NEXT GENERATION (NGN) HESI
Leadership and Management
Practice Exam
Official Practice Exam | 2026/2027 Edition
100 120 80% Required
Questions Minutes Passing Score Recertification
TABLE OF CONTENTS
Section 1: Leadership and Management Principles Questions 1-20
Section 2: Communication and Collaboration Questions 21-40
Section 3: Decision-Making and Problem-Solving Questions 41-55
Section 4: Change Process and Innovation Questions 56-70
Section 5: Quality and Safety Questions 71-85
Section 6: Professionalism, Ethical, and Legal Issues Questions 86-100
EXAM INSTRUCTIONS
This practice exam contains 100 multiple-choice questions divided into six sections. Each question presents a
realistic clinical scenario followed by four answer options. Select the one best answer for each question. You have
120 minutes to complete the exam. A passing score of 80% (80 correct answers out of 100) is required. Review the
rationale provided after each question to reinforce your understanding. Do not use any external references during
the exam. Good luck!
This practice exam is for educational purposes only. Not affiliated with Elsevier or HESI.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Leadership and Management Principles | 2026/2027
Q1 Question 1 of 100
A 34-year-old nurse manager on a busy medical-surgical unit notices that staff morale has declined
significantly over the past three months, with increased absenteeism and complaints about workload.
The manager decides to implement a shared governance model to empower the nursing staff. Which
leadership theory best supports this approach?
A. Autocratic leadership theory
B. Situational leadership theory
C. Transformational leadership theory
D. Laissez-faire leadership theory
Correct Answer: C
Rationale:
Transformational leadership theory focuses on inspiring and empowering followers to participate in
decision-making and organizational change, which directly supports shared governance. Autocratic leadership
centralizes decision-making, and laissez-faire avoids it, making both incompatible with the empowering approach
described.
Q2 Question 2 of 100
A newly appointed charge nurse on a telemetry unit, age 29, is struggling to gain the respect of senior
staff members who have worked on the unit for over ten years. Several experienced nurses have openly
questioned her decisions during shift huddles. Which strategy should the charge nurse implement first to
establish credibility?
A. Request a transfer to a different unit to avoid confrontation
B. Seek input from experienced staff members on unit decisions while developing her own
competence
C. Implement strict disciplinary measures for insubordination
D. Delegate all decision-making to the most senior nurse on the unit
Correct Answer: B
Rationale:
Seeking input from experienced staff demonstrates respect for their expertise while building collaborative
relationships, which is consistent with situational and transformational leadership principles. Strict discipline or
complete delegation would undermine her authority, and transferring avoids the problem entirely.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 2
,Q3 Question 3 of 100
A nurse leader is conducting a performance evaluation for a staff nurse who consistently meets job
expectations but rarely volunteers for additional responsibilities or unit committees. The leader wants to
motivate this nurse toward greater engagement. According to Herzberg's motivation-hygiene theory,
which strategy is most appropriate?
A. Increase the nurse's hourly wage to improve satisfaction
B. Provide more frequent performance feedback focused on deficiencies
C. Improve working conditions and ensure adequate staffing
D. Offer opportunities for professional growth and recognition for achievements
Correct Answer: D
Rationale:
Herzberg's theory distinguishes hygiene factors (salary, conditions) from motivators (achievement, recognition,
growth). Since the nurse already meets expectations, adding motivators like professional development and
recognition is most likely to increase engagement. Salary and conditions are hygiene factors that prevent
dissatisfaction but do not motivate.
Q4 Question 4 of 100
A 45-year-old director of nursing is implementing a new scheduling system that requires significant
changes to how staff bid for shifts. Several nurses have expressed strong resistance, stating the current
system works fine. According to Lewin's change theory, which phase is the director currently
navigating?
A. Refreezing
B. Unfreezing
C. Moving
D. Evaluating
Correct Answer: B
Rationale:
The unfreezing phase involves overcoming resistance and preparing the organization for change, which matches
the director's current challenge of staff resistance. The moving phase involves implementing the change, and
refreezing involves stabilizing the new system. Evaluating is not one of Lewin's phases.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 100
A nurse manager notices that two of her team leaders have very different management styles. One is
highly directive and task-focused, while the other is relationship-oriented and collaborative. Both teams
achieve similar patient outcomes. This observation best illustrates which management principle?
A. Unity of command
B. Contingency theory
C. Scientific management
D. Bureaucratic management
Correct Answer: B
Rationale:
Contingency theory holds that there is no single best way to manage and that effective leadership depends on the
specific situation and context. The fact that both different styles achieve similar outcomes supports this principle.
Unity of command refers to having one supervisor, and scientific and bureaucratic management prescribe specific
rigid approaches.
Q6 Question 6 of 100
During a staff meeting, a nurse manager announces that starting next month, all nurses must complete
a mandatory online training module on infection control before they can work any shifts. A senior nurse
loudly objects, saying she has 25 years of experience and does not need the training. The manager
should respond by doing which of the following first?
A. Excuse the senior nurse from the requirement based on her experience
B. Issue a written warning for unprofessional conduct during the meeting
C. Acknowledge her experience and explain the rationale for the mandatory training
D. Postpone the training requirement until all staff agree to participate
Correct Answer: C
Rationale:
Acknowledging the nurse's experience demonstrates respect while explaining the rationale helps unfreeze
resistance to change, consistent with Lewin's theory. Excusing her undermines fairness, issuing a warning
escalates conflict, and postponing delays necessary compliance.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 4
Leadership and Management
Practice Exam
Official Practice Exam | 2026/2027 Edition
100 120 80% Required
Questions Minutes Passing Score Recertification
TABLE OF CONTENTS
Section 1: Leadership and Management Principles Questions 1-20
Section 2: Communication and Collaboration Questions 21-40
Section 3: Decision-Making and Problem-Solving Questions 41-55
Section 4: Change Process and Innovation Questions 56-70
Section 5: Quality and Safety Questions 71-85
Section 6: Professionalism, Ethical, and Legal Issues Questions 86-100
EXAM INSTRUCTIONS
This practice exam contains 100 multiple-choice questions divided into six sections. Each question presents a
realistic clinical scenario followed by four answer options. Select the one best answer for each question. You have
120 minutes to complete the exam. A passing score of 80% (80 correct answers out of 100) is required. Review the
rationale provided after each question to reinforce your understanding. Do not use any external references during
the exam. Good luck!
This practice exam is for educational purposes only. Not affiliated with Elsevier or HESI.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Leadership and Management Principles | 2026/2027
Q1 Question 1 of 100
A 34-year-old nurse manager on a busy medical-surgical unit notices that staff morale has declined
significantly over the past three months, with increased absenteeism and complaints about workload.
The manager decides to implement a shared governance model to empower the nursing staff. Which
leadership theory best supports this approach?
A. Autocratic leadership theory
B. Situational leadership theory
C. Transformational leadership theory
D. Laissez-faire leadership theory
Correct Answer: C
Rationale:
Transformational leadership theory focuses on inspiring and empowering followers to participate in
decision-making and organizational change, which directly supports shared governance. Autocratic leadership
centralizes decision-making, and laissez-faire avoids it, making both incompatible with the empowering approach
described.
Q2 Question 2 of 100
A newly appointed charge nurse on a telemetry unit, age 29, is struggling to gain the respect of senior
staff members who have worked on the unit for over ten years. Several experienced nurses have openly
questioned her decisions during shift huddles. Which strategy should the charge nurse implement first to
establish credibility?
A. Request a transfer to a different unit to avoid confrontation
B. Seek input from experienced staff members on unit decisions while developing her own
competence
C. Implement strict disciplinary measures for insubordination
D. Delegate all decision-making to the most senior nurse on the unit
Correct Answer: B
Rationale:
Seeking input from experienced staff demonstrates respect for their expertise while building collaborative
relationships, which is consistent with situational and transformational leadership principles. Strict discipline or
complete delegation would undermine her authority, and transferring avoids the problem entirely.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 2
,Q3 Question 3 of 100
A nurse leader is conducting a performance evaluation for a staff nurse who consistently meets job
expectations but rarely volunteers for additional responsibilities or unit committees. The leader wants to
motivate this nurse toward greater engagement. According to Herzberg's motivation-hygiene theory,
which strategy is most appropriate?
A. Increase the nurse's hourly wage to improve satisfaction
B. Provide more frequent performance feedback focused on deficiencies
C. Improve working conditions and ensure adequate staffing
D. Offer opportunities for professional growth and recognition for achievements
Correct Answer: D
Rationale:
Herzberg's theory distinguishes hygiene factors (salary, conditions) from motivators (achievement, recognition,
growth). Since the nurse already meets expectations, adding motivators like professional development and
recognition is most likely to increase engagement. Salary and conditions are hygiene factors that prevent
dissatisfaction but do not motivate.
Q4 Question 4 of 100
A 45-year-old director of nursing is implementing a new scheduling system that requires significant
changes to how staff bid for shifts. Several nurses have expressed strong resistance, stating the current
system works fine. According to Lewin's change theory, which phase is the director currently
navigating?
A. Refreezing
B. Unfreezing
C. Moving
D. Evaluating
Correct Answer: B
Rationale:
The unfreezing phase involves overcoming resistance and preparing the organization for change, which matches
the director's current challenge of staff resistance. The moving phase involves implementing the change, and
refreezing involves stabilizing the new system. Evaluating is not one of Lewin's phases.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 100
A nurse manager notices that two of her team leaders have very different management styles. One is
highly directive and task-focused, while the other is relationship-oriented and collaborative. Both teams
achieve similar patient outcomes. This observation best illustrates which management principle?
A. Unity of command
B. Contingency theory
C. Scientific management
D. Bureaucratic management
Correct Answer: B
Rationale:
Contingency theory holds that there is no single best way to manage and that effective leadership depends on the
specific situation and context. The fact that both different styles achieve similar outcomes supports this principle.
Unity of command refers to having one supervisor, and scientific and bureaucratic management prescribe specific
rigid approaches.
Q6 Question 6 of 100
During a staff meeting, a nurse manager announces that starting next month, all nurses must complete
a mandatory online training module on infection control before they can work any shifts. A senior nurse
loudly objects, saying she has 25 years of experience and does not need the training. The manager
should respond by doing which of the following first?
A. Excuse the senior nurse from the requirement based on her experience
B. Issue a written warning for unprofessional conduct during the meeting
C. Acknowledge her experience and explain the rationale for the mandatory training
D. Postpone the training requirement until all staff agree to participate
Correct Answer: C
Rationale:
Acknowledging the nurse's experience demonstrates respect while explaining the rationale helps unfreeze
resistance to change, consistent with Lewin's theory. Excusing her undermines fairness, issuing a warning
escalates conflict, and postponing delays necessary compliance.
NGN HESI Leadership -- 2026/2027 | Passing Score: 80% | Page 4
