NUR 204 / NUR204 HESI Leadership and
Management V2 Exam 2026/2027 | Questions
with Correct Answers & Detailed Rationales |
Fortis | Grade A
Section 1: Leadership Theories and Styles (Questions 1-30)
1. The charge nurse on a 32-bed medical unit receives report that the new admission
nurse will arrive 2 hours late. Two RNs are already out on sick leave, and one LPN is
available. The unit has 28 occupied beds, including four fresh post-ops (POD #0) and
two patients on continuous heparin drips. Which action best demonstrates
transformational leadership?
A) Assign the LPN to monitor the heparin drips while the charge nurse takes the new
admissions
B) Cancel all routine scheduled baths to free up staff time
C) Call the nursing supervisor to request additional staffing and concurrently hold morning
huddles to reprioritize assignments
D) Instruct the staff to “work harder” and complete tasks as usual until the late nurse arrives
Correct Answer: C
Rationale: Transformational leaders inspire and engage staff by actively problem-solving,
communicating transparently, and advocating for system-level support (e.g., supervisor
, assistance). Simultaneously holding huddles reprioritizes care without compromising safety.
Option A is unsafe because LPNs cannot titrate heparin drips. Option B may reduce comfort
but does not address workload or safety. Option D uses passive transactional tactics and
risks burnout and errors .
2. A newly licensed RN tells the charge nurse, “I feel unprepared to care for a patient
on a ventilator.” Which response by the charge nurse demonstrates servant
leadership?
A) “You’ll be fine—just review the policy.”
B) “I’ll assign you a different patient and arrange a ventilator competency class this week.”
C) “Everyone feels that way; take the assignment anyway.”
D) “Ask the respiratory therapist to watch you.”
Correct Answer: B
Rationale: Servant leaders prioritize staff growth and well-being. Arranging education and
temporarily reassigning the patient protects both nurse and patient while building
competence. Option A dismisses the concern. Option C forces an unsafe assignment.
Option D places responsibility on another discipline without ensuring RN competence .
3. Which statement BEST differentiates between “management” and “leadership” in
nursing practice?
A) Management focuses on vision, while leadership focuses on operations
, B) Management uses influence, while leadership uses authority
C) Management maintains stability, while leadership promotes change
D) Management empowers staff, while leadership controls resources
Correct Answer: C
Rationale: Management typically focuses on maintaining stability, efficiency, and
organizational systems. Leadership focuses on creating vision, promoting change, and
inspiring innovation. Management uses formal authority while leadership uses influence
(Option B is reversed) .
4. A charge nurse notices that a staff nurse consistently avoids making decisions
and defers all clinical questions to the charge nurse. According to the Situational
Leadership Model, what is the MOST appropriate leadership response?
A) Provide clear, specific direction and closely supervise
B) Delegate decision-making authority and step back
C) Use a hands-off approach and let the nurse learn independently
D) Assign the nurse to a less demanding unit
Correct Answer: A
Rationale: According to Situational Leadership, a follower with low readiness (low
competence and low confidence) requires high task behavior and high relationship
behavior—directing and closely supervising. Delegating (B) and hands-off (C) would be
appropriate for high-readiness followers .
, 5. A nurse leader is preparing to implement a new evidence-based fall prevention
program. According to Kotter’s Change Management Model, which action represents
the FIRST step?
A) Create a vision for change
B) Establish a sense of urgency
C) Empower staff to act on the vision
D) Generate short-term wins
Correct Answer: B
Rationale: Kotter’s 8-Step Change Model begins with establishing a sense of urgency (Step
1). This involves explaining why change is needed and creating motivation among
stakeholders. Creating a vision (Step 3), empowering staff (Step 5), and generating short-
term wins (Step 6) occur later in the process .
6. During a code blue, the charge nurse notes that the new RN is standing at the foot
of the bed looking overwhelmed. Which initial action is most appropriate?
A) Tell the RN to document on the code sheet
B) Assign the RN to give IV medications per ACLS protocol
C) Ask the RN to leave the room to reduce clutter
D) Ignore the RN and continue with the code
Correct Answer: A
Management V2 Exam 2026/2027 | Questions
with Correct Answers & Detailed Rationales |
Fortis | Grade A
Section 1: Leadership Theories and Styles (Questions 1-30)
1. The charge nurse on a 32-bed medical unit receives report that the new admission
nurse will arrive 2 hours late. Two RNs are already out on sick leave, and one LPN is
available. The unit has 28 occupied beds, including four fresh post-ops (POD #0) and
two patients on continuous heparin drips. Which action best demonstrates
transformational leadership?
A) Assign the LPN to monitor the heparin drips while the charge nurse takes the new
admissions
B) Cancel all routine scheduled baths to free up staff time
C) Call the nursing supervisor to request additional staffing and concurrently hold morning
huddles to reprioritize assignments
D) Instruct the staff to “work harder” and complete tasks as usual until the late nurse arrives
Correct Answer: C
Rationale: Transformational leaders inspire and engage staff by actively problem-solving,
communicating transparently, and advocating for system-level support (e.g., supervisor
, assistance). Simultaneously holding huddles reprioritizes care without compromising safety.
Option A is unsafe because LPNs cannot titrate heparin drips. Option B may reduce comfort
but does not address workload or safety. Option D uses passive transactional tactics and
risks burnout and errors .
2. A newly licensed RN tells the charge nurse, “I feel unprepared to care for a patient
on a ventilator.” Which response by the charge nurse demonstrates servant
leadership?
A) “You’ll be fine—just review the policy.”
B) “I’ll assign you a different patient and arrange a ventilator competency class this week.”
C) “Everyone feels that way; take the assignment anyway.”
D) “Ask the respiratory therapist to watch you.”
Correct Answer: B
Rationale: Servant leaders prioritize staff growth and well-being. Arranging education and
temporarily reassigning the patient protects both nurse and patient while building
competence. Option A dismisses the concern. Option C forces an unsafe assignment.
Option D places responsibility on another discipline without ensuring RN competence .
3. Which statement BEST differentiates between “management” and “leadership” in
nursing practice?
A) Management focuses on vision, while leadership focuses on operations
, B) Management uses influence, while leadership uses authority
C) Management maintains stability, while leadership promotes change
D) Management empowers staff, while leadership controls resources
Correct Answer: C
Rationale: Management typically focuses on maintaining stability, efficiency, and
organizational systems. Leadership focuses on creating vision, promoting change, and
inspiring innovation. Management uses formal authority while leadership uses influence
(Option B is reversed) .
4. A charge nurse notices that a staff nurse consistently avoids making decisions
and defers all clinical questions to the charge nurse. According to the Situational
Leadership Model, what is the MOST appropriate leadership response?
A) Provide clear, specific direction and closely supervise
B) Delegate decision-making authority and step back
C) Use a hands-off approach and let the nurse learn independently
D) Assign the nurse to a less demanding unit
Correct Answer: A
Rationale: According to Situational Leadership, a follower with low readiness (low
competence and low confidence) requires high task behavior and high relationship
behavior—directing and closely supervising. Delegating (B) and hands-off (C) would be
appropriate for high-readiness followers .
, 5. A nurse leader is preparing to implement a new evidence-based fall prevention
program. According to Kotter’s Change Management Model, which action represents
the FIRST step?
A) Create a vision for change
B) Establish a sense of urgency
C) Empower staff to act on the vision
D) Generate short-term wins
Correct Answer: B
Rationale: Kotter’s 8-Step Change Model begins with establishing a sense of urgency (Step
1). This involves explaining why change is needed and creating motivation among
stakeholders. Creating a vision (Step 3), empowering staff (Step 5), and generating short-
term wins (Step 6) occur later in the process .
6. During a code blue, the charge nurse notes that the new RN is standing at the foot
of the bed looking overwhelmed. Which initial action is most appropriate?
A) Tell the RN to document on the code sheet
B) Assign the RN to give IV medications per ACLS protocol
C) Ask the RN to leave the room to reduce clutter
D) Ignore the RN and continue with the code
Correct Answer: A
