NUR 204 HESI Leadership and
Management Version 2 Actual Exam Prep
(2026/2027) | Fortis College Practice
Question Bank with Detailed Rationales &
Verified Answers
A nurse manager notices that two staff nurses frequently disagree about patient
assignments. Which action should the manager take first?
A. Reassign both nurses to different units
B. Ask each nurse to submit a written complaint
C. Meet with the nurses to identify the source of the conflict
D. Report the nurses to human resources
Rationale: Conflict management should begin by identifying the underlying issue.
Direct communication can clarify perceptions, expectations, and contributing
factors before disciplinary or administrative actions are considered.
Which leadership behavior best demonstrates transformational leadership?
A. Maintaining existing routines without discussion
B. Encouraging staff to develop new approaches to improve patient care
C. Making all decisions independently
D. Assigning tasks solely according to seniority
Rationale: Transformational leaders inspire staff to pursue improvement,
innovation, professional growth, and shared organizational goals.
A nurse is delegating a task to an experienced nursing assistant. Which
responsibility remains with the registered nurse?
A. Performing routine hygiene
B. Measuring intake and output
,C. Ambulating a stable patient
D. Evaluating the patient's response to care
Rationale: The RN may delegate appropriate tasks, but nursing judgment,
assessment, and evaluation of outcomes remain the RN's responsibility.
A nurse manager wants to improve staff participation in unit decisions. Which
leadership style is most appropriate?
A. Autocratic
B. Laissez-faire
C. Democratic
D. Bureaucratic
Rationale: Democratic leadership encourages participation, collaboration, and
shared decision-making among team members.
A charge nurse assigns an experienced licensed practical nurse to administer
medications to an appropriate patient population. Which delegation principle is
being applied?
A. Right circumstance
B. Right supervision
C. Right person
D. Right documentation
Rationale: The right person principle requires the nurse to ensure that the
individual receiving the delegated task has the appropriate education, competence,
and scope of practice.
A nurse manager receives several complaints about inadequate communication
during shift changes. Which intervention is most appropriate?
A. Increase disciplinary actions
B. Eliminate verbal reports
C. Implement a standardized handoff communication process
D. Require nurses to work longer shifts
Rationale: Standardized handoff processes help ensure that essential patient
information is communicated consistently and reduce omissions during transitions
of care.
,Which statement by a nurse demonstrates effective assertive communication?
A. “You always make mistakes during report.”
B. “I don't care what you think about the assignment.”
C. “Everyone knows that your report is incomplete.”
D. “I need the patient's allergy information included in the handoff.”
Rationale: Assertive communication expresses concerns clearly and respectfully
without blaming, threatening, or demeaning another person.
A nurse manager is developing a quality-improvement project. What should the
manager do first?
A. Implement the proposed intervention
B. Purchase new equipment
C. Identify and define the problem
D. Evaluate the results
Rationale: Quality-improvement efforts begin with clearly identifying the problem
or opportunity for improvement before selecting and implementing interventions.
A nurse observes a coworker repeatedly arriving late for work. Which action is
most appropriate initially?
A. Discuss the coworker's behavior with other staff
B. Post a complaint on the unit bulletin board
C. Address the concern through the appropriate supervisory process
D. Ignore the behavior
Rationale: Attendance concerns should be handled professionally through
established organizational procedures while maintaining confidentiality.
Which situation is an example of horizontal violence?
A. A manager counseling an employee
B. A nurse teaching a student
C. One nurse repeatedly belittling another nurse in front of coworkers
D. A physician changing a treatment order
Rationale: Horizontal violence refers to hostile, demeaning, or aggressive
behavior between individuals at similar levels within an organization.
, A nurse manager wants to determine whether a new staffing intervention improved
patient outcomes. Which measurement is most useful?
A. Staff members' favorite work shifts
B. Number of staff meetings held
C. Changes in relevant patient outcome indicators before and after
implementation
D. Number of emails sent by the manager
Rationale: Outcome measures provide evidence about whether an intervention
produced the desired effect on patient care.
Which action by a nurse manager demonstrates effective time management?
A. Completing the easiest tasks first regardless of urgency
B. Performing every task personally
C. Prioritizing activities according to urgency and importance
D. Delaying complex responsibilities until the end of the shift
Rationale: Effective time management requires prioritization based on patient
safety, urgency, deadlines, and available resources.
A newly appointed charge nurse asks an experienced nurse for guidance about
handling a difficult staff situation. Which response demonstrates effective
leadership?
A. “You should already know how to handle this.”
B. “Ask someone else.”
C. “Let's review the situation and consider possible approaches.”
D. “I'll make every decision for you.”
Rationale: Effective leaders support staff development by coaching, encouraging
problem-solving, and helping team members build confidence and competence.
A nurse manager uses a leadership approach in which decision-making authority is
largely retained by the manager. Which style is being demonstrated?
A. Democratic
B. Transformational
C. Autocratic
D. Participative
Management Version 2 Actual Exam Prep
(2026/2027) | Fortis College Practice
Question Bank with Detailed Rationales &
Verified Answers
A nurse manager notices that two staff nurses frequently disagree about patient
assignments. Which action should the manager take first?
A. Reassign both nurses to different units
B. Ask each nurse to submit a written complaint
C. Meet with the nurses to identify the source of the conflict
D. Report the nurses to human resources
Rationale: Conflict management should begin by identifying the underlying issue.
Direct communication can clarify perceptions, expectations, and contributing
factors before disciplinary or administrative actions are considered.
Which leadership behavior best demonstrates transformational leadership?
A. Maintaining existing routines without discussion
B. Encouraging staff to develop new approaches to improve patient care
C. Making all decisions independently
D. Assigning tasks solely according to seniority
Rationale: Transformational leaders inspire staff to pursue improvement,
innovation, professional growth, and shared organizational goals.
A nurse is delegating a task to an experienced nursing assistant. Which
responsibility remains with the registered nurse?
A. Performing routine hygiene
B. Measuring intake and output
,C. Ambulating a stable patient
D. Evaluating the patient's response to care
Rationale: The RN may delegate appropriate tasks, but nursing judgment,
assessment, and evaluation of outcomes remain the RN's responsibility.
A nurse manager wants to improve staff participation in unit decisions. Which
leadership style is most appropriate?
A. Autocratic
B. Laissez-faire
C. Democratic
D. Bureaucratic
Rationale: Democratic leadership encourages participation, collaboration, and
shared decision-making among team members.
A charge nurse assigns an experienced licensed practical nurse to administer
medications to an appropriate patient population. Which delegation principle is
being applied?
A. Right circumstance
B. Right supervision
C. Right person
D. Right documentation
Rationale: The right person principle requires the nurse to ensure that the
individual receiving the delegated task has the appropriate education, competence,
and scope of practice.
A nurse manager receives several complaints about inadequate communication
during shift changes. Which intervention is most appropriate?
A. Increase disciplinary actions
B. Eliminate verbal reports
C. Implement a standardized handoff communication process
D. Require nurses to work longer shifts
Rationale: Standardized handoff processes help ensure that essential patient
information is communicated consistently and reduce omissions during transitions
of care.
,Which statement by a nurse demonstrates effective assertive communication?
A. “You always make mistakes during report.”
B. “I don't care what you think about the assignment.”
C. “Everyone knows that your report is incomplete.”
D. “I need the patient's allergy information included in the handoff.”
Rationale: Assertive communication expresses concerns clearly and respectfully
without blaming, threatening, or demeaning another person.
A nurse manager is developing a quality-improvement project. What should the
manager do first?
A. Implement the proposed intervention
B. Purchase new equipment
C. Identify and define the problem
D. Evaluate the results
Rationale: Quality-improvement efforts begin with clearly identifying the problem
or opportunity for improvement before selecting and implementing interventions.
A nurse observes a coworker repeatedly arriving late for work. Which action is
most appropriate initially?
A. Discuss the coworker's behavior with other staff
B. Post a complaint on the unit bulletin board
C. Address the concern through the appropriate supervisory process
D. Ignore the behavior
Rationale: Attendance concerns should be handled professionally through
established organizational procedures while maintaining confidentiality.
Which situation is an example of horizontal violence?
A. A manager counseling an employee
B. A nurse teaching a student
C. One nurse repeatedly belittling another nurse in front of coworkers
D. A physician changing a treatment order
Rationale: Horizontal violence refers to hostile, demeaning, or aggressive
behavior between individuals at similar levels within an organization.
, A nurse manager wants to determine whether a new staffing intervention improved
patient outcomes. Which measurement is most useful?
A. Staff members' favorite work shifts
B. Number of staff meetings held
C. Changes in relevant patient outcome indicators before and after
implementation
D. Number of emails sent by the manager
Rationale: Outcome measures provide evidence about whether an intervention
produced the desired effect on patient care.
Which action by a nurse manager demonstrates effective time management?
A. Completing the easiest tasks first regardless of urgency
B. Performing every task personally
C. Prioritizing activities according to urgency and importance
D. Delaying complex responsibilities until the end of the shift
Rationale: Effective time management requires prioritization based on patient
safety, urgency, deadlines, and available resources.
A newly appointed charge nurse asks an experienced nurse for guidance about
handling a difficult staff situation. Which response demonstrates effective
leadership?
A. “You should already know how to handle this.”
B. “Ask someone else.”
C. “Let's review the situation and consider possible approaches.”
D. “I'll make every decision for you.”
Rationale: Effective leaders support staff development by coaching, encouraging
problem-solving, and helping team members build confidence and competence.
A nurse manager uses a leadership approach in which decision-making authority is
largely retained by the manager. Which style is being demonstrated?
A. Democratic
B. Transformational
C. Autocratic
D. Participative
