, HESI Exit Exam Leadership and Management Questions
and Answers with Rationale 2026/2027
Question 1
A charge nurse is making shift assignments on a medical-surgical unit.
Which client is most appropriate to assign to an experienced licensed
practical nurse (LPN)?
A. A newly admitted client with acute unstable status and a new
diagnosis of diabetic ketoacidosis
B. A stable client diagnosed with chronic obstructive pulmonary
disease who requires scheduled oral medications and routine
dressing changes
C. A client scheduled for discharge who requires initial nursing
admission education and care plan formulation
D. A client experiencing acute chest pain and shortness of breath
Correct Answer: B. A stable client diagnosed with chronic obstructive
pulmonary disease who requires scheduled oral medications and routine
dressing changes
Rationale: According to the scope of practice, LPNs can care for
stable clients with predictable outcomes and perform delegated
tasks such as administering oral medications and dressing changes.
Unstable clients, initial nursing assessments, and new admission
education must be performed by a registered nurse (RN).
Question 2
A nurse manager observes a staff nurse consistently arriving late, failing
to complete documentation on time, and showing indifference toward
client care concerns. What is the appropriate initial leadership action for
the nurse manager to take?
, A. Terminate the staff nurse immediately without discussion.
B. Schedule a private, face-to-face counseling session to discuss
the performance issues, identify root causes, and establish a clear
improvement plan.
C. Publicly reprimand the nurse during the next staff meeting.
D. Ignore the behavior and redistribute the nurse's workload to
other staff members.
Correct Answer: B. Schedule a private, face-to-face counseling session
to discuss the performance issues, identify root causes, and establish a
clear improvement plan.
Rationale: Progressive discipline begins with private counseling
and coaching. This allows the manager to address specific
performance deficits constructively, listen to potential contributing
factors, and set clear expectations for improvement.
Question 3
A registered nurse (RN) is supervising an unlicensed assistive personnel
(UAP) on a busy telemetry unit. Which task can the RN safely delegate
to the UAP?
A. Evaluating the effectiveness of a newly initiated antiarrhythmic
medication infusion
B. Assessing lung sounds on a client experiencing acute shortness
of breath
C. Obtaining and recording routine vital signs on a stable client
who is 2 days post-coronary artery bypass graft
D. Teaching a client about low-sodium dietary modifications prior
to discharge
Correct Answer: C. Obtaining and recording routine vital signs on a
stable client who is 2 days post-coronary artery bypass graft
, Rationale: Delegation requires assigning tasks within the UAP's
training and scope of practice for stable clients with predictable
outcomes. Vital sign measurement on stable clients is appropriate
for UAPs, whereas assessment, evaluation, and client education are
non-delegable RN responsibilities.
Question 4
A nurse manager wants to implement a major electronic health record
documentation change on the nursing unit. To ensure staff buy-in and a
smooth transition, which leadership style should the manager primarily
employ during this change process?
A. Autocratic leadership, issuing strict commands without staff
input
B. Laissez-faire leadership, providing total independence with zero
guidance
C. Democratic (participative) leadership, involving staff nurses in
planning, discussions, and decision-making
D. Passive-aggressive leadership, withholding information from
staff
Correct Answer: C. Democratic (participative) leadership, involving
staff nurses in planning, discussions, and decision-making
Rationale: Democratic leadership fosters collaboration,
engagement, and shared governance. In nursing management,
involving frontline staff in major operational changes significantly
increases acceptance, morale, and successful implementation.
Question 5
A staff nurse notices a colleague smelling strongly of alcohol while
caring for clients on a surgical unit. What is the priority ethical and
professional action for the nurse to take?
A. Ignore the situation to avoid ruining a friendship.
and Answers with Rationale 2026/2027
Question 1
A charge nurse is making shift assignments on a medical-surgical unit.
Which client is most appropriate to assign to an experienced licensed
practical nurse (LPN)?
A. A newly admitted client with acute unstable status and a new
diagnosis of diabetic ketoacidosis
B. A stable client diagnosed with chronic obstructive pulmonary
disease who requires scheduled oral medications and routine
dressing changes
C. A client scheduled for discharge who requires initial nursing
admission education and care plan formulation
D. A client experiencing acute chest pain and shortness of breath
Correct Answer: B. A stable client diagnosed with chronic obstructive
pulmonary disease who requires scheduled oral medications and routine
dressing changes
Rationale: According to the scope of practice, LPNs can care for
stable clients with predictable outcomes and perform delegated
tasks such as administering oral medications and dressing changes.
Unstable clients, initial nursing assessments, and new admission
education must be performed by a registered nurse (RN).
Question 2
A nurse manager observes a staff nurse consistently arriving late, failing
to complete documentation on time, and showing indifference toward
client care concerns. What is the appropriate initial leadership action for
the nurse manager to take?
, A. Terminate the staff nurse immediately without discussion.
B. Schedule a private, face-to-face counseling session to discuss
the performance issues, identify root causes, and establish a clear
improvement plan.
C. Publicly reprimand the nurse during the next staff meeting.
D. Ignore the behavior and redistribute the nurse's workload to
other staff members.
Correct Answer: B. Schedule a private, face-to-face counseling session
to discuss the performance issues, identify root causes, and establish a
clear improvement plan.
Rationale: Progressive discipline begins with private counseling
and coaching. This allows the manager to address specific
performance deficits constructively, listen to potential contributing
factors, and set clear expectations for improvement.
Question 3
A registered nurse (RN) is supervising an unlicensed assistive personnel
(UAP) on a busy telemetry unit. Which task can the RN safely delegate
to the UAP?
A. Evaluating the effectiveness of a newly initiated antiarrhythmic
medication infusion
B. Assessing lung sounds on a client experiencing acute shortness
of breath
C. Obtaining and recording routine vital signs on a stable client
who is 2 days post-coronary artery bypass graft
D. Teaching a client about low-sodium dietary modifications prior
to discharge
Correct Answer: C. Obtaining and recording routine vital signs on a
stable client who is 2 days post-coronary artery bypass graft
, Rationale: Delegation requires assigning tasks within the UAP's
training and scope of practice for stable clients with predictable
outcomes. Vital sign measurement on stable clients is appropriate
for UAPs, whereas assessment, evaluation, and client education are
non-delegable RN responsibilities.
Question 4
A nurse manager wants to implement a major electronic health record
documentation change on the nursing unit. To ensure staff buy-in and a
smooth transition, which leadership style should the manager primarily
employ during this change process?
A. Autocratic leadership, issuing strict commands without staff
input
B. Laissez-faire leadership, providing total independence with zero
guidance
C. Democratic (participative) leadership, involving staff nurses in
planning, discussions, and decision-making
D. Passive-aggressive leadership, withholding information from
staff
Correct Answer: C. Democratic (participative) leadership, involving
staff nurses in planning, discussions, and decision-making
Rationale: Democratic leadership fosters collaboration,
engagement, and shared governance. In nursing management,
involving frontline staff in major operational changes significantly
increases acceptance, morale, and successful implementation.
Question 5
A staff nurse notices a colleague smelling strongly of alcohol while
caring for clients on a surgical unit. What is the priority ethical and
professional action for the nurse to take?
A. Ignore the situation to avoid ruining a friendship.
