HESI Leadership & Management –
Comprehensive Practice Exam Prep
Document 2026/2027 | Nursing Leadership,
Delegation & NGN Clinical Judgment | 85
Verified Questions with Detailed Rationales
SECTION 1: Delegation & Staff Management (Questions 1-15)
Q1. A charge nurse is assigning tasks to a licensed practical nurse
(LPN) and an unlicensed assistive personnel (UAP). Which task is most
appropriate for the LPN?
• A) Bathe a patient with pneumonia
• B) Reinforce teaching on insulin pump use previously taught by the
RN
• C) Monitor a patient's nasogastric (NG) tube for patency and output
• D) Ambulate a patient with a fractured hip
Answer: C – LPNs can monitor stable patients, including NG tube output
and patency. Bathing and ambulating are UAP tasks. Reinforcing teaching
requires an RN's assessment of learning needs first.
Q2. A nurse manager delegates vital signs on a stable postoperative
patient to a UAP. Later, the UAP reports the blood pressure is 88/50 mm
Hg but does not document it. What is the RN's priority action?
• A) Document the UAP's report in the patient's chart
• B) Ask the UAP why they did not document the finding
• C) Assess the patient immediately and reassign the task if needed
, • D) Report the UAP to the state board of nursing
Answer: C – The RN is legally responsible for assessment, follow-up, and
supervision. Immediate patient assessment takes priority; documentation
and education follow.
Q3. Which of the following is an example of correct delegation by an
RN?
• A) Asking the UAP to interpret a change in respiratory rate
• B) Directing the LPN to administer enteral feeding to a stable stroke
patient
• C) Telling the UAP to teach a diabetic patient foot care
• D) Assigning the LPN to complete the admission assessment
Answer: B – Administering enteral feedings is within LPN scope in most
states for stable patients. Teaching and admission assessment are RN
responsibilities. UAPs cannot interpret data.
Q4. The five rights of delegation include all of the following EXCEPT:
• A) Right task
• B) Right circumstances
• C) Right diagnosis
• D) Right supervision
Answer: C – The five rights are: right task, right circumstance, right person,
right direction/communication, right supervision. Diagnosis is not a right of
delegation.
Q5. An RN delegates a patient's morning hygiene to a UAP. The UAP
reports the patient is suddenly confused and short of breath. The RN
should:
, • A) Stop the UAP's other tasks and assess the patient
• B) Tell the UAP to finish and report later
• C) Ask the UAP to call the provider
• D) Document the UAP's observation
Answer: A – The RN must immediately assess any change in patient
condition. Delegation does not remove the RN's responsibility for patient
assessment. The RN should stop the UAP's other tasks and assess the
patient.
Q6. A charge nurse is making shift assignments for 2 experienced RNs,
1 graduate RN, 1 LPN, and 2 UAPs. Which client should the nurse assign
to the most experienced RN?
• A) A 36-year-old admitted with angina who has a history of coronary
artery disease
• B) A patient with stable vital signs scheduled for discharge
• C) A patient requiring routine medication administration
• D) A patient with a new diagnosis of diabetes
Answer: A – A patient with angina and cardiac history requires complex
assessment and clinical judgment. The most experienced RN should
handle this assignment.
Q7. Which task is appropriate to delegate to a nursing assistant (NA)?
• A) Administering oral medications to a stable patient
• B) Performing wound care on a postoperative patient
• C) Assisting a patient with ambulation to the bathroom
• D) Developing a plan of care for a newly admitted patient
Answer: C – Delegation to an NA includes routine activities of daily living,
such as ambulation and hygiene assistance.
, Q8. A charge nurse delegates collection of a sputum specimen to a
UAP. Before delegating this task, which action is most important for the
nurse to implement?
• A) Determine if the UAP has received training to collect the specimen
• B) Explain the procedure to the patient
• C) Document the delegation in the patient's chart
• D) Observe the UAP performing the task
Answer: A – Before delegation, the RN must ensure the delegatee is
competent and trained to perform the task. Determining training and
competency is essential for safe delegation.
Q9. An RN is leading a team of two LPNs and three UAPs. Which patient
requires an RN assessment first?
• A) Patient with a fever of 100.4°F (38°C) after chemotherapy
• B) Patient who reports "my chest feels tight" after blood transfusion
started 10 minutes ago
• C) Patient requesting pain medication for chronic back pain
• D) Patient with a small amount of serous drainage on a surgical
dressing
Answer: B – Chest tightness post-transfusion suggests possible
transfusion reaction (anaphylaxis or hemolytic). This is a life-threatening
priority over stable fever or pain.
Q10. The nurse assigns collection of a sputum specimen to a UAP.
Before delegating this task to the UAP, which action is most important
for the nurse to implement?
Comprehensive Practice Exam Prep
Document 2026/2027 | Nursing Leadership,
Delegation & NGN Clinical Judgment | 85
Verified Questions with Detailed Rationales
SECTION 1: Delegation & Staff Management (Questions 1-15)
Q1. A charge nurse is assigning tasks to a licensed practical nurse
(LPN) and an unlicensed assistive personnel (UAP). Which task is most
appropriate for the LPN?
• A) Bathe a patient with pneumonia
• B) Reinforce teaching on insulin pump use previously taught by the
RN
• C) Monitor a patient's nasogastric (NG) tube for patency and output
• D) Ambulate a patient with a fractured hip
Answer: C – LPNs can monitor stable patients, including NG tube output
and patency. Bathing and ambulating are UAP tasks. Reinforcing teaching
requires an RN's assessment of learning needs first.
Q2. A nurse manager delegates vital signs on a stable postoperative
patient to a UAP. Later, the UAP reports the blood pressure is 88/50 mm
Hg but does not document it. What is the RN's priority action?
• A) Document the UAP's report in the patient's chart
• B) Ask the UAP why they did not document the finding
• C) Assess the patient immediately and reassign the task if needed
, • D) Report the UAP to the state board of nursing
Answer: C – The RN is legally responsible for assessment, follow-up, and
supervision. Immediate patient assessment takes priority; documentation
and education follow.
Q3. Which of the following is an example of correct delegation by an
RN?
• A) Asking the UAP to interpret a change in respiratory rate
• B) Directing the LPN to administer enteral feeding to a stable stroke
patient
• C) Telling the UAP to teach a diabetic patient foot care
• D) Assigning the LPN to complete the admission assessment
Answer: B – Administering enteral feedings is within LPN scope in most
states for stable patients. Teaching and admission assessment are RN
responsibilities. UAPs cannot interpret data.
Q4. The five rights of delegation include all of the following EXCEPT:
• A) Right task
• B) Right circumstances
• C) Right diagnosis
• D) Right supervision
Answer: C – The five rights are: right task, right circumstance, right person,
right direction/communication, right supervision. Diagnosis is not a right of
delegation.
Q5. An RN delegates a patient's morning hygiene to a UAP. The UAP
reports the patient is suddenly confused and short of breath. The RN
should:
, • A) Stop the UAP's other tasks and assess the patient
• B) Tell the UAP to finish and report later
• C) Ask the UAP to call the provider
• D) Document the UAP's observation
Answer: A – The RN must immediately assess any change in patient
condition. Delegation does not remove the RN's responsibility for patient
assessment. The RN should stop the UAP's other tasks and assess the
patient.
Q6. A charge nurse is making shift assignments for 2 experienced RNs,
1 graduate RN, 1 LPN, and 2 UAPs. Which client should the nurse assign
to the most experienced RN?
• A) A 36-year-old admitted with angina who has a history of coronary
artery disease
• B) A patient with stable vital signs scheduled for discharge
• C) A patient requiring routine medication administration
• D) A patient with a new diagnosis of diabetes
Answer: A – A patient with angina and cardiac history requires complex
assessment and clinical judgment. The most experienced RN should
handle this assignment.
Q7. Which task is appropriate to delegate to a nursing assistant (NA)?
• A) Administering oral medications to a stable patient
• B) Performing wound care on a postoperative patient
• C) Assisting a patient with ambulation to the bathroom
• D) Developing a plan of care for a newly admitted patient
Answer: C – Delegation to an NA includes routine activities of daily living,
such as ambulation and hygiene assistance.
, Q8. A charge nurse delegates collection of a sputum specimen to a
UAP. Before delegating this task, which action is most important for the
nurse to implement?
• A) Determine if the UAP has received training to collect the specimen
• B) Explain the procedure to the patient
• C) Document the delegation in the patient's chart
• D) Observe the UAP performing the task
Answer: A – Before delegation, the RN must ensure the delegatee is
competent and trained to perform the task. Determining training and
competency is essential for safe delegation.
Q9. An RN is leading a team of two LPNs and three UAPs. Which patient
requires an RN assessment first?
• A) Patient with a fever of 100.4°F (38°C) after chemotherapy
• B) Patient who reports "my chest feels tight" after blood transfusion
started 10 minutes ago
• C) Patient requesting pain medication for chronic back pain
• D) Patient with a small amount of serous drainage on a surgical
dressing
Answer: B – Chest tightness post-transfusion suggests possible
transfusion reaction (anaphylaxis or hemolytic). This is a life-threatening
priority over stable fever or pain.
Q10. The nurse assigns collection of a sputum specimen to a UAP.
Before delegating this task to the UAP, which action is most important
for the nurse to implement?
