HESI RN Leadership and
Management Exam | Nurse
Supervisor Exam | 2025/2026
Edition
Section 1: Introduction
Features leadership scenarios and decision-making questions covering team coordination,
delegation, conflict resolution, quality improvement, and budgeting. Essential for future
charge nurses and nurse leaders preparing for HESI's Leadership exam.
Section 2: Exam Questions and Answers
Format
• 150 questions reflecting the HESI RN Leadership and Management Exam structure
• Includes multiple-choice and select-all-that-apply questions
• Correct answers highlighted in luminous green
• Rationales provided to enhance understanding of leadership principles
1. A nurse manager notices a decrease in patient satisfaction scores. What should the
nurse manager do first?
A) Increase staff workload
B) Review patient feedback and staff performance
C) Terminate underperforming staff
D) Ignore the scores if they improve next month
Correct Answer: B) Review patient feedback and staff performance
Rationale: Assessing feedback and performance identifies root causes, enabling
targeted improvements, aligning with 2025 ANA leadership standards.
2. A charge nurse delegates wound care to a licensed practical nurse (LPN). Which
action ensures safe delegation?
A) Assume the LPN is competent without verification
B) Provide clear instructions and supervise
C) Assign the task without follow-up
D) Delegate to an unlicensed assistive personnel
Correct Answer: B) Provide clear instructions and supervise
Rationale: Clear instructions and supervision ensure competency and safety, per
NCSBN 2025 delegation guidelines.
3. Two nurses disagree on patient care priorities. What should the nurse leader do?
A) Choose a side and enforce the decision
B) Facilitate a meeting to resolve the conflict
C) Ignore the disagreement
D) Reassign one nurse to another unit
Correct Answer: B) Facilitate a meeting to resolve the conflict
, Rationale: Facilitation promotes collaboration, a key 2025 leadership skill per AONL
resources.
4. A nurse manager implements a new quality improvement initiative. What is the first
step?
A) Train all staff immediately
B) Assess current practices and set goals
C) Evaluate outcomes after one week
D) Purchase new equipment
Correct Answer: B) Assess current practices and set goals
Rationale: Baseline assessment and goal-setting align with the Plan-Do-Study-Act
(PDSA) cycle, a 2025 standard.
5. A unit is over budget due to overtime costs. What should the nurse supervisor do?
A) Reduce staff hours without planning
B) Analyze staffing patterns and adjust schedules
C) Request more funding without justification
D) Approve all overtime requests
Correct Answer: B) Analyze staffing patterns and adjust schedules
Rationale: Data-driven scheduling optimizes resources, per 2025 healthcare financial
guidelines.
6. A nurse reports a medication error. What should the nurse leader do first?
A) Discipline the nurse immediately
B) Ensure patient safety and investigate
C) Document the error without follow-up
D) Blame the pharmacy
Correct Answer: B) Ensure patient safety and investigate
Rationale: Patient safety is priority, per 2025 Joint Commission standards.
7. A charge nurse observes a staff member violating hand hygiene protocol. What action
should be taken?
A) Report the staff to human resources
B) Provide immediate education and monitor
C) Ignore the violation if no harm occurs
D) Terminate the staff member
Correct Answer: B) Provide immediate education and monitor
Rationale: Education reinforces compliance, per 2025 CDC guidelines.
8. A nurse leader is developing a staff schedule. What factor is most important?
A) Staff preferences only
B) Patient acuity and staff competency
C) Minimizing costs regardless of coverage
D) Assigning the most experienced nurses to night shifts
Correct Answer: B) Patient acuity and staff competency
Rationale: Matching acuity and skills ensures safety, per 2025 ANA staffing
principles.
9. During a staffing shortage, a nurse refuses a delegated task. What should the nurse
leader do?
A) Reassign the task without discussion
B) Discuss the refusal and clarify scope of practice
C) Write up the nurse for insubordination
D) Ignore the refusal
Correct Answer: B) Discuss the refusal and clarify scope of practice
Rationale: Dialogue ensures appropriate delegation, per NCSBN 2025 guidelines.
, 10. A nurse manager conducts a performance review. What should be the focus?
A) Only negative feedback
B) Balanced feedback and professional goals
C) Personal criticism without support
D) Focusing on peer comparisons
Correct Answer: B) Balanced feedback and professional goals
Rationale: Balanced feedback fosters growth, per 2025 AONL standards.
11. A nurse leader identifies a need for staff training on electronic health records (EHR).
What is the first step?
A) Schedule training without assessment
B) Assess staff competency and needs
C) Purchase new software immediately
D) Assign a trainer without planning
Correct Answer: B) Assess staff competency and needs
Rationale: Needs assessment ensures effective training, per 2025 HIMSS guidelines.
12. A charge nurse receives a complaint about a rude staff member. What should the
nurse do?
A) Confront the staff publicly
B) Investigate and address privately
C) Ignore the complaint
D) Terminate the staff member
Correct Answer: B) Investigate and address privately
Rationale: Private investigation maintains professionalism, per 2025 ANA ethics.
13. A nurse manager is developing a budget for the next fiscal year. What should be
prioritized?
A) Non-essential equipment
B) Staff salaries and patient care supplies
C) Luxury office upgrades
D) Travel expenses
Correct Answer: B) Staff salaries and patient care supplies
Rationale: Prioritizing staff and supplies ensures quality, per 2025 budgeting
standards.
14. A team fails to meet a deadline for a quality improvement project. What should the
nurse leader do?
A) Blame the team leader
B) Evaluate barriers and adjust timelines
C) Terminate the project
D) Increase workload to compensate
Correct Answer: B) Evaluate barriers and adjust timelines
Rationale: Evaluating barriers supports success, per 2025 AONL guidelines.
15. A nurse leader observes unsafe staffing ratios. What action should be taken?
A) Ignore if no complaints are received
B) Report to administration and adjust staffing
C) Reduce staff hours
D) Blame the charge nurse
Correct Answer: B) Report to administration and adjust staffing
Rationale: Reporting ensures safety, per 2025 ANA staffing standards.
16. A charge nurse delegates medication administration to a new graduate nurse. What
must be ensured?
A) The nurse has completed orientation
Management Exam | Nurse
Supervisor Exam | 2025/2026
Edition
Section 1: Introduction
Features leadership scenarios and decision-making questions covering team coordination,
delegation, conflict resolution, quality improvement, and budgeting. Essential for future
charge nurses and nurse leaders preparing for HESI's Leadership exam.
Section 2: Exam Questions and Answers
Format
• 150 questions reflecting the HESI RN Leadership and Management Exam structure
• Includes multiple-choice and select-all-that-apply questions
• Correct answers highlighted in luminous green
• Rationales provided to enhance understanding of leadership principles
1. A nurse manager notices a decrease in patient satisfaction scores. What should the
nurse manager do first?
A) Increase staff workload
B) Review patient feedback and staff performance
C) Terminate underperforming staff
D) Ignore the scores if they improve next month
Correct Answer: B) Review patient feedback and staff performance
Rationale: Assessing feedback and performance identifies root causes, enabling
targeted improvements, aligning with 2025 ANA leadership standards.
2. A charge nurse delegates wound care to a licensed practical nurse (LPN). Which
action ensures safe delegation?
A) Assume the LPN is competent without verification
B) Provide clear instructions and supervise
C) Assign the task without follow-up
D) Delegate to an unlicensed assistive personnel
Correct Answer: B) Provide clear instructions and supervise
Rationale: Clear instructions and supervision ensure competency and safety, per
NCSBN 2025 delegation guidelines.
3. Two nurses disagree on patient care priorities. What should the nurse leader do?
A) Choose a side and enforce the decision
B) Facilitate a meeting to resolve the conflict
C) Ignore the disagreement
D) Reassign one nurse to another unit
Correct Answer: B) Facilitate a meeting to resolve the conflict
, Rationale: Facilitation promotes collaboration, a key 2025 leadership skill per AONL
resources.
4. A nurse manager implements a new quality improvement initiative. What is the first
step?
A) Train all staff immediately
B) Assess current practices and set goals
C) Evaluate outcomes after one week
D) Purchase new equipment
Correct Answer: B) Assess current practices and set goals
Rationale: Baseline assessment and goal-setting align with the Plan-Do-Study-Act
(PDSA) cycle, a 2025 standard.
5. A unit is over budget due to overtime costs. What should the nurse supervisor do?
A) Reduce staff hours without planning
B) Analyze staffing patterns and adjust schedules
C) Request more funding without justification
D) Approve all overtime requests
Correct Answer: B) Analyze staffing patterns and adjust schedules
Rationale: Data-driven scheduling optimizes resources, per 2025 healthcare financial
guidelines.
6. A nurse reports a medication error. What should the nurse leader do first?
A) Discipline the nurse immediately
B) Ensure patient safety and investigate
C) Document the error without follow-up
D) Blame the pharmacy
Correct Answer: B) Ensure patient safety and investigate
Rationale: Patient safety is priority, per 2025 Joint Commission standards.
7. A charge nurse observes a staff member violating hand hygiene protocol. What action
should be taken?
A) Report the staff to human resources
B) Provide immediate education and monitor
C) Ignore the violation if no harm occurs
D) Terminate the staff member
Correct Answer: B) Provide immediate education and monitor
Rationale: Education reinforces compliance, per 2025 CDC guidelines.
8. A nurse leader is developing a staff schedule. What factor is most important?
A) Staff preferences only
B) Patient acuity and staff competency
C) Minimizing costs regardless of coverage
D) Assigning the most experienced nurses to night shifts
Correct Answer: B) Patient acuity and staff competency
Rationale: Matching acuity and skills ensures safety, per 2025 ANA staffing
principles.
9. During a staffing shortage, a nurse refuses a delegated task. What should the nurse
leader do?
A) Reassign the task without discussion
B) Discuss the refusal and clarify scope of practice
C) Write up the nurse for insubordination
D) Ignore the refusal
Correct Answer: B) Discuss the refusal and clarify scope of practice
Rationale: Dialogue ensures appropriate delegation, per NCSBN 2025 guidelines.
, 10. A nurse manager conducts a performance review. What should be the focus?
A) Only negative feedback
B) Balanced feedback and professional goals
C) Personal criticism without support
D) Focusing on peer comparisons
Correct Answer: B) Balanced feedback and professional goals
Rationale: Balanced feedback fosters growth, per 2025 AONL standards.
11. A nurse leader identifies a need for staff training on electronic health records (EHR).
What is the first step?
A) Schedule training without assessment
B) Assess staff competency and needs
C) Purchase new software immediately
D) Assign a trainer without planning
Correct Answer: B) Assess staff competency and needs
Rationale: Needs assessment ensures effective training, per 2025 HIMSS guidelines.
12. A charge nurse receives a complaint about a rude staff member. What should the
nurse do?
A) Confront the staff publicly
B) Investigate and address privately
C) Ignore the complaint
D) Terminate the staff member
Correct Answer: B) Investigate and address privately
Rationale: Private investigation maintains professionalism, per 2025 ANA ethics.
13. A nurse manager is developing a budget for the next fiscal year. What should be
prioritized?
A) Non-essential equipment
B) Staff salaries and patient care supplies
C) Luxury office upgrades
D) Travel expenses
Correct Answer: B) Staff salaries and patient care supplies
Rationale: Prioritizing staff and supplies ensures quality, per 2025 budgeting
standards.
14. A team fails to meet a deadline for a quality improvement project. What should the
nurse leader do?
A) Blame the team leader
B) Evaluate barriers and adjust timelines
C) Terminate the project
D) Increase workload to compensate
Correct Answer: B) Evaluate barriers and adjust timelines
Rationale: Evaluating barriers supports success, per 2025 AONL guidelines.
15. A nurse leader observes unsafe staffing ratios. What action should be taken?
A) Ignore if no complaints are received
B) Report to administration and adjust staffing
C) Reduce staff hours
D) Blame the charge nurse
Correct Answer: B) Report to administration and adjust staffing
Rationale: Reporting ensures safety, per 2025 ANA staffing standards.
16. A charge nurse delegates medication administration to a new graduate nurse. What
must be ensured?
A) The nurse has completed orientation
