THE COMPLETE HESI LEADERSHIP
EXAM PREP TEST BANK: 400
QUESTIONS WITH CORRECT ANSWERS
AND DETAILED RATIONALES |
ALREADY GRADED A+ | GUARANTEED
PASS!!
1. A nurse manager is implementing a new electronic health record (EHR)
system. Several staff nurses are resistant to the change. Which action by the
nurse manager best facilitates the staff's acceptance of this change?
A. Mandating that all staff must attend a training session by the end of the week.
B. Identifying the "early adopters" on the unit and having them act as super-users.
C. Threatening to write up staff members who do not use the new system correctly.
D. Allowing staff to continue using the paper charting system indefinitely.
Correct Answer: B. Identifying early adopters and using them as champions helps
facilitate change by providing peer support and demonstrating successful use of the
new system. This utilizes a bottom-up approach to change management, which
increases buy-in.
2. A charge nurse is making assignments for a medical-surgical unit. Which
client should be assigned to the most experienced RN?
A. A 45-year-old client 1 day post-operative from an appendectomy, reporting pain.
B. A 60-year-old client newly diagnosed with diabetes requiring teaching on self-
injections.
C. A 72-year-old client with a new tracheostomy who is being weaned from the
ventilator.
D. A 50-year-old client with a urinary tract infection requiring IV antibiotics.
,Correct Answer: C. The client with a new tracheostomy being weaned from a
ventilator is the most unstable and requires the highest level of assessment and
critical thinking skills. This client should be assigned to the most experienced RN.
3. A UAP reports to the nurse that a client's blood pressure is 88/52 mmHg. The
client is asymptomatic. What is the nurse's best action?
A. Tell the UAP to recheck the blood pressure in 15 minutes.
B. Instruct the UAP to increase the client's IV fluid rate.
C. Ask the UAP to assess the client's apical pulse.
D. Go to the room and reassess the client's blood pressure and condition.
Correct Answer: D. The RN is responsible for the final assessment and interpretation
of client data. A UAP should not be asked to interpret vital signs or make clinical
judgments. The nurse must go and reassess the client personally.
4. A nurse enters a client's room and finds the client on the floor next to the
bed. The client states, "I tried to go to the bathroom and fell." What is the
nurse's priority action?
A. Help the client back into bed.
B. Call the healthcare provider immediately.
C. Assess the client for any injuries.
D. Complete an incident report.
Correct Answer: C. Assessment is always the priority. Before moving the client or
notifying the provider, the nurse must perform a head-to-toe assessment to rule out
any fractures, head trauma, or internal bleeding that could be worsened by
movement.
5. A nurse is delegating tasks to an LPN/VN and a UAP. Which task is
appropriate to delegate to the LPN/VN but NOT to the UAP?
A. Ambulating a client who had a stroke.
B. Feeding a client with dementia.
C. Administering a tube feeding to a client with a gastrostomy tube.
D. Obtaining a daily weight on a client with heart failure.
,Correct Answer: C. Administration of tube feedings involves assessment of the tube
placement and gastric residual, which requires nursing judgment. This is within the
LPN/VN scope of practice, but not appropriate for a UAP.
6. A nurse is caring for a client who refuses to take their prescribed
anticoagulant medication. The client is alert, oriented, and understands the
risks. What is the nurse's best response?
A. "I will need to document your refusal, but you are making a dangerous choice."
B. "I will call your healthcare provider to get a new order for a different medication."
C. "I am going to have your family come in to talk some sense into you."
D. "Let's discuss your concerns about this medication so I can better understand."
Correct Answer: D. The nurse must first explore the client's reasons for refusal to
respect autonomy and possibly resolve a misunderstanding. While the client has the
right to refuse, the nurse's advocacy role is to ensure the refusal is informed.
7. A unit is experiencing a high number of medication errors. After analyzing
the data, the nurse manager notices most errors occur during shift change.
Which intervention is most effective to address this issue?
A. Implement a 30-minute "quiet time" at the beginning of each shift for checking
orders.
B. Require all medications to be checked by two nurses prior to administration.
C. Mandate that no medications be given during the 15 minutes before shift change.
D. Switch to an automated medication dispensing system in the staff breakroom.
Correct Answer: A. Implementing a structured "quiet time" for order review and
medication preparation during the busiest time (shift change) helps minimize
distractions and interruptions, directly targeting the root cause of the errors.
8. During a staff meeting, two nurses are arguing loudly about the rotation of
weekend shifts. The conflict is disrupting the meeting. The nurse manager
states, "Let's take a 10-minute break and we will discuss this further in my
office after the meeting." Which conflict management style is the manager
using?
A. Competing
, B. Avoiding
C. Compromising
D. Collaborating
Correct Answer: B. Taking a break and postponing the discussion is a form of
avoiding the immediate conflict. While sometimes necessary to de-escalate, it is
temporary and does not resolve the underlying issue. The manager is using this to
regain control of the meeting.
9. A nurse receives a telephone order from a healthcare provider for a
medication. Which of the following is the most appropriate way to document
the telephone order?
A. Write the order on a sticky note and place it on the chart for the provider to sign
later.
B. Document the order in the chart and sign it as a verbal order.
C. Use the "read-back" technique, then document the order as a telephone order
with the provider's name.
D. Tell the provider to fax the order to the unit to avoid mistakes.
Correct Answer: C. The nurse must write the order, read it back to the provider to
verify accuracy, and then document it as a telephone order, including the provider's
name, the date, and the time.
10. A client is receiving a continuous IV infusion of heparin. The UAP reports
that the client's IV pump is alarming "occlusion." What is the nurse's priority
action?
A. Instruct the UAP to flush the IV line with normal saline.
B. Silence the alarm and restart the pump.
C. Assess the IV site for patency, redness, or swelling.
D. Call the healthcare provider for a new order.
Correct Answer: C. The nurse must first assess the IV site to determine the cause of
the occlusion. If the site is infiltrated, the infusion must be stopped immediately to
prevent tissue damage, especially with an anticoagulant.
EXAM PREP TEST BANK: 400
QUESTIONS WITH CORRECT ANSWERS
AND DETAILED RATIONALES |
ALREADY GRADED A+ | GUARANTEED
PASS!!
1. A nurse manager is implementing a new electronic health record (EHR)
system. Several staff nurses are resistant to the change. Which action by the
nurse manager best facilitates the staff's acceptance of this change?
A. Mandating that all staff must attend a training session by the end of the week.
B. Identifying the "early adopters" on the unit and having them act as super-users.
C. Threatening to write up staff members who do not use the new system correctly.
D. Allowing staff to continue using the paper charting system indefinitely.
Correct Answer: B. Identifying early adopters and using them as champions helps
facilitate change by providing peer support and demonstrating successful use of the
new system. This utilizes a bottom-up approach to change management, which
increases buy-in.
2. A charge nurse is making assignments for a medical-surgical unit. Which
client should be assigned to the most experienced RN?
A. A 45-year-old client 1 day post-operative from an appendectomy, reporting pain.
B. A 60-year-old client newly diagnosed with diabetes requiring teaching on self-
injections.
C. A 72-year-old client with a new tracheostomy who is being weaned from the
ventilator.
D. A 50-year-old client with a urinary tract infection requiring IV antibiotics.
,Correct Answer: C. The client with a new tracheostomy being weaned from a
ventilator is the most unstable and requires the highest level of assessment and
critical thinking skills. This client should be assigned to the most experienced RN.
3. A UAP reports to the nurse that a client's blood pressure is 88/52 mmHg. The
client is asymptomatic. What is the nurse's best action?
A. Tell the UAP to recheck the blood pressure in 15 minutes.
B. Instruct the UAP to increase the client's IV fluid rate.
C. Ask the UAP to assess the client's apical pulse.
D. Go to the room and reassess the client's blood pressure and condition.
Correct Answer: D. The RN is responsible for the final assessment and interpretation
of client data. A UAP should not be asked to interpret vital signs or make clinical
judgments. The nurse must go and reassess the client personally.
4. A nurse enters a client's room and finds the client on the floor next to the
bed. The client states, "I tried to go to the bathroom and fell." What is the
nurse's priority action?
A. Help the client back into bed.
B. Call the healthcare provider immediately.
C. Assess the client for any injuries.
D. Complete an incident report.
Correct Answer: C. Assessment is always the priority. Before moving the client or
notifying the provider, the nurse must perform a head-to-toe assessment to rule out
any fractures, head trauma, or internal bleeding that could be worsened by
movement.
5. A nurse is delegating tasks to an LPN/VN and a UAP. Which task is
appropriate to delegate to the LPN/VN but NOT to the UAP?
A. Ambulating a client who had a stroke.
B. Feeding a client with dementia.
C. Administering a tube feeding to a client with a gastrostomy tube.
D. Obtaining a daily weight on a client with heart failure.
,Correct Answer: C. Administration of tube feedings involves assessment of the tube
placement and gastric residual, which requires nursing judgment. This is within the
LPN/VN scope of practice, but not appropriate for a UAP.
6. A nurse is caring for a client who refuses to take their prescribed
anticoagulant medication. The client is alert, oriented, and understands the
risks. What is the nurse's best response?
A. "I will need to document your refusal, but you are making a dangerous choice."
B. "I will call your healthcare provider to get a new order for a different medication."
C. "I am going to have your family come in to talk some sense into you."
D. "Let's discuss your concerns about this medication so I can better understand."
Correct Answer: D. The nurse must first explore the client's reasons for refusal to
respect autonomy and possibly resolve a misunderstanding. While the client has the
right to refuse, the nurse's advocacy role is to ensure the refusal is informed.
7. A unit is experiencing a high number of medication errors. After analyzing
the data, the nurse manager notices most errors occur during shift change.
Which intervention is most effective to address this issue?
A. Implement a 30-minute "quiet time" at the beginning of each shift for checking
orders.
B. Require all medications to be checked by two nurses prior to administration.
C. Mandate that no medications be given during the 15 minutes before shift change.
D. Switch to an automated medication dispensing system in the staff breakroom.
Correct Answer: A. Implementing a structured "quiet time" for order review and
medication preparation during the busiest time (shift change) helps minimize
distractions and interruptions, directly targeting the root cause of the errors.
8. During a staff meeting, two nurses are arguing loudly about the rotation of
weekend shifts. The conflict is disrupting the meeting. The nurse manager
states, "Let's take a 10-minute break and we will discuss this further in my
office after the meeting." Which conflict management style is the manager
using?
A. Competing
, B. Avoiding
C. Compromising
D. Collaborating
Correct Answer: B. Taking a break and postponing the discussion is a form of
avoiding the immediate conflict. While sometimes necessary to de-escalate, it is
temporary and does not resolve the underlying issue. The manager is using this to
regain control of the meeting.
9. A nurse receives a telephone order from a healthcare provider for a
medication. Which of the following is the most appropriate way to document
the telephone order?
A. Write the order on a sticky note and place it on the chart for the provider to sign
later.
B. Document the order in the chart and sign it as a verbal order.
C. Use the "read-back" technique, then document the order as a telephone order
with the provider's name.
D. Tell the provider to fax the order to the unit to avoid mistakes.
Correct Answer: C. The nurse must write the order, read it back to the provider to
verify accuracy, and then document it as a telephone order, including the provider's
name, the date, and the time.
10. A client is receiving a continuous IV infusion of heparin. The UAP reports
that the client's IV pump is alarming "occlusion." What is the nurse's priority
action?
A. Instruct the UAP to flush the IV line with normal saline.
B. Silence the alarm and restart the pump.
C. Assess the IV site for patency, redness, or swelling.
D. Call the healthcare provider for a new order.
Correct Answer: C. The nurse must first assess the IV site to determine the cause of
the occlusion. If the site is infiltrated, the infusion must be stopped immediately to
prevent tissue damage, especially with an anticoagulant.
