HESI LEADERSHIP AND MANAGEMENT
COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Holding a meeting to discuss the limitations of the current paper-based system and the
need for change.
B. Providing training sessions for all staff members on the new software.
C. Monitoring the staff’s compliance with the new system after one month of use.
D. Rewarding employees who successfully transition to the new system quickly.
Answer: A
Conceptual Explanation: Unfreezing involves creating the motivation to change by
helping individuals understand that the current method is ineffective or that a better way
exists.
,2. Which task is most appropriate for a Registered Nurse (RN) to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Assessing a patient’s pain level two hours after medication administration.
B. Obtaining vital signs on a stable patient who is awaiting discharge.
C. Teaching a postoperative patient how to use an incentive spirometer.
D. Updating the care plan for a patient with new-onset diabetes.
Answer: B
Conceptual Explanation: UAPs can perform tasks that are repetitive, non-invasive, and do
not require clinical judgment, such as vital signs on stable patients.
3. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with a hip fracture reporting pain of 8/10.
B. A patient with pneumonia who has a new onset of confusion and restlessness.
C. A patient with diabetes whose fasting blood glucose is 150 mg/dL.
D. A patient who requires a dressing change for a stage 2 pressure injury.
Answer: B
Conceptual Explanation: Confusion and restlessness are early signs of hypoxia
(pneumonia), which takes priority according to the ABC (Airway, Breathing, Circulation)
framework.
, 4. A nurse manager uses a ‘laissez-faire’ leadership style. Which outcome is most likely to
occur in this unit?
A. High productivity and clear direction from the manager.
B. Disorganization and lack of guidance for new staff members.
C. Staff members feeling empowered and supported in their decision-making.
D. Strict adherence to rules and policies with frequent oversight.
Answer: B
Conceptual Explanation: Laissez-faire leadership involves minimal interference, which
can lead to chaos or lack of direction, especially if the team is not highly self-motivated.
5. Which ethical principle is violated when a nurse fails to provide a patient with a scheduled
pain medication?
A. Autonomy
B. Justice
C. Fidelity
D. Nonmaleficence
Answer: C
Conceptual Explanation: Fidelity refers to the obligation to be faithful to agreements and
responsibilities, such as providing care as promised and scheduled.
COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘unfreezing’ stage?
A. Holding a meeting to discuss the limitations of the current paper-based system and the
need for change.
B. Providing training sessions for all staff members on the new software.
C. Monitoring the staff’s compliance with the new system after one month of use.
D. Rewarding employees who successfully transition to the new system quickly.
Answer: A
Conceptual Explanation: Unfreezing involves creating the motivation to change by
helping individuals understand that the current method is ineffective or that a better way
exists.
,2. Which task is most appropriate for a Registered Nurse (RN) to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Assessing a patient’s pain level two hours after medication administration.
B. Obtaining vital signs on a stable patient who is awaiting discharge.
C. Teaching a postoperative patient how to use an incentive spirometer.
D. Updating the care plan for a patient with new-onset diabetes.
Answer: B
Conceptual Explanation: UAPs can perform tasks that are repetitive, non-invasive, and do
not require clinical judgment, such as vital signs on stable patients.
3. A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with a hip fracture reporting pain of 8/10.
B. A patient with pneumonia who has a new onset of confusion and restlessness.
C. A patient with diabetes whose fasting blood glucose is 150 mg/dL.
D. A patient who requires a dressing change for a stage 2 pressure injury.
Answer: B
Conceptual Explanation: Confusion and restlessness are early signs of hypoxia
(pneumonia), which takes priority according to the ABC (Airway, Breathing, Circulation)
framework.
, 4. A nurse manager uses a ‘laissez-faire’ leadership style. Which outcome is most likely to
occur in this unit?
A. High productivity and clear direction from the manager.
B. Disorganization and lack of guidance for new staff members.
C. Staff members feeling empowered and supported in their decision-making.
D. Strict adherence to rules and policies with frequent oversight.
Answer: B
Conceptual Explanation: Laissez-faire leadership involves minimal interference, which
can lead to chaos or lack of direction, especially if the team is not highly self-motivated.
5. Which ethical principle is violated when a nurse fails to provide a patient with a scheduled
pain medication?
A. Autonomy
B. Justice
C. Fidelity
D. Nonmaleficence
Answer: C
Conceptual Explanation: Fidelity refers to the obligation to be faithful to agreements and
responsibilities, such as providing care as promised and scheduled.
