NEXT GENERATION (NGN)
HESI Leadership and
Management Exam
Question 1: Delegation
A registered nurse (RN) is caring for four patients on a medical-surgical unit. Which
task is most appropriate to delegate to a licensed practical nurse (LPN)?
A. Performing the initial assessment on a newly admitted patient
B. Administering oral medications to a stable patient
C. Developing the plan of care for a patient with complex needs
D. Performing patient teaching on a new insulin regimen
Answer: B
Rationale: LPNs can safely administer oral medications to stable patients. Initial
assessments, care planning, and patient teaching require RN-level judgment and
critical thinking.
Question 2: Prioritization (NGN style – multiple patient scenario)
The RN has the following patient assignments:
Patient A: Postoperative day 1, vitals stable, pain 6/10
Patient B: Admitted with chest pain, awaiting ECG results
,Patient C: Diabetic with a blood glucose of 55 mg/dL
Patient D: Receiving IV antibiotics for cellulitis, reports mild itching
Which patient should the RN assess first?
A. Patient A
B. Patient B
C. Patient C
D. Patient D
Answer: C
Rationale: The diabetic patient with hypoglycemia (blood glucose 55 mg/dL) is at
immediate risk for complications and requires rapid intervention. This follows the
NGN focus on patient safety and immediate threat assessment.
Question 3: Ethical Decision-Making
A patient refuses a blood transfusion due to religious beliefs. The family insists the
transfusion is necessary to save the patient’s life. What should the nurse do first?
A. Administer the transfusion to save the patient
B. Respect the patient’s wishes and document refusal
C. Ask the family to sign a consent form
D. Call the physician to override the refusal
Answer: B
Rationale: Patient autonomy is prioritized. The nurse must respect the patient’s
decision even if the family disagrees, documenting the refusal and notifying the
physician.
Question 4: Conflict Resolution
,Two nurses disagree on the best approach for a patient’s wound care. What is the
most appropriate initial action for the charge nurse?
A. Tell them to follow the hospital policy
B. Mediate a discussion between the two nurses
C. Assign the patient to one nurse permanently
D. Document the disagreement in the chart
Answer: B
Rationale: Effective conflict resolution involves mediation and collaborative problem-
solving to ensure patient care is not compromised.
Question 5: Staffing and Time Management
A new nurse asks for guidance on prioritizing care. Which statement by the RN
demonstrates correct prioritization principles?
A. “Always care for patients in the order they arrived.”
B. “Address patients with the most acute or life-threatening needs first.”
C. “Delegate all assessments to LPNs to save time.”
D. “Patient satisfaction is more important than clinical urgency.”
Answer: B
Rationale: Prioritization is based on the urgency and severity of patient needs,
consistent with NGN HESI priorities.
Question 6: Legal and Regulatory Considerations
A nurse witnesses another nurse taking medication from the unit supply for personal
use. What is the nurse’s best initial action?
A. Confront the nurse immediately
B. Document the incident and notify the charge nurse or supervisor
C. Ignore it to avoid conflict
D. Call law enforcement immediately
, Answer: B
Rationale: Nurses are legally obligated to report unsafe or illegal practices to protect
patients and comply with institutional policies.
Question 7: Quality Improvement
A nurse notices frequent medication errors during shift handoff. Which is the best
action?
A. Report errors to the manager and recommend a standardized handoff protocol
B. Assign more staff to reduce workload
C. Ignore minor errors as long as patients are not harmed
D. Blame the previous shift for mistakes
Answer: A
Rationale: NGN HESI emphasizes quality improvement and system-based solutions
rather than individual blame.Question 8: Delegation
An RN is delegating tasks on a medical-surgical unit. Which task is inappropriate to
assign to a certified nursing assistant (CNA)?
A. Assisting a patient with ambulation
B. Taking vital signs for a stable patient
C. Administering oral medications
D. Providing hygiene care
Answer: C
Rationale: CNAs cannot administer medications. Delegation should match the staff
member’s licensure and scope of practice.
Question 9: Crisis Management
HESI Leadership and
Management Exam
Question 1: Delegation
A registered nurse (RN) is caring for four patients on a medical-surgical unit. Which
task is most appropriate to delegate to a licensed practical nurse (LPN)?
A. Performing the initial assessment on a newly admitted patient
B. Administering oral medications to a stable patient
C. Developing the plan of care for a patient with complex needs
D. Performing patient teaching on a new insulin regimen
Answer: B
Rationale: LPNs can safely administer oral medications to stable patients. Initial
assessments, care planning, and patient teaching require RN-level judgment and
critical thinking.
Question 2: Prioritization (NGN style – multiple patient scenario)
The RN has the following patient assignments:
Patient A: Postoperative day 1, vitals stable, pain 6/10
Patient B: Admitted with chest pain, awaiting ECG results
,Patient C: Diabetic with a blood glucose of 55 mg/dL
Patient D: Receiving IV antibiotics for cellulitis, reports mild itching
Which patient should the RN assess first?
A. Patient A
B. Patient B
C. Patient C
D. Patient D
Answer: C
Rationale: The diabetic patient with hypoglycemia (blood glucose 55 mg/dL) is at
immediate risk for complications and requires rapid intervention. This follows the
NGN focus on patient safety and immediate threat assessment.
Question 3: Ethical Decision-Making
A patient refuses a blood transfusion due to religious beliefs. The family insists the
transfusion is necessary to save the patient’s life. What should the nurse do first?
A. Administer the transfusion to save the patient
B. Respect the patient’s wishes and document refusal
C. Ask the family to sign a consent form
D. Call the physician to override the refusal
Answer: B
Rationale: Patient autonomy is prioritized. The nurse must respect the patient’s
decision even if the family disagrees, documenting the refusal and notifying the
physician.
Question 4: Conflict Resolution
,Two nurses disagree on the best approach for a patient’s wound care. What is the
most appropriate initial action for the charge nurse?
A. Tell them to follow the hospital policy
B. Mediate a discussion between the two nurses
C. Assign the patient to one nurse permanently
D. Document the disagreement in the chart
Answer: B
Rationale: Effective conflict resolution involves mediation and collaborative problem-
solving to ensure patient care is not compromised.
Question 5: Staffing and Time Management
A new nurse asks for guidance on prioritizing care. Which statement by the RN
demonstrates correct prioritization principles?
A. “Always care for patients in the order they arrived.”
B. “Address patients with the most acute or life-threatening needs first.”
C. “Delegate all assessments to LPNs to save time.”
D. “Patient satisfaction is more important than clinical urgency.”
Answer: B
Rationale: Prioritization is based on the urgency and severity of patient needs,
consistent with NGN HESI priorities.
Question 6: Legal and Regulatory Considerations
A nurse witnesses another nurse taking medication from the unit supply for personal
use. What is the nurse’s best initial action?
A. Confront the nurse immediately
B. Document the incident and notify the charge nurse or supervisor
C. Ignore it to avoid conflict
D. Call law enforcement immediately
, Answer: B
Rationale: Nurses are legally obligated to report unsafe or illegal practices to protect
patients and comply with institutional policies.
Question 7: Quality Improvement
A nurse notices frequent medication errors during shift handoff. Which is the best
action?
A. Report errors to the manager and recommend a standardized handoff protocol
B. Assign more staff to reduce workload
C. Ignore minor errors as long as patients are not harmed
D. Blame the previous shift for mistakes
Answer: A
Rationale: NGN HESI emphasizes quality improvement and system-based solutions
rather than individual blame.Question 8: Delegation
An RN is delegating tasks on a medical-surgical unit. Which task is inappropriate to
assign to a certified nursing assistant (CNA)?
A. Assisting a patient with ambulation
B. Taking vital signs for a stable patient
C. Administering oral medications
D. Providing hygiene care
Answer: C
Rationale: CNAs cannot administer medications. Delegation should match the staff
member’s licensure and scope of practice.
Question 9: Crisis Management
