HESI Leadership & Management
Exam-Questions And Answers With
Rationales/Graded A+/2026
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Section 1: Delegation & Prioritization (Questions 1–20)
1. The charge nurse is assigning tasks for a medical-surgical unit. Which task is
most appropriate to delegate to a licensed practical nurse (LPN)?
• A. Initial admission assessment of a new patient with pneumonia
• B. Administering enteral tube feeding to a stable patient
• C. Creating the nursing care plan for a diabetic patient
• D. Teaching a post-op patient about incentive spirometry
Rationale: LPNs can administer enteral feedings to stable patients. Initial
assessment, care plan creation, and teaching require RN-level assessment and
evaluation.
2. A nurse on a busy telemetry unit has four patients. Which patient should the
nurse assess first?
• A. Patient with chronic hypertension, BP 145/90, HR 88
• B. Patient post–cardiac catheterization with groin bleeding and BP
90/60
• C. Patient with chest pain relieved by nitroglycerin 15 minutes ago
• D. Patient with new-onset atrial fibrillation, HR 110, stable
Rationale: Bleeding after cardiac cath with hypotension is a life-threatening
complication (possible retroperitoneal bleed). Priority is circulation.
, 3. Which task can an unlicensed assistive personnel (UAP) perform under the
supervision of an RN?
• A. Reinforcing dietary teaching for a new diabetic
• B. Measuring orthostatic blood pressures
• C. Assessing a patient’s sacral wound for infection
• D. Administering IV antibiotics
Rationale: UAPs can obtain vital signs including orthostatic BPs. Assessment,
teaching, and IV meds require licensed personnel.
4. The RN receives shift report. Which patient should be seen first?
• A. Patient post-op day 2, requesting pain medication
• B. Patient with tracheostomy who has thick secretions and SpO2 88%
• C. Patient with dementia trying to get out of bed
• D. Patient requesting discharge teaching
Rationale: Low SpO2 with airway compromise is an airway/breathing priority.
5. A nurse is delegating ambulation of a stable post-op patient to a UAP. Which
instruction by the nurse is most appropriate?
• A. "Ambulate Mr. Jones in the hall for 10 minutes; call me if he reports
dizziness."
• B. "Decide if Mr. Jones is strong enough to walk without a gait belt."
• C. "Please assess Mr. Jones’s balance before ambulation."
• D. "You can ambulate him whenever you have time today."
Rationale: Delegation must include clear directions, limits, and when to report
back. Assessment is an RN responsibility.
6. Which patient is most appropriate to assign to a float nurse from the postpartum
unit to a medical-surgical unit?
• A. Patient with active GI bleed and hypotension
• B. Patient with stable cellulitis requiring daily IV antibiotics
Exam-Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Section 1: Delegation & Prioritization (Questions 1–20)
1. The charge nurse is assigning tasks for a medical-surgical unit. Which task is
most appropriate to delegate to a licensed practical nurse (LPN)?
• A. Initial admission assessment of a new patient with pneumonia
• B. Administering enteral tube feeding to a stable patient
• C. Creating the nursing care plan for a diabetic patient
• D. Teaching a post-op patient about incentive spirometry
Rationale: LPNs can administer enteral feedings to stable patients. Initial
assessment, care plan creation, and teaching require RN-level assessment and
evaluation.
2. A nurse on a busy telemetry unit has four patients. Which patient should the
nurse assess first?
• A. Patient with chronic hypertension, BP 145/90, HR 88
• B. Patient post–cardiac catheterization with groin bleeding and BP
90/60
• C. Patient with chest pain relieved by nitroglycerin 15 minutes ago
• D. Patient with new-onset atrial fibrillation, HR 110, stable
Rationale: Bleeding after cardiac cath with hypotension is a life-threatening
complication (possible retroperitoneal bleed). Priority is circulation.
, 3. Which task can an unlicensed assistive personnel (UAP) perform under the
supervision of an RN?
• A. Reinforcing dietary teaching for a new diabetic
• B. Measuring orthostatic blood pressures
• C. Assessing a patient’s sacral wound for infection
• D. Administering IV antibiotics
Rationale: UAPs can obtain vital signs including orthostatic BPs. Assessment,
teaching, and IV meds require licensed personnel.
4. The RN receives shift report. Which patient should be seen first?
• A. Patient post-op day 2, requesting pain medication
• B. Patient with tracheostomy who has thick secretions and SpO2 88%
• C. Patient with dementia trying to get out of bed
• D. Patient requesting discharge teaching
Rationale: Low SpO2 with airway compromise is an airway/breathing priority.
5. A nurse is delegating ambulation of a stable post-op patient to a UAP. Which
instruction by the nurse is most appropriate?
• A. "Ambulate Mr. Jones in the hall for 10 minutes; call me if he reports
dizziness."
• B. "Decide if Mr. Jones is strong enough to walk without a gait belt."
• C. "Please assess Mr. Jones’s balance before ambulation."
• D. "You can ambulate him whenever you have time today."
Rationale: Delegation must include clear directions, limits, and when to report
back. Assessment is an RN responsibility.
6. Which patient is most appropriate to assign to a float nurse from the postpartum
unit to a medical-surgical unit?
• A. Patient with active GI bleed and hypotension
• B. Patient with stable cellulitis requiring daily IV antibiotics
