2026 RN EXIT HESI TEST BANK LEADERSHIP HESI
LEADERSHIP EXIT EXAM (2026/2027) Comprehensive
Questions and Verified Answers (Detailed &
Elaborated) ACTUAL EXAM 2026/2027 TEST!!
1. A charge nurse is making assignments on a medical-surgical unit. Which
patient should be assigned to the most experienced RN?
A) Patient with pneumonia requiring IV antibiotics every 6 hours
B) Patient newly admitted with unstable atrial fibrillation and hypotension
C) Patient post-appendectomy day 2 requesting pain medication
D) Patient with a urinary tract infection and oral antibiotics
Answer B: Patient newly admitted with unstable atrial fibrillation and
hypotension
Rationale: Acuity matching is essential; the most experienced RN must handle
hemodynamically unstable patients. Stable patients with predictable outcomes can
be assigned to other staff.
2. The RN delegates vital signs to a UAP for a patient post-cardiac
catheterization. Which action requires the RN to intervene immediately?
A) UAP takes blood pressure on the same arm as the femoral access site
,B) UAP records temperature 98.6°F orally
C) UAP applies a pulse oximeter to the finger
D) UAP reports a heart rate of 90 bpm
Answer A: UAP takes blood pressure on the same arm as the femoral access
site
Rationale: Blood pressure should never be taken on the arm with the femoral
access site due to risk of bleeding or hematoma.
3. Which of the following is the first step the nurse should take to resolve a
conflict between two staff members?
A) Report the conflict to human resources
B) Meet with both employees privately to understand each perspective
C) Assign one employee to a different shift
D) Implement a formal disciplinary action
Answer B: Meet with both employees privately to understand each
perspective
Rationale: The first step in conflict management is private discussion to
understand both perspectives before taking action.
4. During a mass casualty incident, a victim is found unconscious, not
breathing, and has no pulse. What triage tag color is assigned?
A) Red (immediate)
B) Yellow (delayed)
,C) Green (minor)
D) Black (expectant)
Answer D: Black (expectant)
Rationale: Patients with no signs of life (no pulse, no breathing, no spontaneous
respirations after airway opening) in a mass casualty incident are tagged black
(expectant) as resources are reserved for those with salvageable life threats.
5. An RN notes that a UAP frequently forgets to record intake and output.
What is the best initial leadership response?
A) Report the UAP to the state board of nursing
B) Counsel the UAP privately, review expectations, and document the conversation
C) Fire the UAP immediately
D) Reassign I&O to another UAP without addressing the issue
Answer B: Counsel the UAP privately, review expectations, and document the
conversation
Rationale: Progressive discipline starts with private counseling and education.
Leadership includes coaching before punitive action.
6. Which patient should the charge nurse assign to a float RN from the
postpartum unit?
A) Patient with a chest tube after lobectomy
B) Patient with a new colostomy needing teaching
C) Patient with stable cellulitis receiving IV vancomycin
, D) Patient on a ventilator with sedation
Answer C: Patient with stable cellulitis receiving IV vancomycin
Rationale: Float nurses should be assigned to stable patients with predictable
outcomes. Complex patients (chest tube, new colostomy, ventilator) require unit-
experienced staff.
7. A patient falls while a UAP is assisting them to the bathroom. The UAP did
not lock the bed brakes. Who is legally responsible?
A) Only the UAP
B) Only the RN who delegated
C) The RN and the facility
D) The RN, UAP, and facility
Answer D: The RN, UAP, and facility
Rationale: Liability is shared in delegation: RN is responsible for delegation and
supervision; UAP for task performance; and facility for training and policies.
8. A nurse manager is planning a budget. Which item is considered a fixed
cost?
A) Overtime pay
B) Salaries for full-time staff
C) Disposable gloves
D) Agency nurse costs
Answer B: Salaries for full-time staff
LEADERSHIP EXIT EXAM (2026/2027) Comprehensive
Questions and Verified Answers (Detailed &
Elaborated) ACTUAL EXAM 2026/2027 TEST!!
1. A charge nurse is making assignments on a medical-surgical unit. Which
patient should be assigned to the most experienced RN?
A) Patient with pneumonia requiring IV antibiotics every 6 hours
B) Patient newly admitted with unstable atrial fibrillation and hypotension
C) Patient post-appendectomy day 2 requesting pain medication
D) Patient with a urinary tract infection and oral antibiotics
Answer B: Patient newly admitted with unstable atrial fibrillation and
hypotension
Rationale: Acuity matching is essential; the most experienced RN must handle
hemodynamically unstable patients. Stable patients with predictable outcomes can
be assigned to other staff.
2. The RN delegates vital signs to a UAP for a patient post-cardiac
catheterization. Which action requires the RN to intervene immediately?
A) UAP takes blood pressure on the same arm as the femoral access site
,B) UAP records temperature 98.6°F orally
C) UAP applies a pulse oximeter to the finger
D) UAP reports a heart rate of 90 bpm
Answer A: UAP takes blood pressure on the same arm as the femoral access
site
Rationale: Blood pressure should never be taken on the arm with the femoral
access site due to risk of bleeding or hematoma.
3. Which of the following is the first step the nurse should take to resolve a
conflict between two staff members?
A) Report the conflict to human resources
B) Meet with both employees privately to understand each perspective
C) Assign one employee to a different shift
D) Implement a formal disciplinary action
Answer B: Meet with both employees privately to understand each
perspective
Rationale: The first step in conflict management is private discussion to
understand both perspectives before taking action.
4. During a mass casualty incident, a victim is found unconscious, not
breathing, and has no pulse. What triage tag color is assigned?
A) Red (immediate)
B) Yellow (delayed)
,C) Green (minor)
D) Black (expectant)
Answer D: Black (expectant)
Rationale: Patients with no signs of life (no pulse, no breathing, no spontaneous
respirations after airway opening) in a mass casualty incident are tagged black
(expectant) as resources are reserved for those with salvageable life threats.
5. An RN notes that a UAP frequently forgets to record intake and output.
What is the best initial leadership response?
A) Report the UAP to the state board of nursing
B) Counsel the UAP privately, review expectations, and document the conversation
C) Fire the UAP immediately
D) Reassign I&O to another UAP without addressing the issue
Answer B: Counsel the UAP privately, review expectations, and document the
conversation
Rationale: Progressive discipline starts with private counseling and education.
Leadership includes coaching before punitive action.
6. Which patient should the charge nurse assign to a float RN from the
postpartum unit?
A) Patient with a chest tube after lobectomy
B) Patient with a new colostomy needing teaching
C) Patient with stable cellulitis receiving IV vancomycin
, D) Patient on a ventilator with sedation
Answer C: Patient with stable cellulitis receiving IV vancomycin
Rationale: Float nurses should be assigned to stable patients with predictable
outcomes. Complex patients (chest tube, new colostomy, ventilator) require unit-
experienced staff.
7. A patient falls while a UAP is assisting them to the bathroom. The UAP did
not lock the bed brakes. Who is legally responsible?
A) Only the UAP
B) Only the RN who delegated
C) The RN and the facility
D) The RN, UAP, and facility
Answer D: The RN, UAP, and facility
Rationale: Liability is shared in delegation: RN is responsible for delegation and
supervision; UAP for task performance; and facility for training and policies.
8. A nurse manager is planning a budget. Which item is considered a fixed
cost?
A) Overtime pay
B) Salaries for full-time staff
C) Disposable gloves
D) Agency nurse costs
Answer B: Salaries for full-time staff
