LEADERSHIP HESI MAIN EXAMINATION 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔Middle manager - ✔✔Unit manager and supervisor
Supervises staff, prepare budgets, prepare work schedules, writing and implementing
policies that guide client care and unit operations, and maintains the quality of client
services
✔✔Nurse executive - ✔✔Top level nurse manager and may be DON, VP for client care
services
Supervises numerous departments and works closely with the administrative team of
the organization
Ensures that all client care provided by nurses is consistent with the objective of the
health care organization
✔✔Organizational chart - ✔✔Depicts and communicates how activities are arranged,
how authority relationships are defined, and how communication channels are
established
✔✔Centralization - ✔✔The making of decisions by a few individuals at the top of the
organization or by managers of a department or unit and decisions are communicated
thereafter to the employees
✔✔Decentralization - ✔✔Distribution of authority throughout the organization to allow
for increased responsibility and delegation in decision making
Tries to move the decision making as close ro the client as possible
✔✔Quality improvement - ✔✔Performance improvement
Focuses on processes or systems that significantly contribute to client safety and
effective client care outcomes
Criteria are used to monitor outcomes of care and to determine the need for change to
improve the quality of care
✔✔Retrospective audit - ✔✔Evaluation method used to inspect the medical record after
the client's discharge for documentation of compliance with the standards
✔✔Concurrent audit - ✔✔An evaluation method used to inspect compliance of nurses
with predetermined standards and criteria while the nurses are providing care during the
client's stay
✔✔Lewin's change process - ✔✔Unfreezing: problem is identified and individuals
involved gather facts and evidence supporting a basis for change
Moving and changing: change is planned and implemented
, Refreezing: change becomes stabilized
Change process does not guarantee positive outcomes
✔✔Intrapersonal conflict - ✔✔Occurs within a person
✔✔Interpersonal conflict - ✔✔Occurs between and among clients, nurses, or other staff
members
✔✔Organizational conflict - ✔✔Occurs when an employee confronts the policies and
procedures of the organization
✔✔Process for medication reconciliation - ✔✔Obtain a list of current meds from the
client
Develop an accurate list of newly prescribed medications
Compare new medications to the list of current medications
Identify and investigate any discrepancies and collaborate with the HCP as necessary
Communicate the finalized list with the client, caregivers, health care providers, and
other team members
✔✔RN - ✔✔Performs invasive and sterile procedures
Assessment
Planning care
Initiating teaching
Administering medications intravenously
Anything that a LPN can do
✔✔LPN/LVN - ✔✔Can perform tasks that the UAP can perform but also certain invasive
tasks
Dressing changes, suctioning, urinary catheterization, and medication administration
(oral, subcutaneous, intramuscular, and selected piggyback medications)
Can also REVIEW with the client teaching plans that were INITIATED by the RN
✔✔UAP/CNA - ✔✔Non-invasive interventions
Skin care, ROM exercises, ambulation, grooming, hygiene measures
✔✔High, intermediate, and low priorities - ✔✔High priorities: client needs that are life-
threatening or that could result in harm to the client if they are left untreated
Intermediate priorities: non-emergency, non-life threatening client needs
Low priorities: client needs that are not related directly to the client's illness or prognosis
QUESTIONS AND SOLUTIONS RATED A+
✔✔Middle manager - ✔✔Unit manager and supervisor
Supervises staff, prepare budgets, prepare work schedules, writing and implementing
policies that guide client care and unit operations, and maintains the quality of client
services
✔✔Nurse executive - ✔✔Top level nurse manager and may be DON, VP for client care
services
Supervises numerous departments and works closely with the administrative team of
the organization
Ensures that all client care provided by nurses is consistent with the objective of the
health care organization
✔✔Organizational chart - ✔✔Depicts and communicates how activities are arranged,
how authority relationships are defined, and how communication channels are
established
✔✔Centralization - ✔✔The making of decisions by a few individuals at the top of the
organization or by managers of a department or unit and decisions are communicated
thereafter to the employees
✔✔Decentralization - ✔✔Distribution of authority throughout the organization to allow
for increased responsibility and delegation in decision making
Tries to move the decision making as close ro the client as possible
✔✔Quality improvement - ✔✔Performance improvement
Focuses on processes or systems that significantly contribute to client safety and
effective client care outcomes
Criteria are used to monitor outcomes of care and to determine the need for change to
improve the quality of care
✔✔Retrospective audit - ✔✔Evaluation method used to inspect the medical record after
the client's discharge for documentation of compliance with the standards
✔✔Concurrent audit - ✔✔An evaluation method used to inspect compliance of nurses
with predetermined standards and criteria while the nurses are providing care during the
client's stay
✔✔Lewin's change process - ✔✔Unfreezing: problem is identified and individuals
involved gather facts and evidence supporting a basis for change
Moving and changing: change is planned and implemented
, Refreezing: change becomes stabilized
Change process does not guarantee positive outcomes
✔✔Intrapersonal conflict - ✔✔Occurs within a person
✔✔Interpersonal conflict - ✔✔Occurs between and among clients, nurses, or other staff
members
✔✔Organizational conflict - ✔✔Occurs when an employee confronts the policies and
procedures of the organization
✔✔Process for medication reconciliation - ✔✔Obtain a list of current meds from the
client
Develop an accurate list of newly prescribed medications
Compare new medications to the list of current medications
Identify and investigate any discrepancies and collaborate with the HCP as necessary
Communicate the finalized list with the client, caregivers, health care providers, and
other team members
✔✔RN - ✔✔Performs invasive and sterile procedures
Assessment
Planning care
Initiating teaching
Administering medications intravenously
Anything that a LPN can do
✔✔LPN/LVN - ✔✔Can perform tasks that the UAP can perform but also certain invasive
tasks
Dressing changes, suctioning, urinary catheterization, and medication administration
(oral, subcutaneous, intramuscular, and selected piggyback medications)
Can also REVIEW with the client teaching plans that were INITIATED by the RN
✔✔UAP/CNA - ✔✔Non-invasive interventions
Skin care, ROM exercises, ambulation, grooming, hygiene measures
✔✔High, intermediate, and low priorities - ✔✔High priorities: client needs that are life-
threatening or that could result in harm to the client if they are left untreated
Intermediate priorities: non-emergency, non-life threatening client needs
Low priorities: client needs that are not related directly to the client's illness or prognosis
