76Question
A manager notices that two departments share a small pool of float nurses and have competing priorities. No staff member has yet noticed or complained about a problem. At which stage of conflict is this situation?
- Felt conflict
- Manifest conflict
- Aftermath
- Latent conflict
Show the answer and explanation
Answer: D. Latent conflict
Topic: stages of conflict
In latent conflict the conditions for conflict, such as scarce resources or competing goals, exist but the parties are not yet aware of them. Felt conflict involves emotions, manifest conflict involves visible behavior, and aftermath follows resolution or suppression.
Why the others are wrong
- A – Felt conflict means people have emotional reactions such as anxiety or anger; none are described.
- B – Manifest conflict is open behavior such as arguing or complaining; none has occurred.
- C – Aftermath comes after the conflict has been resolved or suppressed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
77Question
A client scheduled for knee surgery tells the nurse, 'I'm afraid I won't be able to go back to work.' Which response demonstrates active listening?
- 'Most people return to work within a few weeks, so there is really no need to worry about it.'
- 'Let's review your consent form before the surgeon arrives.'
- 'Have you talked to your employer about this yet?'
- 'It sounds like you are worried about how surgery will affect your job.'
Show the answer and explanation
Answer: D. 'It sounds like you are worried about how surgery will affect your job.'
Topic: active listening response
Active listening includes paraphrasing or reflecting what the speaker has said, which confirms understanding and invites the client to continue. Reassurance, changing the subject and closed questions block the client's expression of concern.
Why the others are wrong
- A – Reassurance dismisses the feeling and cuts off further discussion.
- B – This changes the subject and ignores the client's concern.
- C – A closed question moves to action before the client's fear has been explored.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
78Question
Two nurses are in conflict over float assignments. One nurse sits quietly, defines what the real issue is and tries to understand how the other nurse sees it before she decides how to respond. According to Thomas's conflict process model, which stage is she in?
- Conceptualization: each side defines the issue and thinks about the other's view
- Frustration: a goal is felt to be blocked by the other party
- Behavior: each party acts out its chosen response, such as arguing, yielding or collaborating
- Outcome: the result and its effect on future interactions
Show the answer and explanation
Answer: A. Conceptualization: each side defines the issue and thinks about the other's view
Topic: Thomas conflict process model
In Thomas's model, conflict moves through frustration, conceptualization, behavior and outcome. Conceptualization is the stage in which each party defines the issue and considers the other's perspective before choosing a behavior.
Why the others are wrong
- B – Frustration is the earlier stage in which the person feels blocked; she is already reflecting on the issue.
- C – Behavior is the stage of action; she has not yet chosen how to respond.
- D – Outcome is the result of the exchange, which has not yet occurred.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
79Question
A unit's overtime budget for the quarter was $40,000. Actual overtime spending was $46,000. How should the nurse manager describe the variance?
- $6,000 favorable, because spending was within 15 percent of the plan
- $6,000 unfavorable, which is 13 percent over the planned amount
- $6,000 unfavorable, which is 15 percent over the planned amount
- $46,000 unfavorable, the full amount spent
Show the answer and explanation
Answer: C. $6,000 unfavorable, which is 15 percent over the planned amount
Topic: calculating budget variance
A budget variance is the difference between actual and budgeted amounts. Spending $46,000 against $40,000 is $6,000 over, which is unfavorable, and the percentage is calculated on the budgeted amount: 6,000 divided by 40,000 is 15 percent.
Why the others are wrong
- A – Spending more than planned on an expense is unfavorable, not favorable.
- B – The percentage was found by dividing by the actual amount (13 percent); the base is the budget.
- D – The variance is the difference, not the total amount spent.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
80Question
Two nurses have stopped speaking to each other after a dispute. At shift handoff they now exchange only the bare minimum. What is the most important reason for the manager to intervene promptly?
- Visitors may notice the tension between the two nurses and form a poor impression of the unit
- Staff satisfaction scores are reviewed by administration every quarter
- Other nurses may feel obliged to take sides in the dispute
- Critical information may be missed at handoff, which threatens client safety
Show the answer and explanation
Answer: D. Critical information may be missed at handoff, which threatens client safety
Topic: effects of unresolved interpersonal conflict
Unresolved interpersonal conflict can disrupt communication, and in health care that can compromise client safety. Safety takes priority over morale, image or reporting concerns, though those are also affected.
Why the others are wrong
- A – Image matters little compared with client safety.
- B – Survey timing is administrative and not the reason to intervene.
- C – Staff taking sides is a harm to the team, but it is less urgent than a client safety risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
81Question
A manager wants to improve retention of new graduates on her unit. Which action reflects a transformational leadership style?
- Meets with each new graduate to set growth goals and links daily work to the unit's vision
- Gives rewards only when numeric targets are met and steps in only when those targets are missed or standards are broken
- Makes all scheduling and practice decisions alone and expects staff to follow directions
- Leaves new graduates to organize their own work and offers help only if they ask
Show the answer and explanation
Answer: A. Meets with each new graduate to set growth goals and links daily work to the unit's vision
Topic: transformational leadership and retention
Transformational leaders inspire with a shared vision, give individual attention and encourage professional growth. This style is associated with higher job satisfaction and retention. B describes transactional, C autocratic and D laissez-faire leadership.
Why the others are wrong
- B – Rewards and corrections tied to targets are transactional leadership.
- C – Making all decisions alone is autocratic and tends to lower engagement.
- D – Minimal involvement is laissez-faire and leaves new graduates without needed support.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
82Question
A hospital is adopting a shared governance model. Which description best fits the role of staff nurses under this model?
- They carry out practice decisions made by senior leaders and give feedback only on request
- They make practice decisions through unit councils and are accountable for the results
- They are limited to advising on staffing while leaders set clinical standards
- They are responsible for the hospital's financial planning and executive hiring
Show the answer and explanation
Answer: B. They make practice decisions through unit councils and are accountable for the results
Topic: shared governance model
Shared governance is a structure in which staff nurses participate in decisions about practice, quality and the work environment, usually through councils, with authority and accountability for the outcomes. It empowers nurses without making them responsible for all management functions.
Why the others are wrong
- A – This describes a traditional top-down model, not shared governance.
- C – Advice only is not shared authority.
- D – Executive finance and hiring are not what shared governance gives staff nurses.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
83Question
A manager is preparing the unit's operating budget for the coming year. Which expense belongs in the operating budget rather than the capital budget?
- Purchase of a new bedside monitoring system for the unit that will last about ten years
- Construction of an additional patient wing for the hospital
- Replacement of 20 infusion pumps that have reached the end of their useful life
- Salaries, routine supplies and staff education
Show the answer and explanation
Answer: D. Salaries, routine supplies and staff education
Topic: operating versus capital budget
The operating budget covers the day-to-day costs of running the unit, such as salaries, supplies and education. Major equipment and buildings with a long useful life are capital expenses and are planned in the capital budget.
Why the others are wrong
- A – A long-lived major equipment purchase is a capital expense.
- B – Construction is a capital project.
- C – Replacing durable equipment is a capital expenditure.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
84Question
When building next year's unit budget, a manager takes this year's expenses and adds 3 percent for expected supply price increases. Which budgeting approach is this?
- Incremental budget based on last year's spending
- Zero-based budget, in which every expense must be justified anew
- Capital budget, used for long-term equipment purchases
- Flexible budget, recalculated at period end once actual volume is known
Show the answer and explanation
Answer: A. Incremental budget based on last year's spending
Topic: incremental budgeting
An incremental budget starts with the previous period's figures and adjusts them for known changes such as inflation or expected volume. A zero-based budget starts from zero, and a flexible budget adjusts for changes in activity.
Why the others are wrong
- B – Zero-based budgeting begins at zero and requires full justification, not last year's baseline.
- C – A capital budget covers major long-term purchases, not routine expenses.
- D – A flexible budget adjusts to actual activity levels; the manager here only added a fixed percentage.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
85Question
During a surge, nurses on a unit tell their manager they are worried about being moved to unfamiliar units without training. Which manager action best addresses their need to feel prepared?
- Tell nurses that flexibility is a core professional expectation during surges
- Send a one-time email listing the staff who might be reassigned
- Provide brief just-in-time orientation and a resource guide before any redeployment
- Ask nurses to send their concerns to human resources once the surge has ended and the unit is stable
Show the answer and explanation
Answer: C. Provide brief just-in-time orientation and a resource guide before any redeployment
Topic: preparing staff during crisis redeployment
Health care workers in a crisis need to feel heard, protected, prepared, supported and cared for. Preparing them means giving the training, information and resources they need before they are asked to work in unfamiliar roles.
Why the others are wrong
- A – Stating an expectation does not give nurses the skills or information they need.
- B – A list of names informs but does not prepare anyone to work safely.
- D – Waiting until after the surge does nothing for current preparedness and safety.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
86Question
A nurse on a unit says loudly that the new electronic documentation system will 'make care worse' and refuses to attend training. Which response by the nurse manager best addresses resistance to change?
- Ignore the comments until the nurse sees that the other staff accept the system
- Meet privately to hear the concerns and involve the nurse in planning the rollout
- Warn the nurse that continued opposition will be placed in her performance file
- Assign the nurse to a unit that is not yet using the new system
Show the answer and explanation
Answer: B. Meet privately to hear the concerns and involve the nurse in planning the rollout
Topic: managing resistance to change
Resistance is best managed by listening, understanding the reasons and involving people in planning and implementing the change. Ignoring, threatening or avoiding the person leaves the concerns unaddressed and may spread resistance.
Why the others are wrong
- A – Ignoring open resistance lets it grow and leaves possible valid concerns unheard.
- C – Threats create fear and compliance without commitment.
- D – Avoiding the person only delays the change and does not address the concerns.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
87Question
A nurse is charting at the computer when a client begins to describe worries about going home. Which action is the first step in listening actively?
- Say 'go on' while continuing to type so the charting is finished sooner
- Ask a series of questions about the client's home situation
- Stop typing, turn toward the client and make eye contact
- Offer advice about community resources right away
Show the answer and explanation
Answer: C. Stop typing, turn toward the client and make eye contact
Topic: first step of active listening
Active listening begins with giving the speaker full attention: stop other tasks, face the person and make appropriate eye contact. Questions, feedback and advice come afterward.
Why the others are wrong
- A – Continuing the task while grunting acknowledgment shows divided attention.
- B – Questions follow attention; asking many at once may also redirect the client.
- D – Advice before the client has been heard is premature.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
88Question
Census on a medical unit has been lower than projected for two months. Which use of the unit budget by the manager shows correct understanding?
- Keep the original staffing plan unchanged because the budget cannot be revised during the year
- Compare actual figures with the budget and adjust staffing and spending plans to match actual volume
- Treat budget reports as a record of the past with no value for planning future activity
- Prepare the budget separately from the hospital's strategic plan so that the unit remains independent of it
Show the answer and explanation
Answer: B. Compare actual figures with the budget and adjust staffing and spending plans to match actual volume
Topic: using the budget to revise plans
A budget is a planning and control tool. Managers compare actual results with the plan, investigate variances and revise plans and strategies, and the budget should be linked to the organization's strategic plan.
Why the others are wrong
- A – Budgets are monitored and plans adjusted when actual results differ from projections.
- C – Budget reports are used to plan and to revise future activity.
- D – Budgets translate the strategic plan and should be developed in line with it.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
89Question
A community health nurse volunteers at an emergency shelter. Which activity is an example of secondary prevention?
- Offering seasonal influenza vaccine to residents who come to the intake desk each evening
- Teaching residents how to wash their hands and cover coughs during meals
- Arranging outpatient physical therapy for a resident who is recovering from a stroke
- Running a blood pressure screening to find residents with undiagnosed hypertension
Show the answer and explanation
Answer: D. Running a blood pressure screening to find residents with undiagnosed hypertension
Topic: levels of prevention
Secondary prevention detects disease early, before symptoms, through screening. Primary prevention (vaccination, education) prevents disease, and tertiary prevention (rehabilitation) limits disability after disease is established.
Why the others are wrong
- A – Vaccination prevents disease and is primary prevention.
- B – Health education to prevent infection is primary prevention.
- C – Rehabilitation after a stroke is tertiary prevention.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
90Question
A nurse is helping an emergency shelter prepare for an outbreak of influenza-like illness among residents. Which measures are appropriate?
Select all that apply.
- Place alcohol-based hand rub at the entrance and in the dining area
- Move cots so that residents sleep head to toe with extra space between beds
- Set aside a separate area for residents who develop symptoms
- Close the shelter to all new residents until the outbreak ends
- Arrange an on-site vaccination clinic with the local health department
- Ask residents with symptoms to leave the shelter until they recover
Show the answers and explanation
Answers: A, B, C and E.
- A – Place alcohol-based hand rub at the entrance and in the dining area
- B – Move cots so that residents sleep head to toe with extra space between beds
- C – Set aside a separate area for residents who develop symptoms
- E – Arrange an on-site vaccination clinic with the local health department
Topic: infection control in congregate living
In congregate settings, practical measures such as accessible hand hygiene, spacing of beds, separation of ill residents and vaccination reduce spread. Excluding people who have no other housing is neither safe nor ethical.
Why the others are wrong
- D – Closing the shelter to all new residents leaves people without housing and is not a proportionate measure.
- F – Residents may have nowhere else to go; they should be separated and cared for, not removed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
91Question
A nurse is considering challenges of practicing in a small rural community. Which statements are accurate?
Select all that apply.
- Nurses often care for neighbors and relatives, which can make privacy more difficult to protect
- Limited specialist services mean that clients may need transfer over long distances
- Rural hospitals usually have a large float pool to cover absences
- Nurses may have fewer colleagues for consultation and professional support
- Reliable high-speed internet is available to nearly all rural households
- Dual relationships with clients are rare because the community is small
Show the answers and explanation
Answers: A, B and D.
- A – Nurses often care for neighbors and relatives, which can make privacy more difficult to protect
- B – Limited specialist services mean that clients may need transfer over long distances
- D – Nurses may have fewer colleagues for consultation and professional support
Topic: challenges of rural nursing practice
Rural practice often involves personal relationships with clients, limited specialist and staffing resources, long transfer distances and professional isolation. Broadband access is uneven, and dual relationships are common, not rare.
Why the others are wrong
- C – Rural hospitals typically have small staffs and little float coverage.
- E – Broadband access in rural areas is uneven and limits telehealth in many places.
- F – In small communities, dual relationships are common and need active management.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
92Question
A client newly diagnosed with cancer says, 'I do not think I can handle this.' Which nurse responses are therapeutic?
Select all that apply.
- 'It sounds like you are feeling overwhelmed.'
- 'What worries you most right now?'
- 'Everything will turn out fine.'
- 'You need to stay strong for your family.'
- 'I will sit with you for a few minutes.'
- 'Why would you feel that way?'
Show the answers and explanation
Answers: A, B and E.
- A – 'It sounds like you are feeling overwhelmed.'
- B – 'What worries you most right now?'
- E – 'I will sit with you for a few minutes.'
Topic: therapeutic communication responses
Therapeutic communication uses reflection, open-ended questions and presence to help the client express feelings. False reassurance, advice-giving and 'why' questions block communication or imply judgment.
Why the others are wrong
- C – False reassurance cannot be promised and shuts down the client's feelings.
- D – This tells the client how to feel and increases the burden.
- F – 'Why' questions can sound accusing and put the client on the defensive.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
93Question
A client says, 'I'm fine,' but the nurse observes the client grimacing, holding his abdomen and avoiding eye contact. Which findings are examples of nonverbal communication?
Select all that apply.
- Grimacing
- Holding the abdomen
- The words 'I'm fine'
- Avoiding eye contact
- A pain score written on the intake form
Show the answers and explanation
Answers: A, B and D.
- A – Grimacing
- B – Holding the abdomen
- D – Avoiding eye contact
Topic: nonverbal communication cues
Nonverbal communication includes facial expression, posture, gestures and eye contact. Spoken words and written entries are verbal communication. When verbal and nonverbal messages conflict, the nurse should explore further.
Why the others are wrong
- C – The spoken words are verbal communication.
- E – A written score is a written (verbal) form of communication.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
94Question
Two RNs both ask for the same Saturday off, and the manager can approve only one. After talking, they agree that one will work the first Saturday and the other the second, so each gets half of what she wanted. Which conflict-management approach is this?
- Compromising
- Collaborating
- Accommodating
- Avoiding
Show the answer and explanation
Answer: A. Compromising
Topic: conflict-management modes
In compromising, each party gives up part of what it wants to reach a middle ground. Collaborating seeks a solution that fully meets both parties' needs, accommodating means yielding completely, and avoiding means withdrawing from the conflict.
Why the others are wrong
- B – Collaborating finds a solution that fully satisfies both, and here each loses half.
- C – Accommodating means one party gives in completely.
- D – Avoiding means neither addresses the issue, and these nurses talked it through.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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