HESI RN Leadership & Management
Exam 2025/2026 – Delegation &
Conflict Case Scenarios Questions &
Answers in Full with Rationales |
100% Verified | Graded A+
Case Study 1: Delegation in a Medical-Surgical Unit
Scenario: A charge nurse on a 30-bed medical-surgical unit is preparing assignments for the day
shift. The team includes two registered nurses (RNs), one licensed practical nurse (LPN), and
two unlicensed assistive personnel (UAPs). Clients include a postoperative hip replacement
client, a client with diabetes requiring insulin, a client with a new colostomy, and a client with
heart failure experiencing shortness of breath.
Question 1 (Multiple Choice)
Which task is most appropriate to delegate to the UAP?
• A) Administering insulin to the client with diabetes
• B) Teaching the client with a new colostomy about stoma care
• C) Assisting the postoperative client with ambulation
• D) Assessing the client’s colostomy output for abnormalities
• Answer: C. Assisting the postoperative client with ambulation
• Rationale: UAPs can assist with activities of daily living like ambulation, which is
within their scope. Administering insulin (A) and teaching (B) require nursing judgment,
reserved for RNs or LPNs. Assessing output (D) involves clinical assessment, beyond a
UAP’s scope.
Question 2 (Select All That Apply)
Which factors should the charge nurse consider when delegating tasks to the LPN? (Select all
that apply.)
• A) The LPN’s experience with the task
• B) The complexity of the client’s condition
• C) The LPN’s willingness to perform the task
• D) The availability of RN supervision
• E) The client’s preference for the caregiver
, • Answers: A, B, C, D
• Rationale:
o A: Experience ensures LPN competence.
o B: Complex conditions may require RN oversight.
o C: Willingness affects performance.
o D: RN supervision is required for certain LPN tasks.
o E: Client preference is not a primary factor in delegation decisions.
Question 3 (Bow-Tie)
Complete the bow-tie diagram for delegating care for the postoperative hip replacement client:
• Condition: Postoperative hip replacement recovery
• Actions to Take: (Select two)
o A) Delegate vital signs monitoring to the UAP
o B) Assign wound assessment to the RN
o C) Administer IV pain medication
• Parameters to Monitor: (Select two)
o D) Pain level
o E) Surgical site for infection
o F) Blood glucose levels
• Potential Complications: (Select one)
o G) Wound dehiscence
o H) Hyperglycemia
o I) Deep vein thrombosis
• Answers:
o Actions to Take: A, B
o Parameters to Monitor: D, E
o Potential Complication: I
• Rationale:
o Actions: Vital signs monitoring (A) is within the UAP’s scope, while wound
assessment (B) requires RN expertise. Administering IV medications (C) cannot
be delegated to UAPs or LPNs in most settings.
o Parameters: Pain level (D) and surgical site (E) are critical to monitor post-
surgery.
o Complication: Deep vein thrombosis (I) is a significant risk post-hip replacement
due to immobility.
Question 4 (Multiple Choice)
Which task should the charge nurse delegate to the LPN for the client with heart failure?
• A) Assess respiratory status
• B) Administer oral furosemide as prescribed
• C) Develop a discharge teaching plan
• D) Interpret ECG changes
, • Answer: B. Administer oral furosemide as prescribed
• Rationale: LPNs can administer oral medications within their scope. Assessing
respiratory status (A), developing teaching plans (C), and interpreting ECGs (D) require
RN-level judgment.
Question 5 (Drag and Drop)
Place the steps of the delegation process in the correct order:
• A) Provide clear instructions
• B) Evaluate the outcome of the task
• C) Identify the task to delegate
• D) Select the appropriate delegatee
• E) Monitor task performance
• Answer:
1. C) Identify the task to delegate
2. D) Select the appropriate delegatee
3. A) Provide clear instructions
4. E) Monitor task performance
5. B) Evaluate the outcome of the task
• Rationale: The delegation process follows the Five Rights of Delegation: identify the
right task, select the right person, provide clear direction, supervise, and evaluate
outcomes.
Case Study 2: Conflict Resolution in the Emergency
Department
Scenario: In the emergency department, an RN and a UAP have a conflict. The RN delegated
obtaining a client’s blood pressure, but the UAP states they are too busy with other tasks. The
RN becomes frustrated, and the interaction escalates, disrupting teamwork.
Question 6 (Multiple Choice)
What is the first action the charge nurse should take to address this conflict?
• A) Reassign the task to another UAP
• B) Facilitate a private discussion between the RN and UAP
• C) Discipline the UAP for refusing the task
• D) Report the incident to the nurse manager
• Answer: B. Facilitate a private discussion between the RN and UAP
• Rationale: A private discussion promotes understanding and teamwork. Reassigning (A)
avoids the issue, disciplining (C) is premature, and reporting (D) escalates unnecessarily.
Exam 2025/2026 – Delegation &
Conflict Case Scenarios Questions &
Answers in Full with Rationales |
100% Verified | Graded A+
Case Study 1: Delegation in a Medical-Surgical Unit
Scenario: A charge nurse on a 30-bed medical-surgical unit is preparing assignments for the day
shift. The team includes two registered nurses (RNs), one licensed practical nurse (LPN), and
two unlicensed assistive personnel (UAPs). Clients include a postoperative hip replacement
client, a client with diabetes requiring insulin, a client with a new colostomy, and a client with
heart failure experiencing shortness of breath.
Question 1 (Multiple Choice)
Which task is most appropriate to delegate to the UAP?
• A) Administering insulin to the client with diabetes
• B) Teaching the client with a new colostomy about stoma care
• C) Assisting the postoperative client with ambulation
• D) Assessing the client’s colostomy output for abnormalities
• Answer: C. Assisting the postoperative client with ambulation
• Rationale: UAPs can assist with activities of daily living like ambulation, which is
within their scope. Administering insulin (A) and teaching (B) require nursing judgment,
reserved for RNs or LPNs. Assessing output (D) involves clinical assessment, beyond a
UAP’s scope.
Question 2 (Select All That Apply)
Which factors should the charge nurse consider when delegating tasks to the LPN? (Select all
that apply.)
• A) The LPN’s experience with the task
• B) The complexity of the client’s condition
• C) The LPN’s willingness to perform the task
• D) The availability of RN supervision
• E) The client’s preference for the caregiver
, • Answers: A, B, C, D
• Rationale:
o A: Experience ensures LPN competence.
o B: Complex conditions may require RN oversight.
o C: Willingness affects performance.
o D: RN supervision is required for certain LPN tasks.
o E: Client preference is not a primary factor in delegation decisions.
Question 3 (Bow-Tie)
Complete the bow-tie diagram for delegating care for the postoperative hip replacement client:
• Condition: Postoperative hip replacement recovery
• Actions to Take: (Select two)
o A) Delegate vital signs monitoring to the UAP
o B) Assign wound assessment to the RN
o C) Administer IV pain medication
• Parameters to Monitor: (Select two)
o D) Pain level
o E) Surgical site for infection
o F) Blood glucose levels
• Potential Complications: (Select one)
o G) Wound dehiscence
o H) Hyperglycemia
o I) Deep vein thrombosis
• Answers:
o Actions to Take: A, B
o Parameters to Monitor: D, E
o Potential Complication: I
• Rationale:
o Actions: Vital signs monitoring (A) is within the UAP’s scope, while wound
assessment (B) requires RN expertise. Administering IV medications (C) cannot
be delegated to UAPs or LPNs in most settings.
o Parameters: Pain level (D) and surgical site (E) are critical to monitor post-
surgery.
o Complication: Deep vein thrombosis (I) is a significant risk post-hip replacement
due to immobility.
Question 4 (Multiple Choice)
Which task should the charge nurse delegate to the LPN for the client with heart failure?
• A) Assess respiratory status
• B) Administer oral furosemide as prescribed
• C) Develop a discharge teaching plan
• D) Interpret ECG changes
, • Answer: B. Administer oral furosemide as prescribed
• Rationale: LPNs can administer oral medications within their scope. Assessing
respiratory status (A), developing teaching plans (C), and interpreting ECGs (D) require
RN-level judgment.
Question 5 (Drag and Drop)
Place the steps of the delegation process in the correct order:
• A) Provide clear instructions
• B) Evaluate the outcome of the task
• C) Identify the task to delegate
• D) Select the appropriate delegatee
• E) Monitor task performance
• Answer:
1. C) Identify the task to delegate
2. D) Select the appropriate delegatee
3. A) Provide clear instructions
4. E) Monitor task performance
5. B) Evaluate the outcome of the task
• Rationale: The delegation process follows the Five Rights of Delegation: identify the
right task, select the right person, provide clear direction, supervise, and evaluate
outcomes.
Case Study 2: Conflict Resolution in the Emergency
Department
Scenario: In the emergency department, an RN and a UAP have a conflict. The RN delegated
obtaining a client’s blood pressure, but the UAP states they are too busy with other tasks. The
RN becomes frustrated, and the interaction escalates, disrupting teamwork.
Question 6 (Multiple Choice)
What is the first action the charge nurse should take to address this conflict?
• A) Reassign the task to another UAP
• B) Facilitate a private discussion between the RN and UAP
• C) Discipline the UAP for refusing the task
• D) Report the incident to the nurse manager
• Answer: B. Facilitate a private discussion between the RN and UAP
• Rationale: A private discussion promotes understanding and teamwork. Reassigning (A)
avoids the issue, disciplining (C) is premature, and reporting (D) escalates unnecessarily.
