Nurse Executive Certification Practice Test

NE-BC exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

Exam : NE-BC
Exam Name : ANCC Nurse Executive Certification
Number of Questions : 175
Scored Questions : 150
Unscored Questions : 25

Category Domains of Practice No. of Questions Percent
I Structures and Processes 27 18%
II Professional Practice 55 37%
III Leadership 33 22%
IV Knowledge Management 35 23%
Total 150 100%

There are 175 questions on this examination. Of these, 150 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine how well these questions will perform before they are used on the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important for a candidate to answer all questions. A candidate's score, however, is based solely on the 150 scored questions. Performance on pretest questions does not affect a candidate's score.

I. Structures and Processes (18%)
A. Human Capital Management
Knowledge of:
1. Federal and state laws (e.g., Family and Medical Leave Act [FMLA], American with Disabilities Act [ADA], Fair Labor Standards Act [FLSA], wage and hour laws, equal employment opportunities, Occupational Safety and Health Administration [OSHA],
workers compensation)
2. Labor relations (e.g., collective bargaining, contract negotiations, grievances and arbitrations, National Labor Relations Board [NLRB])
3. Resource utilization (e.g., cross training, job descriptions )
4. Principles associated with human resources (e.g., employee assistance and counseling, compensation, benefits, coaching, performance management)
5. Organizational culture (e.g., just culture, transparency)
6. Organizational structure (e.g., chain of command, organizational chart, span of control)
Skills in:
7. Participating in developing and modifying administrative policies and procedures
8. Implementing and enforcing administrative policies and procedures (e.g., monitoring compliance)
9. Providing feedback on effectiveness of administrative policies and procedures
10. Evaluating the effectiveness of roles based on changing needs in the health care environment (e.g., new or expanded job descriptions, professional development)
B. Financial Management
Knowledge of:
1. Basic financial and budgeting principles (e.g., revenue cycle, supply and labor expenses, productivity, depreciation, return on investment [ROI], cost-benefit analysis)
2. Reimbursement methods (e.g., payor systems, pay for performance, payment bundling, value-based purchasing)
3. Contractual agreements (e.g., vendors, materials, staffing)
4. Principles of staffing workload (e.g., full-time equivalents [FTE], hours per patient day, skill mix)
Skills in:
5. Developing a budget (e.g., operational, capital)
6. Analyzing variances and managing a budget (e.g., operational, capital)
7. Efficient resource utilization (e.g., contractual agreements, outsourcing)
8. Determining appropriate staffing workload
C. Health and Public Policy
Knowledge of:
1. Legal issues (e.g., fraud, whistle-blowing, the Health Insurance Portability and Accountability Act [HIPAA], corporate compliance, electronic access and security, harassment, malpractice, negligence)
2. Consumer-driven health care (e.g., public reporting, Community Health Needs Assessment [CHNA], Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS], Healthgrades)
3. Emergency planning and response
4. Planning and responding to internal and external disasters
5. Planning and responding to health and public policy issues
6. Assessing, addressing, and preventing legal issues (e.g., violations, fraud, whistleblowing, the Health Insurance Portability and Accountability Act [HIPAA], corporate compliance, electronic access and security, harassment)

II. Professional Practice (37%)
A. Care Management/Delivery
Knowledge of:
1. Health care delivery models and settings (e.g., accountable care organization [ACO], patient-centered medical home [PCMH], nurse-led clinic, telehealth, e-health, inpatient, ambulatory care, home health, rehabilitation, etc.)
2. Laws, regulations, and accrediting bodies (e.g., The Joint Commission, Centers for Medicare and Medicaid Services, Nurse Practice Act)
3. Standards of nursing practice (e.g., clinical practice guidelines, clinical pathways, ANA Scope and Standards of Practice, Nurse Practice Act)
Skills in:
4. Establishing staffing models (e.g., primary care nursing, team nursing, nurse-patient ratios, skill mix, acuity)
5. Designing workflows based on care delivery model and population served (e.g., patient centered medical home [PCMH], interdisciplinary team, case management, disease management, throughput, staffing assignment and scheduling)
6. Developing policies and procedures that ensure regulatory compliance with professional standards and organizational integrity
B. Professional Practice Environment and Models
Knowledge of:
1. Professional practice models
2. Role delineation (e.g., credentialing, privileging, certification)
3. Professional practice standards (e.g., ANA Scope and Standards of Practice, Nurses Bill of Rights, Nurse Practice Act)
4. Employee performance feedback (e.g., coaching, performance appraisal, Just Culture)
Skills in:
5. Developing clinical staff (e.g., orientation, continuing education, competency validation, performance appraisal, peer review, mentoring, planning, lifelong learning)
6. Creating a professional environment for empowered decision making (e.g., shared governance, staff accountability, critical thinking, civility)
7. Recruiting, recognizing, and retaining staff
8. Providing internal and external customer service (including service recovery)
9. Creating a vision for professional nursing practice that promotes patient and family centered care
C. Communication
Knowledge of:
1. Communication principles (e.g., active listening, reflective communication, two-way communication, interviewing)
2. Communication styles (e.g., persuasive, assertive, passive, aggressive, passiveaggressive)
3. Negotiation concepts and strategies (e.g., compromising, collaborating, win-win)
4. Communication processes that support safe patient care (e.g., documentation, handoffs or hand-overs, bedside reporting, incident reporting, reporting sentinel events)
Skills in:
5. Communicating using verbal (e.g., oral and written) and nonverbal methods (e.g., body language, eye contact, active listening)
6. Facilitating collaboration to achieve optimal outcomes (e.g., team building, group dynamics, leveraging diversity)
7. Selecting the appropriate communication method for the audience and situation (e.g., email, role playing, presentation, reports, staff meeting, board meeting, one-on-one conversation, patient/family council, consumer feedback)
8. Conflict management

III. Leadership (22%)
A. Leadership Effectiveness
Knowledge of:
1. Key elements of a healthy work environment
2. Leadership concepts, principles, and styles (e.g., pervasive leadership, servant leadership, situational leadership, appreciative inquiry, culture of transparency, change management theories)
3. Coaching, mentoring, and precepting
4. Emotional intelligence
5. Sources of influence and power
Skills in:
6. Self reflection and personal leadership evaluation
7. Integrating diversity and sensitivity into the work environment
8. Change management
9. Building effective relationships through listening, reflecting, presence, communication, and networking
10. Succession planning
11. Creating an environment to engage and empower employees
B. Strategic Visioning and Planning
Knowledge of:
1. Strategic planning principles (e.g., alignment of nursings strategic plan with the organizational plan, SWOT analysis, components of strategic planning)
2. New program development (e.g., proposals, pro forma, business plans, marketing)
3. Trends that effect nursing practice and the healthcare environment
4. Communicating and building consensus and support for the strategic plan
5. Establishing baselines for processes (i.e., measuring current performance)
6. Evaluating processes and outcome measures over time
7. Project management to support/achieve the strategic plan (e.g., planning, implementing, and monitoring action plans)
C. Ethics and Advocacy
Knowledge of:
1. Ethical principles
2. Business ethics (e.g., corporate compliance, privacy)
3. ANAs Code of Ethics
4. Patients Bill of Rights
Skills in:
5. Advocating for patients (e.g., patient rights, access, and safety)
6. Advocating for staff (e.g., healthy work environment, equipment, staffing)
7. Advocating for the nursing profession (e.g., professional organizations, promoting education, certification, legislative influence)

IV. Knowledge Management (23%)
A. Quality Monitoring and Improvement
Knowledge of:
1. Systems theory
2. Continuous performance improvement (The Plan-Do-Study-Act [PDSA] Cycle, Lean, root cause analysis, tracer methodology)
3. Process and outcome measures (e.g., clinical, financial, safety, patient satisfaction, employee satisfaction)
4. Culture of safety (e.g., risk management, employee engagement, employee safety technologies [patient lifts], patient safety technologies [bar coding])
Skills in:
5. Creating a culture of continuous performance improvement
6. Translating data into information (including use of internal and external benchmarks), and disseminating it at various levels within the organization
7. Evaluating and prioritizing outcomes of care delivery (e.g., nurse sensitive indicators, ORYX indicators, National Patient Safety Goals, core measures)
8. Selecting the appropriate continuous performance improvement technique
9. Action planning to address identified quality issues
B. Evidence-based Practice and Research
Knowledge of:
1. Institutional Review Board (IRB) requirements (e.g., protection of human research subjects)
2. Research and evidence-based practice techniques (e.g., literature review, developing research questions, study methods and design, data management, levels of evidence)
3. Distinguish between performance improvement, evidence-based practice, and research
4. Creating a culture and advocating for resources that support research and scholarly inquiry (e.g., journal club, grant writing, research councils, research participation)
5. Communicating research and evidence-based findings to internal and external stakeholders
6. Incorporating evidence into policies, standards, procedures and guidelines
7. Evaluating and incorporating new knowledge and published research findings into practice
C. Innovation
Knowledge of:
1. Clinical practice innovation
2. Leadership practice innovation
Skills in:
3. Creating a culture that values, encourages, and recognizes new and innovative ideas that benefit the patient, family, organization, or community
4. Developing a framework for implementing innovations (e.g., small tests of change, pilot studies)
5. Leveraging diversity to encourage new and innovative ideas or new patterns of thinking
6. Evaluating and applying technology to support innovation

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ANCC Nurse Executive Certification 2025
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Question: 614
A nurse executive is conducting a SWOT analysis and identifies a potential opportunity in the growing demand for telehealth services. How should the organization best capitalize on this opportunity?
1. Relying on traditional in-person visits only
2. Ignoring telehealth as a passing trend
3. Developing a comprehensive telehealth strategy that includes training for nursing staff
nation: Developing a comprehensive telehealth strategy that includes training for nursing staff the organization to effectively capitalize on the growing demand, improving patient access a elivery.
ion: 615
cent performance evaluation, a nurse manager identified that 30% of their team consistently exceeds performance expectations. If the team consists of 20 nurses, how many nurses are recogni
nding performance based on this percentage?
er: A
nation: 30% of 20 nurses equals 20 � 0.30 = 6 nurses who exceed performance expectations.
ion: 616
a strategic planning session, you are tasked with leading your team through the ADKAR M ew patient safety initiative. What is the primary focus of the "Knowledge" stage in this mod
veloping skills to implement change
Reducing staffing levels to cut costs Answer: C
Expla
allows nd
care d
Quest
In a re outsta
1. 6
2. 4
3. 8
4. 10
Answ Expla Quest
zed for
During odel
for a n el?
1. De
2. Understanding the need for change
3. Reinforcing the change
4. Creating awareness of the benefits of change Answer: B
Explanation: The "Knowledge" stage in the ADKAR Model focuses on providing information about how to change, which is essential for ensuring staff understand the need for change and what it entails.
A nurse leader is tasked with evaluating the effectiveness of a new patient care initiative. What financial analysis would best determine whether the initiative is cost-effective?
1. Variance analysis
2. Capital budgeting
3. Cost-benefit analysis
4. Historical performance metrics Answer: C
nation: A cost-benefit analysis will assess the financial returns generated by the initiative aga ncurred, providing a clear picture of its cost-effectiveness.
ion: 618
ing director is analyzing performance improvement plans for underperforming staff. What is mportant aspect to include in these plans to foster a culture of continuous improvement?
ar expectations and measurable goals cumentation of past performance issues ndatory participation in additional training imeline for achieving performance milestones
er: A
nation: Clear expectations and measurable goals are essential for fostering a culture of contin vement, as they provide staff with specific targets to strive for and a framework for accounta
ion: 619
ect manager is assessing risks for a new patient care initiative. If there are 5 identified risks bility of occurrence of 20%, what is the combined probability that at least one risk will occur
Expla inst the
costs i
Quest
A nurs the
most i
1. Cle
2. Do
3. Ma
4. A t
Answ
Expla uous
impro bility.
Quest
A proj with a
proba ?
1. 72%
2. 64%
3. 80%
4. 84%
Answer: B
Explanation: The probability that none occur is (0.80)^5 = 0.32768, so the probability that at least one occurs is 1 - 0.32768 = 0.67232 or approximately 64%.
Question: 620
In a recent analysis, a healthcare organization found that its average cost per patient for a specific procedure was $15,000. If the organization aims to reduce this cost by 10% while maintaining quality, what is the target cost per patient?
A. $14,000 B. $13,500 C. $15,500 D. $12,000
Answer: B
nation: A 10% reduction from $15,000 is calculated as $15,000 - ($15,000 * 0.10) = $13,500
ion: 621
nurse executive is leading an initiative to Improve community health literacy. Which strategy w ffective in engaging community partners to support this initiative?
laborate with community partners to co-create educational materials that address local healt velop a plan in isolation and present it to partners for approval
us solely on online resources without community input
Rely on existing materials without tailoring them to the community�s needs er: A
nation: Collaborating with community partners to co-create materials ensures that the initiati nt and addresses specific health issues, fostering stronger engagement and support.
ion: 622
nurse manager faces a situation where her team is resistant to adopting a new nursing care mode this, she decides to actively involve team members in the planning and implementation ph eadership style is she utilizing?
vant Leadership
Expla .
Quest
A ould be
most e
1. Col h
issues
2. De
3. Foc D.
Answ
Expla ve is
releva
Quest
A l. To
address ases.
What l
1. Ser
2. Transactional Leadership
3. Situational Leadership
4. Transformational Leadership Answer: D
Explanation: By involving team members in planning and implementation, the nurse manager is practicing transformational leadership, which focuses on collaboration and shared vision.
A nurse executive is evaluating the organization's approach to patient safety after several near misses. Which of the following actions should be prioritized to foster a culture of safety?
1. Punishing staff for errors to deter future incidents
2. Ignoring minor incidents as they do not impact patient care
3. Encouraging open communication and reporting of near misses without fear of retribution
4. Conducting safety training only during annual evaluations Answer: C
nation: Fostering open communication and encouraging reporting of near misses creates a cul here staff feel empowered to address issues proactively, reducing the likelihood of future e
ion: 624
thcare organization is preparing for an accreditation survey by The Joint Commission. Whic lowing actions should the nurse executive prioritize to ensure compliance with standards rel safety and quality of care?
ablishing a patient safety reporting system
nducting regular training sessions on new technology reasing marketing efforts to promote services
ducing staff meetings to focus on patient care er: A
nation: Establishing a patient safety reporting system is crucial for compliance with The Join ission standards, as it helps identify, report, and address safety issues effectively.
ion: 625
ing executive is faced with a situation where a high-performing nurse is considering leaving zation for a competitor. What should the executive do to retain this valuable employee?
er a counter-offer without understanding their concerns
Expla ture of
safety w rrors.
Quest
A heal h of
the fol ated to
patient
1. Est
2. Co
3. Inc
4. Re
Answ
Expla t
Comm
Quest
A nurs the
organi
1. Off
2. Initiate a conversation to understand the nurse's motivations and explore potential solutions
3. Ignore the situation and hope the nurse stays
4. Implement stricter policies to prevent staff from leaving Answer: B
Explanation: Engaging in a conversation to understand the nurse's motivations allows for tailored solutions that address their needs, increasing the likelihood of retention.
A nurse executive is concerned about the implications of recent policy changes on staff morale and patient care. What is the most effective way for her to advocate for her staff during this time of transition?
1. Communicating transparently about the changes and soliciting feedback
2. Focusing on the negative aspects of the changes
3. Implementing changes without discussion to avoid confusion
nation: Communicating transparently about the changes and soliciting feedback fosters a sens ement and support among staff, which can enhance morale during transitions.
ion: 627
pital is investigating the causes of high patient readmission rates for heart failure. Which dat would provide the most relevant information to inform quality improvement efforts?
ient satisfaction surveys
Staff feedback on discharge processes
nical outcome data related to heart failure management ancial reports related to readmission costs
er: C
nation: Clinical outcome data related to heart failure management provides relevant insights into contributing to readmissions, enabling targeted quality improvement efforts.
ion: 628
pital's budget includes an allocation of $2 million for capital expenses. If the real capital e
2.5 million, what is the variance in percentage terms?
unfavorable
Limiting staff involvement in decision-making processes Answer: A
Expla e of
involv
Quest
A hos a
source
A. Pat B.
1. Cli
2. Fin Answ
Expla the
factors
Quest
A hos xpenses
total $
1. 20%
2. 30% unfavorable
3. 25% unfavorable
4. 35% unfavorable Answer: C
Explanation: The variance percentage is calculated as ($2.5 million - $2 million) / $2 million * 100 = 25% unfavorable.

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