HESI NURSING LEADERSHIP AND
MANAGEMENT COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Providing training sessions to staff on how to use the new system.
B. Assessing the staff’s readiness for change and identifying perceived barriers.
C. Updating the unit policies to reflect the new documentation standards.
D. Monitoring the staff’s compliance with the new system after implementation.
Answer: B
Conceptual Explanation: Unfreezing involves creating readiness for change by identifying
the need for change and minimizing resistance. Assessment is the first step in this stage.
2. Which task is most appropriate for a registered nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)?
A. Assisting a stable client with ambulation on the first postoperative day.
B. Monitoring the drainage from a client’s chest tube for sudden changes.
,C. Providing discharge instructions to a client following a laparoscopic cholecystectomy.
D. Feeding a client who is at high risk for aspiration due to dysphagia.
Answer: A
Conceptual Explanation: UAPs can assist stable clients with activities of daily living.
Monitoring, teaching, and managing high-risk feeding require the assessment skills of an
RN.
3. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a history of COPD who has an oxygen saturation of 91%.
B. A client who underwent an appendectomy 4 hours ago and reports pain as 6/10.
C. A client scheduled for surgery in 30 minutes who has not yet signed the informed
consent form.
D. A client with heart failure who is reporting a sudden onset of shortness of breath and
coughing pink frothy sputum.
Answer: D
Conceptual Explanation: Pink frothy sputum and acute shortness of breath suggest
pulmonary edema, which is a life-threatening emergency requiring immediate
intervention.
, 4. A nurse manager is preparing the annual budget and includes the purchase of a new
central monitoring station. In which part of the budget should this be documented?
A. Operating budget
B. Capital budget
C. Personnel budget
D. Revenue budget
Answer: B
Conceptual Explanation: The capital budget involves large, expensive purchases that have
a long life span, typically exceeding a specific dollar amount (e.g., $5,000).
5. A charge nurse is managing a conflict between two nurses regarding the holiday schedule.
One nurse agrees to work Christmas if the other works New Year’s Eve. Which conflict
resolution strategy is being used?
A. Avoiding
B. Compromising
C. Competing
D. Smoothing
Answer: B
Conceptual Explanation: Compromising involves a ‘give and take’ approach where both
parties give up something to reach a mutually acceptable solution.
MANAGEMENT COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Providing training sessions to staff on how to use the new system.
B. Assessing the staff’s readiness for change and identifying perceived barriers.
C. Updating the unit policies to reflect the new documentation standards.
D. Monitoring the staff’s compliance with the new system after implementation.
Answer: B
Conceptual Explanation: Unfreezing involves creating readiness for change by identifying
the need for change and minimizing resistance. Assessment is the first step in this stage.
2. Which task is most appropriate for a registered nurse (RN) to delegate to an unlicensed
assistive personnel (UAP)?
A. Assisting a stable client with ambulation on the first postoperative day.
B. Monitoring the drainage from a client’s chest tube for sudden changes.
,C. Providing discharge instructions to a client following a laparoscopic cholecystectomy.
D. Feeding a client who is at high risk for aspiration due to dysphagia.
Answer: A
Conceptual Explanation: UAPs can assist stable clients with activities of daily living.
Monitoring, teaching, and managing high-risk feeding require the assessment skills of an
RN.
3. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a history of COPD who has an oxygen saturation of 91%.
B. A client who underwent an appendectomy 4 hours ago and reports pain as 6/10.
C. A client scheduled for surgery in 30 minutes who has not yet signed the informed
consent form.
D. A client with heart failure who is reporting a sudden onset of shortness of breath and
coughing pink frothy sputum.
Answer: D
Conceptual Explanation: Pink frothy sputum and acute shortness of breath suggest
pulmonary edema, which is a life-threatening emergency requiring immediate
intervention.
, 4. A nurse manager is preparing the annual budget and includes the purchase of a new
central monitoring station. In which part of the budget should this be documented?
A. Operating budget
B. Capital budget
C. Personnel budget
D. Revenue budget
Answer: B
Conceptual Explanation: The capital budget involves large, expensive purchases that have
a long life span, typically exceeding a specific dollar amount (e.g., $5,000).
5. A charge nurse is managing a conflict between two nurses regarding the holiday schedule.
One nurse agrees to work Christmas if the other works New Year’s Eve. Which conflict
resolution strategy is being used?
A. Avoiding
B. Compromising
C. Competing
D. Smoothing
Answer: B
Conceptual Explanation: Compromising involves a ‘give and take’ approach where both
parties give up something to reach a mutually acceptable solution.
