over how new protocols are learned and implemented. Authoritarian leaders are also less likely to facilitate open discussion forums and are more inclined to dictate policies and monitor adherence.

33.

Which of the following is an essential component of measuring the effectiveness of a new nursing orientation program?

  • The increase in nurse retention rates six months after program implementation.

  • The number of nurses who attended the program.

  • The satisfaction new nurses express with the program’s content.

  • A decrease in the cost of nursing recruitment.

Correct answer: The increase in nurse retention rates six months after program implementation.

Monitoring retention rates post-implementation provides direct insight into the long-term impact of the orientation on nurse engagement and satisfaction, making this the most relevant measure of effectiveness.

Attendance figures indicate interest or compliance but not the effectiveness of the program. Nurses’ satisfaction with the program’s content may not reflect the efficacy of the program. While decreasing the cost of nursing recruitment may be an outcome of the program, it does not directly measure program effectiveness in terms of educational or professional outcomes.

34.

After noticing a decrease in patient satisfaction scores related to nursing care, the nurse manager decides to implement new standards for patient interaction. According to transactional leadership principles, which strategy should the nurse manager prioritize?

  • Setting specific, measurable criteria for patient interaction and linking performance to bonuses or other incentives.

  • Facilitating workshops that focus on the personal values and beliefs of nurses regarding patient care.

  • Encouraging nurses to redefine their personal goals to align with the holistic needs of the patients.

  • Promoting an open-ended, creative approach to problem-solving in patient care scenarios.

Correct answer: Setting specific, measurable criteria for patient interaction and linking performance to bonuses or other incentives.

Setting clear, measurable criteria for performance and linking it to incentives is a key component of transactional leadership, focusing on extrinsic motivation.

Focusing on personal values and beliefs is more aligned with transformational leadership, which aims to engage staff on a deeper, more personal level. Encouraging nurses to redefine their personal goals aligns more with transformational leadership, which seeks to inspire and transform staff attitudes and behaviors. Promoting a creative, open-ended approach is not typically characteristic of transactional leadership, which tends to focus on specific, structured outcomes and efficiency.

35.

Which of the following is most important to ensuring the sustainability of a nurse mentoring program with limited fiscal resources?

  • Seeking external funding and grants to support the program.

  • Asking mentors to shift to working solely on a volunteer basis.

  • Reducing the number of mentees to lower costs.

  • Focusing exclusively on online mentoring to eliminate physical resource needs.

Correct answer: Seeking external funding and grants to support the program.

Seeking external funding and grants can provide the necessary financial support to sustain and potentially expand the program without compromising its quality or reach.

While asking mentors to work solely on a volunteer basis may result in cost savings, it is also likely to affect the efficacy of the program by reducing the availability of mentors. Reducing the number of mentees may limit the program's impact and does not address long-term sustainability. While online mentoring can reduce some costs, it should complement, not replace, face-to-face interactions as it may not address all resource challenges.

36.

What tool is best for a nurse to use to collaborate on a policy revision during a remote meeting with colleagues across different locations?

  • Online collaborative document platform

  • Email

  • Spreadsheet

  • Presentation software

Correct answer: Online collaborative document platform

Online collaborative document platforms enable multiple users to work on a document simultaneously, regardless of location, and is the best option for collaborating on a policy revision remotely.

While email does provide a means of remote communication, email does not allow for real-time collaboration and document editing. Email requires sending different versions of the document back and forth, creating inefficiencies and redundancies. Spreadsheets are not typically used for policy writing or revision. Presentation software is not designed for collaborative text document creation or editing.

37.

A high rate of nurse turnover is most likely to directly affect which of the following?

  • Patient care quality

  • Physician turnover

  • The rates of hospital-acquired pneumonia

  • The speed of administrative decision-making

Correct answer: Patient care quality

High nurse turnover can lead to staffing shortages and decreased nurse satisfaction ultimately lowering the quality of patient care.

Physician turnover is not typically directly impacted by nursing turnover, although similar underlying factors may cause both to correlate. Rates of hospital-acquired pneumonia are less likely to be specifically affected by nursing turnover when compared to the quality of care in general. While administrative decision-making can be affected by staffing levels, the direct impact of nurse turnover is more closely felt in areas of satisfaction and care quality.

38.

A nursing team is considering the implementation of a new protocol for administering subcutaneous insulin in patients with type 2 diabetes. Which step in the research process should they prioritize to ensure the protocol is based on the best available evidence?

  • Reviewing meta-analyses and systematic reviews related to insulin administration.

  • Conducting an internal pilot study to test the protocol.

  • Surveying nursing staff for their opinions on insulin administration methods.

  • Consulting with a diabetes educator for expert advice.

Correct answer: Reviewing meta-analyses and systematic reviews related to insulin administration.

Meta-analyses and systematic reviews synthesize findings from multiple studies, providing the highest level of evidence on the effectiveness of health interventions.

While an internal pilot study can provide valuable insights, it is not the first step in ensuring an evidence-based protocol. Staff opinions are important for implementation considerations but do not substitute for evidence-based practice. Expert advice is valuable but should be supplemented with a comprehensive review of the literature to ensure evidence-based practice.

39.

Which approach should a nurse leader take first when addressing a gap in nursing competencies related to the assessment and management of sepsis?

  • Conduct a needs assessment to identify specific competency gaps.

  • Revise the nursing curriculum to include updated sepsis protocols.

  • Implement a simulation-based training program focused on sepsis scenarios.

  • Schedule a series of lectures on the pathophysiology of sepsis.

Correct answer: Conduct a needs assessment to identify specific competency gaps.

Conducting a needs assessment is the first and most critical step to accurately identify the specific areas of deficiency within the team's knowledge or skills related to sepsis management. This ensures that subsequent educational interventions are targeted and effective.

While revising the curriculum may be important, these revisions should be based on identified needs to ensure relevance. Simulation-based training is effective for skill development but should only be designed after understanding the specific learning needs. Lectures can provide foundational knowledge but may not be the most effective initial approach without first identifying the specific gaps in understanding or practice.

40.

A nurse educator is planning a lecture on managing diabetic emergencies. Which approach should the educator take to ensure that the teaching promotes critical thinking among the participants?

  • Organize the lecture around patient scenarios and encourage participants to discuss management strategies.

  • Begin the session with an overview of diabetes and then focus on detailed protocols for each type of diabetic emergency.

  • Present statistics on diabetic emergencies and discuss the impact on healthcare systems.

  • Provide a list of symptoms of diabetic emergencies and the medications used for treatment.

Correct answer: Organize the lecture around patient scenarios and encourage participants to discuss management strategies.

Patient scenarios prompt learners to apply knowledge in simulated situations and analyze management strategies, promoting critical thinking and reducing dependence on passive learning.

While providing detailed protocols is important, it does not inherently promote critical thinking or engage participants. Discussing statistics and impact is informative but does not directly engage learners in applying or analyzing clinical situations. Listing symptoms and medications is a lower-level cognitive task focusing on recall rather than critical thinking.