Evolve HESI Leadership Management Questions and
answers
1. A nurse manager is leading a quality improvement project to reduce central line-associated
bloodstream infections (CLABSIs). The team implements a bundle of interventions. Which
approach should the manager use to ensure sustained adherence to the new protocol?
A. Conduct a root cause analysis after each infection.
B. Use audit and feedback with monthly performance data.
C. Provide a one-time educational session on the bundle.
D. Replace noncompliant staff with new hires.
Answer: B
2. In a conflict between two staff nurses over scheduling, the nurse manager listens to both parties,
identifies common goals, and proposes a compromise that partially satisfies each nurse's
preferences. This conflict resolution style is best described as:
A. Competing
B. Accommodating
C. Collaborating
D. Compromising
Answer: D
3. A charge nurse must assign four patients to two registered nurses (RNs) and one licensed
practical nurse (LPN). Which patient should be assigned to the LPN?
A. A patient with a new tracheostomy requiring frequent suctioning and monitoring.
B. A patient receiving a blood transfusion for anemia.
C. A patient with a urinary tract infection requiring IV antibiotics every 6 hours.
D. A patient with stable angina who needs discharge teaching.
Answer: C
4. A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious beliefs.
The nurse respects the patient's decision and advocates for alternative treatments. This action
aligns with which ethical principle?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Answer: C
Page 1
,5. A nurse manager notices that the unit's budget is overspent on supplies due to waste. Which
financial strategy should the manager implement first to control costs without compromising
patient care?
A. Reduce staffing ratios to decrease labor costs.
B. Implement a just-in-time inventory system.
C. Increase patient charges for supplies.
D. Request a budget increase from administration.
Answer: B
6. A nurse is leading a team in implementing a new evidence-based protocol for pressure injury
prevention. Which step should the nurse take first?
A. Conduct a literature review to identify best practices.
B. Develop an implementation timeline.
C. Educate staff on the new protocol.
D. Assess barriers to change in the unit.
Answer: A
7. A nurse manager is evaluating the performance of a staff nurse who consistently arrives late and
has received verbal warnings. Which leadership style is most appropriate to address this issue?
A. Laissez-faire
B. Transformational
C. Transactional
D. Servant leadership
Answer: C
8. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate
to delegate?
A. Assessing a patient's lung sounds.
B. Administering a scheduled oral medication.
C. Measuring vital signs on a stable patient.
D. Changing a sterile dressing on a surgical wound.
Answer: C
9. A nurse is preparing to discharge a patient with a new colostomy. The patient expresses anxiety
about managing the colostomy at home. Which nursing intervention is most appropriate?
A. Provide written instructions and schedule a follow-up phone call.
B. Reassure the patient that most people adapt quickly.
C. Arrange for a home health nurse visit.
D. Demonstrate colostomy care and have the patient return the demonstration.
Answer: D
Page 2
, 10. A nurse manager is implementing a shared governance model on the unit. Which outcome is
most indicative of successful implementation?
A. Decreased overtime hours.
B. Increased nurse satisfaction and retention.
C. Reduced supply costs.
D. Faster patient discharge times.
Answer: B
11. In a complex adaptive system, which leadership approach is most effective when the
organization faces a wicked problem with high uncertainty and conflicting stakeholder values?
A. Transformational leadership focused on a clear vision and top-down change
B. Adaptive leadership that encourages experimentation and distributed decision-making
C. Transactional leadership emphasizing contingent rewards and management by exception
D. Servant leadership prioritizing the needs of followers above all else
Answer: B
12. A nurse manager is evaluating the cost-effectiveness of a new staffing model that uses a mix of
RNs and LPNs. The model reduces RN hours by 20% but increases LPN hours by 30%. RN hourly
wage is $45, LPN hourly wage is $25. The unit previously had 100 RN hours per day. What is the
daily cost difference compared to the old model (100% RN)?
A. Decrease of $150
B. Increase of $150
C. Decrease of $250
D. Increase of $250
Answer: A
13. A hospital is implementing a new electronic health record system. The project manager uses
Kotter's 8-step change model. Which step is most critical for ensuring sustained change after the
system goes live?
A. Creating a sense of urgency among staff
B. Forming a powerful guiding coalition
C. Anchoring new approaches in the culture
D. Consolidating gains and producing more change
Answer: C
14. A charge nurse notices that a staff nurse frequently documents assessments after the end of the
shift rather than in real time. Which conflict management strategy would be most appropriate to
address this issue while maintaining a positive working relationship?
A. Forcing the nurse to comply through a written warning
B. Collaborating to understand barriers and develop a plan
C. Avoiding the issue to preserve team harmony
D. Compromising by allowing delayed documentation if no errors occur
Page 3
answers
1. A nurse manager is leading a quality improvement project to reduce central line-associated
bloodstream infections (CLABSIs). The team implements a bundle of interventions. Which
approach should the manager use to ensure sustained adherence to the new protocol?
A. Conduct a root cause analysis after each infection.
B. Use audit and feedback with monthly performance data.
C. Provide a one-time educational session on the bundle.
D. Replace noncompliant staff with new hires.
Answer: B
2. In a conflict between two staff nurses over scheduling, the nurse manager listens to both parties,
identifies common goals, and proposes a compromise that partially satisfies each nurse's
preferences. This conflict resolution style is best described as:
A. Competing
B. Accommodating
C. Collaborating
D. Compromising
Answer: D
3. A charge nurse must assign four patients to two registered nurses (RNs) and one licensed
practical nurse (LPN). Which patient should be assigned to the LPN?
A. A patient with a new tracheostomy requiring frequent suctioning and monitoring.
B. A patient receiving a blood transfusion for anemia.
C. A patient with a urinary tract infection requiring IV antibiotics every 6 hours.
D. A patient with stable angina who needs discharge teaching.
Answer: C
4. A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious beliefs.
The nurse respects the patient's decision and advocates for alternative treatments. This action
aligns with which ethical principle?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Answer: C
Page 1
,5. A nurse manager notices that the unit's budget is overspent on supplies due to waste. Which
financial strategy should the manager implement first to control costs without compromising
patient care?
A. Reduce staffing ratios to decrease labor costs.
B. Implement a just-in-time inventory system.
C. Increase patient charges for supplies.
D. Request a budget increase from administration.
Answer: B
6. A nurse is leading a team in implementing a new evidence-based protocol for pressure injury
prevention. Which step should the nurse take first?
A. Conduct a literature review to identify best practices.
B. Develop an implementation timeline.
C. Educate staff on the new protocol.
D. Assess barriers to change in the unit.
Answer: A
7. A nurse manager is evaluating the performance of a staff nurse who consistently arrives late and
has received verbal warnings. Which leadership style is most appropriate to address this issue?
A. Laissez-faire
B. Transformational
C. Transactional
D. Servant leadership
Answer: C
8. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is appropriate
to delegate?
A. Assessing a patient's lung sounds.
B. Administering a scheduled oral medication.
C. Measuring vital signs on a stable patient.
D. Changing a sterile dressing on a surgical wound.
Answer: C
9. A nurse is preparing to discharge a patient with a new colostomy. The patient expresses anxiety
about managing the colostomy at home. Which nursing intervention is most appropriate?
A. Provide written instructions and schedule a follow-up phone call.
B. Reassure the patient that most people adapt quickly.
C. Arrange for a home health nurse visit.
D. Demonstrate colostomy care and have the patient return the demonstration.
Answer: D
Page 2
, 10. A nurse manager is implementing a shared governance model on the unit. Which outcome is
most indicative of successful implementation?
A. Decreased overtime hours.
B. Increased nurse satisfaction and retention.
C. Reduced supply costs.
D. Faster patient discharge times.
Answer: B
11. In a complex adaptive system, which leadership approach is most effective when the
organization faces a wicked problem with high uncertainty and conflicting stakeholder values?
A. Transformational leadership focused on a clear vision and top-down change
B. Adaptive leadership that encourages experimentation and distributed decision-making
C. Transactional leadership emphasizing contingent rewards and management by exception
D. Servant leadership prioritizing the needs of followers above all else
Answer: B
12. A nurse manager is evaluating the cost-effectiveness of a new staffing model that uses a mix of
RNs and LPNs. The model reduces RN hours by 20% but increases LPN hours by 30%. RN hourly
wage is $45, LPN hourly wage is $25. The unit previously had 100 RN hours per day. What is the
daily cost difference compared to the old model (100% RN)?
A. Decrease of $150
B. Increase of $150
C. Decrease of $250
D. Increase of $250
Answer: A
13. A hospital is implementing a new electronic health record system. The project manager uses
Kotter's 8-step change model. Which step is most critical for ensuring sustained change after the
system goes live?
A. Creating a sense of urgency among staff
B. Forming a powerful guiding coalition
C. Anchoring new approaches in the culture
D. Consolidating gains and producing more change
Answer: C
14. A charge nurse notices that a staff nurse frequently documents assessments after the end of the
shift rather than in real time. Which conflict management strategy would be most appropriate to
address this issue while maintaining a positive working relationship?
A. Forcing the nurse to comply through a written warning
B. Collaborating to understand barriers and develop a plan
C. Avoiding the issue to preserve team harmony
D. Compromising by allowing delayed documentation if no errors occur
Page 3
