HESI Leadership and Management Exam
Questions And Answers Plus Rationales
2026/27 Instant Pdf Download
Delegation & Supervision
1. Which task is most appropriate for the charge nurse to
delegate to an experienced UAP?
A. Assessing a postoperative client’s incision
B. Teaching a client how to use an incentive spirometer
C. Obtaining vital signs on a stable client
D. Administering a tube feeding
Answer: C. Obtaining vital signs on a stable client
Rationale: UAPs can obtain vital signs on stable clients.
Assessment and teaching require licensed nursing judgment.
Tube feeding administration may be delegated to LPNs, not
UAPs, in some states; but vital signs are universally appropriate.
2. A nurse delegates ambulation of a client with a history of
falls to a UAP. Which statement by the UAP indicates
correct understanding?
,A. "I will use a gait belt and stay with the client at all times."
B. "I will have the client walk alone to build confidence."
C. "I will document the distance walked in the chart."
D. "I will assess the client’s strength before walking."
Answer: A. "I will use a gait belt and stay with the client at all
times."
Rationale: Fall risk clients require gait belt and supervision.
UAPs can report findings but not document in the chart
independently; they can document on flow sheets per policy.
Assessment is the nurse’s role.
3. A nurse is supervising a newly licensed nurse. Which
action by the new nurse requires the nurse to intervene?
A. Administering an IM injection without aspirating
B. Checking a client’s blood pressure in the arm with an IV
infusion
C. Using an alcohol-based hand rub before donning sterile
gloves
D. Placing a client on NPO status without a provider’s order
Answer: D. Placing a client on NPO status without a provider’s
order
Rationale: NPO status requires a provider order. The other
,actions: IM injection without aspiration is acceptable for most
vaccines; BP in arm with IV is acceptable if the infusion is not
affecting the arm; alcohol rub is allowed before sterile gloving if
hands are not visibly soiled.
4. The nurse manager is assigning client care. Which client
should be assigned to an LPN?
A. A client 1 hour post-cardiac catheterization with a stable
groin site
B. A client newly diagnosed with diabetic ketoacidosis on an
insulin drip
C. A client with a chest tube and continuous bubbling in the
water seal chamber
D. A client who requires a blood transfusion
Answer: A. A client 1 hour post-cardiac catheterization with a
stable groin site
Rationale: LPNs can care for stable clients with predictable
outcomes. Unstable clients, titratable drips (insulin), chest tube
complications, and blood transfusions require RN assessment
and judgment.
5. A charge nurse is making assignments. Which client is
best assigned to a float RN from the medical-surgical unit?
, A. A client with a new tracheostomy requiring frequent
suctioning
B. A client with pneumonia receiving IV antibiotics and oral care
C. A client with a chest tube and an air leak
D. A client with a ventriculostomy for ICP monitoring
Answer: B. A client with pneumonia receiving IV antibiotics and
oral care
Rationale: A float nurse should receive stable, routine clients.
Tracheostomy suctioning, chest tubes with air leaks, and
ventriculostomy require specialized skills.
6. Which task can be delegated to a UAP but requires
immediate reporting to the RN?
A. Measuring a client’s intake and output
B. Assisting a client with a bedpan
C. Obtaining a blood pressure of 88/50 mm Hg
D. Repositioning a client in bed
Answer: C. Obtaining a blood pressure of 88/50 mm Hg
Rationale: UAPs can take vital signs, but abnormal findings
must be reported immediately to the RN. The other tasks are
routine and do not require immediate reporting unless the
client has a change.
Questions And Answers Plus Rationales
2026/27 Instant Pdf Download
Delegation & Supervision
1. Which task is most appropriate for the charge nurse to
delegate to an experienced UAP?
A. Assessing a postoperative client’s incision
B. Teaching a client how to use an incentive spirometer
C. Obtaining vital signs on a stable client
D. Administering a tube feeding
Answer: C. Obtaining vital signs on a stable client
Rationale: UAPs can obtain vital signs on stable clients.
Assessment and teaching require licensed nursing judgment.
Tube feeding administration may be delegated to LPNs, not
UAPs, in some states; but vital signs are universally appropriate.
2. A nurse delegates ambulation of a client with a history of
falls to a UAP. Which statement by the UAP indicates
correct understanding?
,A. "I will use a gait belt and stay with the client at all times."
B. "I will have the client walk alone to build confidence."
C. "I will document the distance walked in the chart."
D. "I will assess the client’s strength before walking."
Answer: A. "I will use a gait belt and stay with the client at all
times."
Rationale: Fall risk clients require gait belt and supervision.
UAPs can report findings but not document in the chart
independently; they can document on flow sheets per policy.
Assessment is the nurse’s role.
3. A nurse is supervising a newly licensed nurse. Which
action by the new nurse requires the nurse to intervene?
A. Administering an IM injection without aspirating
B. Checking a client’s blood pressure in the arm with an IV
infusion
C. Using an alcohol-based hand rub before donning sterile
gloves
D. Placing a client on NPO status without a provider’s order
Answer: D. Placing a client on NPO status without a provider’s
order
Rationale: NPO status requires a provider order. The other
,actions: IM injection without aspiration is acceptable for most
vaccines; BP in arm with IV is acceptable if the infusion is not
affecting the arm; alcohol rub is allowed before sterile gloving if
hands are not visibly soiled.
4. The nurse manager is assigning client care. Which client
should be assigned to an LPN?
A. A client 1 hour post-cardiac catheterization with a stable
groin site
B. A client newly diagnosed with diabetic ketoacidosis on an
insulin drip
C. A client with a chest tube and continuous bubbling in the
water seal chamber
D. A client who requires a blood transfusion
Answer: A. A client 1 hour post-cardiac catheterization with a
stable groin site
Rationale: LPNs can care for stable clients with predictable
outcomes. Unstable clients, titratable drips (insulin), chest tube
complications, and blood transfusions require RN assessment
and judgment.
5. A charge nurse is making assignments. Which client is
best assigned to a float RN from the medical-surgical unit?
, A. A client with a new tracheostomy requiring frequent
suctioning
B. A client with pneumonia receiving IV antibiotics and oral care
C. A client with a chest tube and an air leak
D. A client with a ventriculostomy for ICP monitoring
Answer: B. A client with pneumonia receiving IV antibiotics and
oral care
Rationale: A float nurse should receive stable, routine clients.
Tracheostomy suctioning, chest tubes with air leaks, and
ventriculostomy require specialized skills.
6. Which task can be delegated to a UAP but requires
immediate reporting to the RN?
A. Measuring a client’s intake and output
B. Assisting a client with a bedpan
C. Obtaining a blood pressure of 88/50 mm Hg
D. Repositioning a client in bed
Answer: C. Obtaining a blood pressure of 88/50 mm Hg
Rationale: UAPs can take vital signs, but abnormal findings
must be reported immediately to the RN. The other tasks are
routine and do not require immediate reporting unless the
client has a change.
