HESI LEADERSHIP EXAM PREP TEST BANK COMPLETE QUESTIONS WITH CORRECT ANSWERS AND RATIONALES

HESI LEADERSHIP EXAM PREP TEST BANK COMPLETE QUESTIONS WITH CORRECT ANSWERS AND RATIONALES 1. The charge nurse is making assignments for a medical-surgical unit. Which client should be assigned to the most experienced RN? A. A client with diabetes mellitus requiring insulin administration B. A client with pneumonia who needs respiratory therapy treatments C. A client with unstable angina experiencing chest pain every 2 hours D. A client with a fractured hip requiring assistance with ambulation ANSWER-C. A client with unstable angina experiencing chest pain every 2 hours Rationale: The most experienced RN should care for the most unstable client. Unstable angina with frequent chest pain requires advanced assessment skills and critical thinking. The other clients have more stable conditions that could be managed by less experienced staff. ________________________________________ 2. The nurse manager is planning staffing for a busy medical-surgical unit. Which factor should be the primary consideration when determining staffing needs? A. Staff preferences for shifts B. Acuity level of the clients C. Number of beds on the unit D. Budget constraints ANSWER-B. Acuity level of the clients Rationale: Client acuity is the primary determinant of staffing needs. Higher acuity clients require more skilled nursing care and closer monitoring. Staff preferences, bed numbers, and budget are secondary considerations that should not supersede client safety needs. ________________________________________ 3. An RN is supervising a practical nurse (PN) who is caring for a client with a new tracheostomy. Which action by the PN requires the RN to intervene? A. Suctioning the tracheostomy when the client coughs excessively B. Applying sterile technique when changing the tracheostomy dressing C. Providing oral care with a soft toothbrush D. Deflating the cuff to check for tracheal damage ANSWER-D. Deflating the cuff to check for tracheal damage Rationale: Cuff deflation and assessment for tracheal damage requires advanced assessment skills beyond the PN scope of practice. The RN should perform this assessment. Suctioning, dressing changes, and oral care are within PN scope. ________________________________________ 4. The nurse is leading a team meeting on the unit. A staff member consistently interrupts others and dominates the conversation. What is the nurse's best initial action? A. Ignore the behavior and continue the meeting B. Speak privately with the staff member after the meeting C. Ask the staff member to allow others to share their thoughts D. End the meeting early and reschedule ANSWER-C. Ask the staff member to allow others to share their thoughts Rationale: The nurse should address the behavior directly but respectfully during the meeting. This models effective leadership and ensures all staff have opportunity to participate. Private conversation may be needed if behavior continues. ________________________________________ 5. The charge nurse is evaluating a newly hired RN's performance. Which observation indicates the new RN understands delegation principles? A. Assigning a UAP to perform a sterile dressing change B. Asking the UAP to report any changes in client condition C. Delegating medication administration to a UAP D. Having the UAP assess a client's lung sounds ANSWER-B. Asking the UAP to report any changes in client condition Rationale: UAPs can report observations to the RN, which is appropriate delegation. Sterile procedures, medication administration, and assessments cannot be delegated to UAPs as they require nursing judgment and licensure. ________________________________________ 6. A client is being discharged with a new colostomy. The PN has been teaching the client about colostomy care. How should the RN evaluate the effectiveness of the teaching? A. Ask the PN if the client seems to understand B. Observe the client performing colostomy care independently C. Review the client's written test results D. Ask the client if they have any questions ANSWER-B. Observe the client performing colostomy care independently Rationale: Return demonstration is the best way to evaluate psychomotor skill learning. Simply asking about understanding or reviewing tests does not confirm the client can perform the skill safely. ________________________________________ 7. The nurse manager is implementing a new evidence-based practice protocol. Which strategy is most effective for promoting staff adherence to the new protocol? A. Mandating compliance with disciplinary action for noncompliance B. Involving staff in the implementation planning process C. Posting the protocol in visible areas throughout the unit D. Sending emails to all staff about the new protocol ANSWER-B. Involving staff in the implementation planning process Rationale: Staff involvement in planning increases buy-in and adherence to change. Mandating compliance, posting information, or sending emails are less effective without staff engagement and ownership. ________________________________________ 8. The emergency department charge nurse must triage four clients. Which client should be seen first?