Free Nurse Executive, Advanced Board Certification Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Nurse Executive, Advanced Board Certification Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1In a nursing organization's strategic planning, what is the primary role of a change vision?

   1. A.To describe the desired future state that guides strategyCorrect answer: A
   2. B.To specify every task in the implementation schedule
   3. C.To assign clinical duties for the next staffing shift
   4. D.To replace the need for a strategy once goals are set

   Explanation: AHRQ says the vision answers "Where do we want to be in the future?" and that leadership "must also develop the strategy to make the vision a reality." Thus the vision establishes direction; an implementation schedule and staffing assignments are different decisions.

   Reference: Teaching Implementation Change Management — Developing a Strategy, Slide 68

2. 2A unit has had no recent adverse event, but its leaders continue to search for emerging threats. Which high-reliability principle is this?

   1. A.Preoccupation with failureCorrect answer: A
   2. B.Commitment to resilience
   3. C.Deference to expertise
   4. D.Sensitivity to operations

   Explanation: AHRQ defines preoccupation with failure as "Awareness of potential for failure and emergence of new threats so that absence of error does not lead to complacency." The other principles address response, expertise, or operational context.

   Reference: High Reliability Organization Principles and Patient Safety — HRO principles, five characteristics

3. 3Under Title I of the ADA, when must a covered employer provide a reasonable accommodation to a qualified employee with a disability?

   1. A.When it enables equal employment opportunity and causes no undue hardshipCorrect answer: A
   2. B.Only after the employee has exhausted every type of personal leave
   3. C.Only when the employee can pay for the accommodation in full
   4. D.Whenever an employee prefers a different work arrangement

   Explanation: EEOC states "Title I of the ADA requires an employer to provide reasonable accommodation to qualified individuals with disabilities who are employees or applicants for employment, except when such accommodation would cause an undue hardship." The duty concerns a qualified person with a disability and retains the undue-hardship limit; preference alone does not establish the duty.

   Reference: Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA — Introduction

4. 4A nurse executive evaluates a patient-centered medical home. What does AHRQ mean by comprehensive care in this model?

   1. A.Meeting most physical and mental health needs across prevention, acute, and chronic careCorrect answer: A
   2. B.Providing only episodic urgent care within the clinic
   3. C.Restricting the team to a single professional discipline
   4. D.Delegating all prevention services outside the model

   Explanation: Defining the PCMH states "The primary care medical home is accountable for meeting the large majority of each patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care." Comprehensiveness spans multiple needs and time horizons.

   Reference: Defining the PCMH — 1. Comprehensive Care

5. 5Which statement best distinguishes a situational team leader from a designated team leader?

   1. A.The situational leader assumes leadership when the case calls for specific skillsCorrect answer: A
   2. B.The situational leader is permanently appointed to lead every clinical case
   3. C.The designated leader assumes control only after a situation is resolved
   4. D.The designated leader has no responsibility for an established team goal

   Explanation: AHRQ states that "The responsibility for leading the team may change depending on the case." It also describes a designated leader for team function and a situational leader who emerges as needed. The other choices reverse or erase these roles.

   Reference: Section 2: Explanation of Key Team Leadership Concepts and Tools — Types of Team Leaders

6. 6A safety team rejects a simple blame explanation and investigates several interacting causes of a near miss. Which HRO principle guides it?

   1. A.Reluctance to simplify interpretationsCorrect answer: A
   2. B.Deference to expertise
   3. C.Commitment to resilience
   4. D.Sensitivity to operations

   Explanation: AHRQ defines reluctance to simplify as "Understanding that the work of providing care is complex and dynamic and that underlying causes must be found, as opposed to surface explanations." The other principles target different parts of reliable work.

   Reference: High Reliability Organization Principles and Patient Safety — HRO principles, five characteristics

7. 7A qualified applicant with a disability cannot use a standard online hiring assessment. Which change falls within the ADA accommodation category for applications?

   1. A.Adjusting the application process so the applicant can be consideredCorrect answer: A
   2. B.Removing every essential function from the advertised position
   3. C.Guaranteeing the applicant selection regardless of qualifications
   4. D.Lowering all future employee performance standards

   Explanation: EEOC states "modifications or adjustments to a job application process that enable a qualified applicant with a disability to be considered for the position such qualified applicant desires" The application-process adjustment addresses access to consideration; it does not require selection or removal of essential duties.

   Reference: Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the ADA — General Principles, Reasonable Accommodation, category (i)

8. 8A medical-home team asks patients to help shape their own care plans and respects their preferences. Which model attribute is being applied?

   1. A.Patient-centered careCorrect answer: A
   2. B.Comprehensive care
   3. C.Coordinated care
   4. D.Accessible services

   Explanation: Defining the PCMH states "Recognizing that patients and families are core members of the care team, medical home practices ensure that they are fully informed partners in establishing care plans." Partnership in care planning is the patient-centered attribute.

   Reference: Defining the PCMH — 2. Patient-Centered

9. 9In ANA's phase 1 shared governance model, who retains final decision-making authority?

   1. A.The executive committee
   2. B.The chief nurse executiveCorrect answer: B
   3. C.The staff nurse representatives
   4. D.The management forum

   Explanation: The ANA phase 1 description states "Chief nurse executive - retains final decision-making authority." Staff representatives and managers have specified roles, while the executive committee receives recommendations.

   Reference: Three Developmental Phases of Shared Governance in Nursing — Phase 1

10. 10Which HRO principle asks leaders to consider how real-time operating conditions affect a clinician's work and patient safety?

    1. A.Preoccupation with failure
    2. B.Sensitivity to operationsCorrect answer: B
    3. C.Reluctance to simplify interpretations
    4. D.Commitment to resilience

    Explanation: AHRQ defines sensitivity to operations as "Recognition that an individual’s work occurs in the complexity of larger operational conditions, and that those conditions can affect safety." This differs from scanning for threats, resisting simple explanations, or adapting to disruptions.

    Reference: High Reliability Organization Principles and Patient Safety — HRO principles, five characteristics