Evolve HESI Leadership Management EXAM with Questions
and Answers/Plus a Rationale Updated 2026 A+/Instant
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EXAM COVERAGE
1. Clinical Leadership, Nursing Management, and Organizational Structure
2. Delegation, Supervision, and Assignment Principles (RN, LPN/LVN, UAP)
3. Quality Improvement, Patient Safety, and Risk Management
4. Ethical, Legal, and Professional Practice Frameworks
5. Conflict Resolution, Change Theory, and Healthcare Economics
1. A charge nurse on a medical-surgical unit is planning client assignments for the shift. Which
client is most appropriate to assign to an experienced licensed practical nurse (LPN), working
under the supervision of a registered nurse?
A. A newly admitted client diagnosed with acute diabetic ketoacidosis requiring IV regular
insulin titration.
B. A stable client diagnosed with chronic obstructive pulmonary disease (COPD) who
requires scheduled oral medications and routine dressing changes.
C. A client scheduled for discharge teaching following a newly placed permanent pacemaker.
D. A client presenting with unstable angina and uncontrolled chest pain rated 8 out of 10.
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: B A stable client diagnosed with chronic obstructive pulmonary disease (COPD) who
requires scheduled oral medications and routine dressing changes.
, CORRECT ANSWER : B
Rationale: According to delegation principles, LPNs can care for stable clients with predictable
outcomes and perform tasks such as administering oral medications and sterile dressing
changes. Option A requires complex IV titration and critical nursing judgment; Option C
involves initial discharge education, which is an RN responsibility; and Option D represents an
unstable client requiring immediate RN assessment and intervention.
2. A nurse manager is addressing a conflict between two staff nurses regarding scheduling
preferences for upcoming holidays. One nurse complains that the other always gets preferred
time off. Which conflict resolution strategy is the nurse manager exhibiting when scheduling a
face-to-face meeting where both parties work together to identify common goals and design a
mutually satisfying compromise?
A. Avoiding
B. Competing
C. Collaborating
D. Smoothing
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: C Collaborating
CORRECT ANSWER : C
Rationale: Collaborating is a win-win conflict resolution strategy where both parties' needs are
met through open communication, mutual respect, and joint problem-solving. Option A
(avoiding) ignores the conflict; option B (competing) results in a win-lose outcome; and option
D (smoothing) minimizes differences to maintain superficial harmony without resolving the core
issue.
3. A registered nurse (RN) is supervising an unlicensed assistive personnel (UAP) on a telemetry
unit. Which task delegated to the UAP requires immediate intervention by the RN?
A. Assisting a client who had a total hip arthroplasty to use a bedside commode.
, B. Obtaining vital signs and reporting a blood pressure of 82/50 mmHg for a client who
just returned from a cardiac catheterization.
C. Measuring and recording the urinary output from an indwelling catheter collection bag.
D. Feeding a client diagnosed with mild Parkinson disease who is at low risk for aspiration.
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: B Obtaining vital signs and reporting a blood pressure of 82/50 mmHg for a client who
just returned from a cardiac catheterization.
CORRECT ANSWER : B
Rationale: Although UAPs can measure vital signs, an abnormal or critical value for a high-risk
postoperative or post-procedural client requires immediate direct RN assessment; waiting for a
UAP to report without immediate nursing follow-up or delegating assessment of unstable clients
is inappropriate. Options A, C, and D represent routine, stable delegated tasks appropriate for
UAP scope of practice.
4. A nurse executive is implementing a major restructuring of care delivery models across a
hospital system using Lewin's change theory. During which stage of change does the nurse
manager reinforce new behavioral norms, establish supportive policies, and ensure that the
changes become integrated into the organizational culture?
A. Unfreezing
B. Moving
C. Refreezing
D. Equilibrium
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
, Answer: C Refreezing
CORRECT ANSWER : C
Rationale: In Lewin's refreezing stage, the change is integrated and stabilized within the
organization's culture, ensuring that old habits do not return. Option A (unfreezing) involves
creating awareness of the need for change; option B (moving/changing) is the implementation
phase where individuals experiment with new behaviors; and option D is not a primary stage in
Lewin's model.
5. A hospital quality improvement committee is reviewing a sentinel event involving a medication
administration error. Which approach reflects a modern "just culture" framework in healthcare
organizations?
A. Blaming and punishing the individual nurse immediately to deter future mistakes.
B. Distinguishing between human error, at-risk behavior, and reckless behavior while
evaluating systemic and environmental factors contributing to the error.
C. Assuming that all errors are entirely isolated acts caused by personal negligence.
D. Concealing internal errors from regulatory bodies to protect institutional reputation.
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: B Distinguishing between human error, at-risk behavior, and reckless behavior while
evaluating systemic and environmental factors contributing to the error.
CORRECT ANSWER : B
Rationale: A just culture balances individual accountability with a recognition of systems-level
flaws, penalizing reckless behavior while supporting workers who commit unintended human
errors or engage in understandable at-risk behaviors. Options A and C reflect a punitive culture
that discourages error reporting, and option D violates legal and ethical safety standards.
6. A charge nurse is evaluating time management strategies for the shift. Which action
demonstrates the most effective utilization of time management principles by a staff nurse?
A. Completing all non-urgent documentation immediately at the start of the shift before checking
client status.
and Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. Clinical Leadership, Nursing Management, and Organizational Structure
2. Delegation, Supervision, and Assignment Principles (RN, LPN/LVN, UAP)
3. Quality Improvement, Patient Safety, and Risk Management
4. Ethical, Legal, and Professional Practice Frameworks
5. Conflict Resolution, Change Theory, and Healthcare Economics
1. A charge nurse on a medical-surgical unit is planning client assignments for the shift. Which
client is most appropriate to assign to an experienced licensed practical nurse (LPN), working
under the supervision of a registered nurse?
A. A newly admitted client diagnosed with acute diabetic ketoacidosis requiring IV regular
insulin titration.
B. A stable client diagnosed with chronic obstructive pulmonary disease (COPD) who
requires scheduled oral medications and routine dressing changes.
C. A client scheduled for discharge teaching following a newly placed permanent pacemaker.
D. A client presenting with unstable angina and uncontrolled chest pain rated 8 out of 10.
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: B A stable client diagnosed with chronic obstructive pulmonary disease (COPD) who
requires scheduled oral medications and routine dressing changes.
, CORRECT ANSWER : B
Rationale: According to delegation principles, LPNs can care for stable clients with predictable
outcomes and perform tasks such as administering oral medications and sterile dressing
changes. Option A requires complex IV titration and critical nursing judgment; Option C
involves initial discharge education, which is an RN responsibility; and Option D represents an
unstable client requiring immediate RN assessment and intervention.
2. A nurse manager is addressing a conflict between two staff nurses regarding scheduling
preferences for upcoming holidays. One nurse complains that the other always gets preferred
time off. Which conflict resolution strategy is the nurse manager exhibiting when scheduling a
face-to-face meeting where both parties work together to identify common goals and design a
mutually satisfying compromise?
A. Avoiding
B. Competing
C. Collaborating
D. Smoothing
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: C Collaborating
CORRECT ANSWER : C
Rationale: Collaborating is a win-win conflict resolution strategy where both parties' needs are
met through open communication, mutual respect, and joint problem-solving. Option A
(avoiding) ignores the conflict; option B (competing) results in a win-lose outcome; and option
D (smoothing) minimizes differences to maintain superficial harmony without resolving the core
issue.
3. A registered nurse (RN) is supervising an unlicensed assistive personnel (UAP) on a telemetry
unit. Which task delegated to the UAP requires immediate intervention by the RN?
A. Assisting a client who had a total hip arthroplasty to use a bedside commode.
, B. Obtaining vital signs and reporting a blood pressure of 82/50 mmHg for a client who
just returned from a cardiac catheterization.
C. Measuring and recording the urinary output from an indwelling catheter collection bag.
D. Feeding a client diagnosed with mild Parkinson disease who is at low risk for aspiration.
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: B Obtaining vital signs and reporting a blood pressure of 82/50 mmHg for a client who
just returned from a cardiac catheterization.
CORRECT ANSWER : B
Rationale: Although UAPs can measure vital signs, an abnormal or critical value for a high-risk
postoperative or post-procedural client requires immediate direct RN assessment; waiting for a
UAP to report without immediate nursing follow-up or delegating assessment of unstable clients
is inappropriate. Options A, C, and D represent routine, stable delegated tasks appropriate for
UAP scope of practice.
4. A nurse executive is implementing a major restructuring of care delivery models across a
hospital system using Lewin's change theory. During which stage of change does the nurse
manager reinforce new behavioral norms, establish supportive policies, and ensure that the
changes become integrated into the organizational culture?
A. Unfreezing
B. Moving
C. Refreezing
D. Equilibrium
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
, Answer: C Refreezing
CORRECT ANSWER : C
Rationale: In Lewin's refreezing stage, the change is integrated and stabilized within the
organization's culture, ensuring that old habits do not return. Option A (unfreezing) involves
creating awareness of the need for change; option B (moving/changing) is the implementation
phase where individuals experiment with new behaviors; and option D is not a primary stage in
Lewin's model.
5. A hospital quality improvement committee is reviewing a sentinel event involving a medication
administration error. Which approach reflects a modern "just culture" framework in healthcare
organizations?
A. Blaming and punishing the individual nurse immediately to deter future mistakes.
B. Distinguishing between human error, at-risk behavior, and reckless behavior while
evaluating systemic and environmental factors contributing to the error.
C. Assuming that all errors are entirely isolated acts caused by personal negligence.
D. Concealing internal errors from regulatory bodies to protect institutional reputation.
A. [Option A text]
B. [Option B text]
C. [Option C text]
D. [Option D text]
Answer: B Distinguishing between human error, at-risk behavior, and reckless behavior while
evaluating systemic and environmental factors contributing to the error.
CORRECT ANSWER : B
Rationale: A just culture balances individual accountability with a recognition of systems-level
flaws, penalizing reckless behavior while supporting workers who commit unintended human
errors or engage in understandable at-risk behaviors. Options A and C reflect a punitive culture
that discourages error reporting, and option D violates legal and ethical safety standards.
6. A charge nurse is evaluating time management strategies for the shift. Which action
demonstrates the most effective utilization of time management principles by a staff nurse?
A. Completing all non-urgent documentation immediately at the start of the shift before checking
client status.
