HESI: NUR 204 Leadership & Management Exam
Version 2 (New 2025/2026 Update) — Questions,
Correct Answers & Detailed Rationales – Fortis
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.
An RN delegates morning vital signs to an experienced UAP. After the UAP reports a BP
of 78/42 on a post-op cholecystectomy patient, the RN immediately reassesses the patient
and finds the cuff was too large. Which QSEN competency is most directly being
addressed?
A. Patient-centered care
B. Safety
C. Evidence-based practice
D. Informatics
Correct Answer: B
Rationale: The RN’s immediate verification prevents harm from hypotensive
misinterpretation, embodying the QSEN safety competency. Patient-centered care focuses
on individual preferences; evidence-based practice relates to intervention selection;
,informatics involves data management. None of the other options directly address the
prevention of adverse events.
3.
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.
4.
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
Rationale: Assigning a concrete, valuable task (documentation) engages the new RN
without exceeding competency in a high-stress moment. It also ensures accurate legal
records. Option B may exceed new RN experience. Option C wastes potential help and
increases anxiety. Option D ignores team development and safety.
5.
The nurse manager learns that two staff members exchanged profanities during a
disagreement about patient assignments. Which conflict resolution strategy produces a
win–win outcome?
A. Collaborating
B. Avoiding
C. Forcing
D. Accommodating
Version 2 (New 2025/2026 Update) — Questions,
Correct Answers & Detailed Rationales – Fortis
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.
An RN delegates morning vital signs to an experienced UAP. After the UAP reports a BP
of 78/42 on a post-op cholecystectomy patient, the RN immediately reassesses the patient
and finds the cuff was too large. Which QSEN competency is most directly being
addressed?
A. Patient-centered care
B. Safety
C. Evidence-based practice
D. Informatics
Correct Answer: B
Rationale: The RN’s immediate verification prevents harm from hypotensive
misinterpretation, embodying the QSEN safety competency. Patient-centered care focuses
on individual preferences; evidence-based practice relates to intervention selection;
,informatics involves data management. None of the other options directly address the
prevention of adverse events.
3.
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.
4.
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
Rationale: Assigning a concrete, valuable task (documentation) engages the new RN
without exceeding competency in a high-stress moment. It also ensures accurate legal
records. Option B may exceed new RN experience. Option C wastes potential help and
increases anxiety. Option D ignores team development and safety.
5.
The nurse manager learns that two staff members exchanged profanities during a
disagreement about patient assignments. Which conflict resolution strategy produces a
win–win outcome?
A. Collaborating
B. Avoiding
C. Forcing
D. Accommodating
