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NUR 204 – HESI LEADERSHIP AND MANAGEMENT V2
(NCLEX-STYLE) 2026/2027 COMPLETE CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NUR
Prepare for the NUR 204 HESI Leadership and Management V2 Exam with this focused
study resource designed to reinforce essential leadership and nursing management
concepts. Review topics such as delegation, prioritization, communication, decision-
making, teamwork, and effective management of patient care. Use this resource to
strengthen your understanding, identify areas that may require additional study, and
improve exam readiness. It provides a structured supplement to your coursework for a
more confident approach to the HESI exam.
MULTIPLE CHOICE.
Section 1: Leadership Theories & Styles (Q1–Q20)
1. A nurse manager is working to improve patient safety and quality of
care. Which of the following strategies is most likely to result in the best
outcomes?
A. Implementing new policies without consulting the staff
B. Using evidence-based practice to inform decisions
C. Giving all nurses the same workload regardless of experience
D. Relying solely on past methods of care without reassessment
Answer: B
Rationale: Evidence-based practice (EBP) integrates clinical expertise,
patient values, and the best research evidence into the decision-making
process, leading to improved patient outcomes and better safety
practices.
2. Which leadership style is characterized by the leader making all
decisions without input from others?
A. Democratic
B. Laissez-faire
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C. Autocratic
D. Transformational
Answer: C
Rationale: An autocratic leadership style involves the leader making
decisions unilaterally, without consulting others. It is a directive approach
where the leader holds most of the power.
3. Which type of leadership theory emphasizes that leaders are born with
inherent traits that make them effective leaders?
A. Trait theory
B. Contingency theory
C. Behavioral theory
D. Situational theory
Answer: A
Rationale: Trait theory focuses on the idea that leaders possess certain
traits or qualities (such as intelligence, confidence, and decisiveness)
that make them natural leaders.
4. A charge nurse on a busy unit receives report that the new admission
nurse will arrive 2 hours late. Two RNs are out on sick leave, and one LPN
is available. The unit has 28 occupied beds, including four fresh post-ops
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
Answer: C
Rationale: Transformational leaders inspire and engage staff by actively
problem-solving, communicating transparently, and advocating for
system-level support. Simultaneously holding huddles reprioritizes care
without compromising safety.
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5. 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."
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.
6. Which leadership style involves the leader making decisions
unilaterally without consulting others?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
Answer: C
Rationale: An autocratic leadership style involves the leader making
decisions unilaterally, without consulting others.
7. A nurse manager is implementing a new electronic health record
system using Lewin's change theory. During the 'unfreezing' stage, which
action should the manager take?
A. Provide technical training sessions for all staff members
B. Integrate the new system into daily routine policies
C. Create a sense of urgency by explaining the need for the change
D. Offer rewards to staff who adopt the system quickly
Answer: C
Rationale: The unfreezing stage involves preparing the organization for
change by increasing awareness of the need for it. Creating a sense of
urgency helps staff understand why the status quo is no longer viable.
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8. Which of the following is a key principle of delegation in nursing
leadership?
A. Delegation should always be to the most experienced nurse available.
B. The nurse delegating the task remains accountable for the outcome.
C. Delegation should be avoided in high-stress situations.
D. Only tasks that require critical thinking should be delegated.
Answer: B
Rationale: While tasks can be delegated, the nurse who delegates is still
responsible for ensuring the task is completed correctly and that the
outcomes are appropriate.
9. A nurse manager is addressing a conflict between two staff members.
What is the first step the manager should take?
A. Select a neutral third party to mediate
B. Assess the situation and understand both perspectives
C. Assign each person additional work to keep them occupied
D. Ignore the situation, hoping it will resolve itself
Answer: B
Rationale: The first step in conflict resolution is to understand both sides
of the issue to gather information and identify underlying concerns before
attempting mediation or a solution.
10. Which of the following is a key responsibility of a nurse manager when
it comes to staff performance?
A. Providing staff with opportunities for growth and professional development
B. Making all decisions without consulting staff
C. Monitoring performance through random checks without giving feedback
D. Reprimanding staff publicly for errors
Answer: A
Rationale: A key responsibility of a nurse manager is to provide staff with
opportunities for growth and professional development.
11. A nurse manager is working on implementing a new technology
system in the unit. Staff members are resistant to the change. Which
strategy should the nurse manager use to address resistance to change?
NUR 204 – HESI LEADERSHIP AND MANAGEMENT V2
(NCLEX-STYLE) 2026/2027 COMPLETE CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NUR
Prepare for the NUR 204 HESI Leadership and Management V2 Exam with this focused
study resource designed to reinforce essential leadership and nursing management
concepts. Review topics such as delegation, prioritization, communication, decision-
making, teamwork, and effective management of patient care. Use this resource to
strengthen your understanding, identify areas that may require additional study, and
improve exam readiness. It provides a structured supplement to your coursework for a
more confident approach to the HESI exam.
MULTIPLE CHOICE.
Section 1: Leadership Theories & Styles (Q1–Q20)
1. A nurse manager is working to improve patient safety and quality of
care. Which of the following strategies is most likely to result in the best
outcomes?
A. Implementing new policies without consulting the staff
B. Using evidence-based practice to inform decisions
C. Giving all nurses the same workload regardless of experience
D. Relying solely on past methods of care without reassessment
Answer: B
Rationale: Evidence-based practice (EBP) integrates clinical expertise,
patient values, and the best research evidence into the decision-making
process, leading to improved patient outcomes and better safety
practices.
2. Which leadership style is characterized by the leader making all
decisions without input from others?
A. Democratic
B. Laissez-faire
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C. Autocratic
D. Transformational
Answer: C
Rationale: An autocratic leadership style involves the leader making
decisions unilaterally, without consulting others. It is a directive approach
where the leader holds most of the power.
3. Which type of leadership theory emphasizes that leaders are born with
inherent traits that make them effective leaders?
A. Trait theory
B. Contingency theory
C. Behavioral theory
D. Situational theory
Answer: A
Rationale: Trait theory focuses on the idea that leaders possess certain
traits or qualities (such as intelligence, confidence, and decisiveness)
that make them natural leaders.
4. A charge nurse on a busy unit receives report that the new admission
nurse will arrive 2 hours late. Two RNs are out on sick leave, and one LPN
is available. The unit has 28 occupied beds, including four fresh post-ops
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
Answer: C
Rationale: Transformational leaders inspire and engage staff by actively
problem-solving, communicating transparently, and advocating for
system-level support. Simultaneously holding huddles reprioritizes care
without compromising safety.
, Page 3 of 36
5. 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."
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.
6. Which leadership style involves the leader making decisions
unilaterally without consulting others?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
Answer: C
Rationale: An autocratic leadership style involves the leader making
decisions unilaterally, without consulting others.
7. A nurse manager is implementing a new electronic health record
system using Lewin's change theory. During the 'unfreezing' stage, which
action should the manager take?
A. Provide technical training sessions for all staff members
B. Integrate the new system into daily routine policies
C. Create a sense of urgency by explaining the need for the change
D. Offer rewards to staff who adopt the system quickly
Answer: C
Rationale: The unfreezing stage involves preparing the organization for
change by increasing awareness of the need for it. Creating a sense of
urgency helps staff understand why the status quo is no longer viable.
, Page 4 of 36
8. Which of the following is a key principle of delegation in nursing
leadership?
A. Delegation should always be to the most experienced nurse available.
B. The nurse delegating the task remains accountable for the outcome.
C. Delegation should be avoided in high-stress situations.
D. Only tasks that require critical thinking should be delegated.
Answer: B
Rationale: While tasks can be delegated, the nurse who delegates is still
responsible for ensuring the task is completed correctly and that the
outcomes are appropriate.
9. A nurse manager is addressing a conflict between two staff members.
What is the first step the manager should take?
A. Select a neutral third party to mediate
B. Assess the situation and understand both perspectives
C. Assign each person additional work to keep them occupied
D. Ignore the situation, hoping it will resolve itself
Answer: B
Rationale: The first step in conflict resolution is to understand both sides
of the issue to gather information and identify underlying concerns before
attempting mediation or a solution.
10. Which of the following is a key responsibility of a nurse manager when
it comes to staff performance?
A. Providing staff with opportunities for growth and professional development
B. Making all decisions without consulting staff
C. Monitoring performance through random checks without giving feedback
D. Reprimanding staff publicly for errors
Answer: A
Rationale: A key responsibility of a nurse manager is to provide staff with
opportunities for growth and professional development.
11. A nurse manager is working on implementing a new technology
system in the unit. Staff members are resistant to the change. Which
strategy should the nurse manager use to address resistance to change?
