HESI Leadership & Management
Examination (Latest 2026 Edition)||
Questions And Answers With
Rationales/Graded A+/2026
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Section 1: Delegation & Staff Supervision (Questions 1–15)
1. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and
an unlicensed assistive personnel (UAP). Which task is most appropriate for
the LPN to perform?
A. Ambulate a client with a fractured hip using a walker.
B. Administer a tube feeding to a client with a gastrostomy tube.
C. Obtain a clean-catch urine specimen.
D. Bathe a client who is on bed rest.
Correct Answer: B
Rationale: LPNs can perform stable, standardized procedures such as tube
feedings, urinary catheterizations, and monitoring stable clients. UAPs can
ambulate, bathe, and obtain urine specimens.
2. A registered nurse (RN) is supervising a UAP. Which action by the UAP
requires the RN to intervene immediately?
A. Placing a fall-risk client’s bed in the lowest position.
B. Reporting a blood pressure of 160/90 mm Hg to the RN.
C. Refusing to reposition a client with severe back pain.
D. Applying restraints to a confused client without an order.
,Correct Answer: D
Rationale: Restraints require a provider’s order and ongoing assessment. UAPs
cannot initiate restraints. This is a violation of safety and legal standards.
3. When delegating to an LPN, which client should the RN assign to the LPN?
A. A client 1 hour post-cardiac catheterization with oozing at the site.
B. A client with new-onset confusion and fever.
C. A stable diabetic client requiring morning insulin and foot care.
D. A client with chest pain and an unstable ECG.
Correct Answer: C
Rationale: Stable, predictable clients are appropriate for LPNs. Unstable or post-
procedural complications require RN assessment.
4. Which of the following is an example of appropriate delegation according to
the Five Rights of Delegation?
A. Asking a UAP to assess a post-op client’s pain level.
B. Directing an LPN to develop a care plan for a new admission.
C. Assigning a UAP to feed a client with dysphagia after proper training.
D. Instructing a UAP to interpret a client’s telemetry rhythm.
Correct Answer: C
Rationale: Feeding a stable client with dysphagia can be delegated if UAP is
trained. Assessment, care planning, and rhythm interpretation require licensed
personnel.
5. An RN on a medical-surgical unit has four clients. The UAP reports that a
client’s blood pressure is 88/50 mm Hg, down from 120/80 mm Hg. What is
the RN’s priority action?
A. Tell the UAP to repeat the BP in 15 minutes.
B. Assess the client immediately.
C. Ask the UAP to increase the IV fluid rate.
D. Document the finding as a normal variation.
Correct Answer: B
Rationale: A significant drop in BP may indicate shock or bleeding. The RN must
assess first before delegating further or intervening.
6. The nurse manager is reviewing delegation errors. Which situation
demonstrates “under-delegation”?
A. A nurse performs a routine dressing change herself instead of allowing the LPN
, to do it.
B. A nurse asks the UAP to check a post-op client’s respiratory rate.
C. A nurse supervises a new graduate performing a sterile procedure.
D. A nurse assigns an LPN to administer oral medications to stable clients.
Correct Answer: A
Rationale: Under-delegation occurs when the RN performs tasks that could be
safely delegated, wasting time and resources.
7. Which statement by a new RN indicates a need for further teaching about
delegation?
A. “I am ultimately accountable for all delegated tasks.”
B. “I can delegate assessment of lung sounds to an experienced LPN.”
C. “The UAP cannot delegate tasks to another UAP without my permission.”
D. “I must verify the competence of the person I’m delegating to.”
Correct Answer: B
Rationale: Assessment (including lung sounds) is an RN responsibility and cannot
be delegated to an LPN or UAP.
8. An LPN refuses to perform a delegated task stating, “I’ve never done that
procedure before.” The RN should:
A. Tell the LPN to figure it out using the policy manual.
B. Assign the task to a UAP.
C. Provide just-in-time training or reassign the task.
D. Report the LPN for insubordination.
Correct Answer: C
Rationale: The Five Rights include “right direction/communication.” If the
delegate lacks competence, the delegator must train or reassign.
9. Which client is most appropriate to assign to a UAP?
A. A client receiving a blood transfusion for anemia.
B. A client on a patient-controlled analgesia (PCA) pump.
C. A client who requires a bed bath and passive range of motion.
D. A client with a fresh tracheostomy needing suctioning.
Correct Answer: C
Rationale: Basic hygiene and ROM are within UAP scope. Transfusion, PCA, and
suctioning require licensed supervision.
Examination (Latest 2026 Edition)||
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Section 1: Delegation & Staff Supervision (Questions 1–15)
1. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and
an unlicensed assistive personnel (UAP). Which task is most appropriate for
the LPN to perform?
A. Ambulate a client with a fractured hip using a walker.
B. Administer a tube feeding to a client with a gastrostomy tube.
C. Obtain a clean-catch urine specimen.
D. Bathe a client who is on bed rest.
Correct Answer: B
Rationale: LPNs can perform stable, standardized procedures such as tube
feedings, urinary catheterizations, and monitoring stable clients. UAPs can
ambulate, bathe, and obtain urine specimens.
2. A registered nurse (RN) is supervising a UAP. Which action by the UAP
requires the RN to intervene immediately?
A. Placing a fall-risk client’s bed in the lowest position.
B. Reporting a blood pressure of 160/90 mm Hg to the RN.
C. Refusing to reposition a client with severe back pain.
D. Applying restraints to a confused client without an order.
,Correct Answer: D
Rationale: Restraints require a provider’s order and ongoing assessment. UAPs
cannot initiate restraints. This is a violation of safety and legal standards.
3. When delegating to an LPN, which client should the RN assign to the LPN?
A. A client 1 hour post-cardiac catheterization with oozing at the site.
B. A client with new-onset confusion and fever.
C. A stable diabetic client requiring morning insulin and foot care.
D. A client with chest pain and an unstable ECG.
Correct Answer: C
Rationale: Stable, predictable clients are appropriate for LPNs. Unstable or post-
procedural complications require RN assessment.
4. Which of the following is an example of appropriate delegation according to
the Five Rights of Delegation?
A. Asking a UAP to assess a post-op client’s pain level.
B. Directing an LPN to develop a care plan for a new admission.
C. Assigning a UAP to feed a client with dysphagia after proper training.
D. Instructing a UAP to interpret a client’s telemetry rhythm.
Correct Answer: C
Rationale: Feeding a stable client with dysphagia can be delegated if UAP is
trained. Assessment, care planning, and rhythm interpretation require licensed
personnel.
5. An RN on a medical-surgical unit has four clients. The UAP reports that a
client’s blood pressure is 88/50 mm Hg, down from 120/80 mm Hg. What is
the RN’s priority action?
A. Tell the UAP to repeat the BP in 15 minutes.
B. Assess the client immediately.
C. Ask the UAP to increase the IV fluid rate.
D. Document the finding as a normal variation.
Correct Answer: B
Rationale: A significant drop in BP may indicate shock or bleeding. The RN must
assess first before delegating further or intervening.
6. The nurse manager is reviewing delegation errors. Which situation
demonstrates “under-delegation”?
A. A nurse performs a routine dressing change herself instead of allowing the LPN
, to do it.
B. A nurse asks the UAP to check a post-op client’s respiratory rate.
C. A nurse supervises a new graduate performing a sterile procedure.
D. A nurse assigns an LPN to administer oral medications to stable clients.
Correct Answer: A
Rationale: Under-delegation occurs when the RN performs tasks that could be
safely delegated, wasting time and resources.
7. Which statement by a new RN indicates a need for further teaching about
delegation?
A. “I am ultimately accountable for all delegated tasks.”
B. “I can delegate assessment of lung sounds to an experienced LPN.”
C. “The UAP cannot delegate tasks to another UAP without my permission.”
D. “I must verify the competence of the person I’m delegating to.”
Correct Answer: B
Rationale: Assessment (including lung sounds) is an RN responsibility and cannot
be delegated to an LPN or UAP.
8. An LPN refuses to perform a delegated task stating, “I’ve never done that
procedure before.” The RN should:
A. Tell the LPN to figure it out using the policy manual.
B. Assign the task to a UAP.
C. Provide just-in-time training or reassign the task.
D. Report the LPN for insubordination.
Correct Answer: C
Rationale: The Five Rights include “right direction/communication.” If the
delegate lacks competence, the delegator must train or reassign.
9. Which client is most appropriate to assign to a UAP?
A. A client receiving a blood transfusion for anemia.
B. A client on a patient-controlled analgesia (PCA) pump.
C. A client who requires a bed bath and passive range of motion.
D. A client with a fresh tracheostomy needing suctioning.
Correct Answer: C
Rationale: Basic hygiene and ROM are within UAP scope. Transfusion, PCA, and
suctioning require licensed supervision.
