Science Medicine Nursing
HESI RN Leadership & Management Exit Exam
(2024–2025) – 120 Practice Questions with
Verified Answers and Detailed Rationales
Which actions of the nurse exhibit transactional 2, 3, 4
leadership? Select all that apply.
The characteristics of transactional leadership include valuing the orders and
1 Motivating or inspiring the employees structures of an organization. The nurse who exhibits transactional leadership will
2 Meeting the targets within the deadline meet the targets within the deadline given by the organization. The nurse will also
3 Working according to organizational rules follow the rules of an organization and will correct the errors of an employee in a
4 Correcting the errors in a reactive manner reactive manner.
5 Increasing the employee commitment of an
organization Motivating or inspiring the employees and increasing employee commitment are
the characteristics of transformational leadership.
The unit nurse manager comes to work obviously 3 Have the supervisor validate the observation.
intoxicated. Which action is the staff nurse ethically
obligated to take? The staff nurse should call the hospital supervisor to confirm and handle the
problem. The security guard has no authority in this situation. Although sending
1 Call the security guard. the nurse manager home removes the nurse manager from the clinical setting, this
2 Tell the nurse manager to go home. action misses an opportunity for documenting the situation and the nurse
3 Have the supervisor validate the observation. manager is in no condition to drive safely. Drinking coffee does not make a
4 Offer the nurse manager a large cup of coffee person less intoxicated.
,Which aspects are considered when determining the 2, 4, 5
willingness of a nursing assistant before delegating a
task? Select all that apply. An individual's willingness is related to attitude, confidence, and commitment.
1 Ability Ability is related to knowledge and skills in a specific situation. Personality
2 Attitude characteristics can influence the effectiveness of the delegator.
3 Personality
4 Confidence
5 Commitment
Which performance appraisal method is used by nurse 4
managers to measure the performance of the nurse both The behaviorally anchored rating scale is a performance appraisal method that
qualitatively and quantitatively? provides an overview of nursing standards by determining performance both
qualitatively and quantitatively.
1 Narrative method
2 Critical incidents method The narrative method requires a manager to write a statement about the nurse's
3 Graphic rating scale form performance. The critical incidents type is a performance appraisal method in
4 Behaviorally anchored rating scales which a manager keeps a written record of positive and negative performance.
The graphic rating scale form is a performance appraisal checklist on which a
manager rates the nurse's performance on a continuum such as excellent, good,
average, and poor.
The healthcare team is caring for clients in an emergency 2 Within 1 hour
department. How soon should the clients triaged as an
emergency severity index-3 (ESI-3) be seen by the The clients triaged as an ESI-3 should be seen by the physician within an hour.
physician according to the five level triage system?
The clients with life-threatening problems are triaged as ESI-1, and they should be
1 Immediately provided with immediate care. The care of the clients in ESI-4 and ESI-5 can be
2 Within 1 hour delayed for some time because the condition of the clients in this level is stable.
3 Could be delayed Clients with major injuries are triaged as an ESI-2 and require treatment within 10
4 Within 10 minutes minutes.
Which question does the registered nurse recognize as 1 "Is the delegation appropriate to the situation?"
related to the right of circumstance when delegating?
The question, "Is the delegation appropriate to the situation?" is related to right
1 "Is the delegation appropriate to the situation?" circumstance.
2 "Is the task within the delegatee's scope of practice?"
3 "Is the prospective delegate a willing and able The question, "Is the task within the delegatee's scope of practice?" is related to
employee?" right task. The question, "Is the prospective delegate a willing and able
4 "Is the delegator able to monitor and evaluate the employee?" is related to right person. The question, "Is the delegator able to
client appropriately?" monitor and evaluate the client appropriately?" is related to right supervision.
Which factors does the registered nurse consider in the 3, 5
decision to delegate process? Select all that apply. Two factors responsible for the decision to delegate process are predictability of
outcomes and complexity of the task to be performed.
1 Evaluation
2 Nursing judgment Evaluation, nursing judgment, and pervasive functions are not factors in the
3 Predictability of outcomes decision to delegate process.
4 Pervasive functions of assessment
5 Complexity of the task to be performed
,Under a leader, a team of followers has failed to achieve 4 Accepts failure and gains experience from it
success in conducting research. What does an effective
leader do in this situation? An effective leader should accept the failure and gain experience from it to avoid
repetition of the same errors.
1 Criticizes the team members for failure
2 Provides excuses for the negative outcome The effective leader should counsel and motivate the team members for future
3 Refuses to take the responsibility for failure success and should not criticize them. Making excuses for the negative outcome
4 Accepts failure and gains experience from it is not the correct action of the effective leader. The effective leader should take
responsibility for the failure and the growth he or she will gain from it.
The nursing manager wants to implement 1, 3, 4
transformational leadership qualities. Which actions best Transformational leaders provide intellectual stimulation and encourage follower
describe this style of leadership? Select all that apply. creativity. They experiment with systems redesign, empower staff, create
enthusiasm for practice, and promote scholarship of practice in client care. They
1 Providing intellectual stimulation use motivator factors liberally to inspire work performance.
2 Intervening only when problems exist
3 Performing experiments with system redesign Intervening only when problems exist is a behavior related to transactional
4 Using motivator factors to inspire work performance leadership. Monitoring performance and taking corrective action is a transactional
5 Monitoring performance and taking action to correct leadership quality.
Which component of delegation is defined as the ability 1
to perform duties in a specific role? Authority is the ability to perform duties in a specific role.
1 Authority Supervision is the provision of guidance and oversight of a delegated task.
2 Supervision Responsibility refers to reliability, dependability, and obligation to accomplish
3 Responsibility work. Accountability involves determining whether the actions are appropriate
4 Accountability and providing a detailed explanation of what has occurred.
The healthcare team is caring for a client with 2
neutropenia. Which task is delegated to unlicensed Unlicensed assistive personnel assisting with the client's personal hygiene.
assistive personnel?
The licensed practical nurse administers antibiotics. Monitoring for signs and
1 Administering antibiotics symptoms is performed by the licensed practical nurse. The registered nurse
2 Assisting with personal hygiene teaches the client and caregivers how to avoid infection.
3 Monitoring for signs and symptoms of infection
4 Teaching the client and caregivers about how to avoid
infection
A client's serum potassium level has increased to 5.8 2
mEq/L (5.8 mmol/L). What action should the nurse Vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac
implement first? dysrhythmias. The healthcare provider should be notified because medical
intervention may be necessary.
1 Call the laboratory to repeat the test.
2 Take vital signs and notify the healthcare provider. A repeat laboratory test will take time and probably reaffirm the original results;
3 Inform the cardiac arrest team to place them on alert. the client needs immediate attention. The cardiac arrest team is always on alert
4 Take an electrocardiogram and have lidocaine and will respond when called for a cardiac arrest. Taking an electrocardiogram
available. and having lidocaine available are insufficient interventions.
, The nurse has accepted a position as a navigator. What 2, 3, 4, 5
should the nurse expect to learn during training for this Navigators are responsible for overcoming health system barriers, providing
role? Select all that apply. health education about diseases from prevention to treatment, addressing
barriers to care, and providing psychosocial support. These are the areas the
1 Approaches to reduce the cost of health care nurse should expect to focus on when being trained in the role.
2 Learning ways to work through the health systems
3 Strategies to teach clients about disease, including Learning approaches to reduce the cost of health care would be appropriate for
prevention and treatment a case manager to learn.
4 Assessing barriers that clients have encountered while
attempting to receive care
5 Helping clients cope with delays in receiving treatment
until barriers are overcome
What aspect of total client care needs to be taken into 1 Cost of nurses
consideration if used on a 24-bed care area?
Since total client care is provided by a registered nurse (RN) it can be very
1 Cost of nurses expensive and not realistic to use a highly skilled and extremely knowledgeable
2 Training needs professional nurse to provide all the care required in a unit of 24 clients.
3 Documentation
4 Time commitment There are no particular issues with training, documentation, or time commitment
with total client care.
For which situations would total client care be an 2, 3, 4
appropriate delivery system? Select all that apply. Total client care is used in critical care settings where one nurse provides total
care to one or two critically ill clients. The client with an endotracheal tube for
1 Client scheduled for lithotripsy for renal calculi pulmonary sepsis and the client recovering from cardiovascular bypass graft
2 Client with an endotracheal tube for pulmonary sepsis surgery are considered acutely ill and will be receiving care in a critical care area.
3 Client recovering from cardiovascular bypass graft The client recovering from cranial surgery to place a cerebrospinal fluid shunt
surgery would be appropriate for total client care.
4 Client recovering from the placement of a
cerebrospinal fluid shunt Total client care would not be an ideal care approach for the client scheduled for
5 Client transferring to a rehabilitation unit after total hip lithotripsy or the client being transferred to a rehabilitation unit.
replacement surgery
Which intervention should the charge nurse perform to 3 Provide additional support and temporarily lower expectations.
manage a task when the unlicensed nursing personal
(UNP) is lacking competence? The charge nurse should manage a task by temporarily lowering expectations and
providing additional support to an unlicensed nursing personal (UNP) who is
1 Provide constructive feedback and assign another task. lacking competence. This strategy allows the UNP to build on strengths, minimize
2 Provide open vocal feedback and withdraw the UNP weaknesses, and gain confidence.
from task.
3 Provide additional support and temporarily lower Providing constructive feedback and assigning another task may not improve the
expectations. strategy of the UNP and may affect the productivity of the new task. Withdrawing
4 Provide accountability to the organization and undergo the UNP from the task and providing open vocal feedback may weaken the
training again. working relationship and the UNP may lose confidence or become frustrated. The
charge nurse should be aware of accountability to the organization in case of a
failure of the delegation, but assigning the UNP for further training may lead to
high risk for legal liability.
HESI RN Leadership & Management Exit Exam
(2024–2025) – 120 Practice Questions with
Verified Answers and Detailed Rationales
Which actions of the nurse exhibit transactional 2, 3, 4
leadership? Select all that apply.
The characteristics of transactional leadership include valuing the orders and
1 Motivating or inspiring the employees structures of an organization. The nurse who exhibits transactional leadership will
2 Meeting the targets within the deadline meet the targets within the deadline given by the organization. The nurse will also
3 Working according to organizational rules follow the rules of an organization and will correct the errors of an employee in a
4 Correcting the errors in a reactive manner reactive manner.
5 Increasing the employee commitment of an
organization Motivating or inspiring the employees and increasing employee commitment are
the characteristics of transformational leadership.
The unit nurse manager comes to work obviously 3 Have the supervisor validate the observation.
intoxicated. Which action is the staff nurse ethically
obligated to take? The staff nurse should call the hospital supervisor to confirm and handle the
problem. The security guard has no authority in this situation. Although sending
1 Call the security guard. the nurse manager home removes the nurse manager from the clinical setting, this
2 Tell the nurse manager to go home. action misses an opportunity for documenting the situation and the nurse
3 Have the supervisor validate the observation. manager is in no condition to drive safely. Drinking coffee does not make a
4 Offer the nurse manager a large cup of coffee person less intoxicated.
,Which aspects are considered when determining the 2, 4, 5
willingness of a nursing assistant before delegating a
task? Select all that apply. An individual's willingness is related to attitude, confidence, and commitment.
1 Ability Ability is related to knowledge and skills in a specific situation. Personality
2 Attitude characteristics can influence the effectiveness of the delegator.
3 Personality
4 Confidence
5 Commitment
Which performance appraisal method is used by nurse 4
managers to measure the performance of the nurse both The behaviorally anchored rating scale is a performance appraisal method that
qualitatively and quantitatively? provides an overview of nursing standards by determining performance both
qualitatively and quantitatively.
1 Narrative method
2 Critical incidents method The narrative method requires a manager to write a statement about the nurse's
3 Graphic rating scale form performance. The critical incidents type is a performance appraisal method in
4 Behaviorally anchored rating scales which a manager keeps a written record of positive and negative performance.
The graphic rating scale form is a performance appraisal checklist on which a
manager rates the nurse's performance on a continuum such as excellent, good,
average, and poor.
The healthcare team is caring for clients in an emergency 2 Within 1 hour
department. How soon should the clients triaged as an
emergency severity index-3 (ESI-3) be seen by the The clients triaged as an ESI-3 should be seen by the physician within an hour.
physician according to the five level triage system?
The clients with life-threatening problems are triaged as ESI-1, and they should be
1 Immediately provided with immediate care. The care of the clients in ESI-4 and ESI-5 can be
2 Within 1 hour delayed for some time because the condition of the clients in this level is stable.
3 Could be delayed Clients with major injuries are triaged as an ESI-2 and require treatment within 10
4 Within 10 minutes minutes.
Which question does the registered nurse recognize as 1 "Is the delegation appropriate to the situation?"
related to the right of circumstance when delegating?
The question, "Is the delegation appropriate to the situation?" is related to right
1 "Is the delegation appropriate to the situation?" circumstance.
2 "Is the task within the delegatee's scope of practice?"
3 "Is the prospective delegate a willing and able The question, "Is the task within the delegatee's scope of practice?" is related to
employee?" right task. The question, "Is the prospective delegate a willing and able
4 "Is the delegator able to monitor and evaluate the employee?" is related to right person. The question, "Is the delegator able to
client appropriately?" monitor and evaluate the client appropriately?" is related to right supervision.
Which factors does the registered nurse consider in the 3, 5
decision to delegate process? Select all that apply. Two factors responsible for the decision to delegate process are predictability of
outcomes and complexity of the task to be performed.
1 Evaluation
2 Nursing judgment Evaluation, nursing judgment, and pervasive functions are not factors in the
3 Predictability of outcomes decision to delegate process.
4 Pervasive functions of assessment
5 Complexity of the task to be performed
,Under a leader, a team of followers has failed to achieve 4 Accepts failure and gains experience from it
success in conducting research. What does an effective
leader do in this situation? An effective leader should accept the failure and gain experience from it to avoid
repetition of the same errors.
1 Criticizes the team members for failure
2 Provides excuses for the negative outcome The effective leader should counsel and motivate the team members for future
3 Refuses to take the responsibility for failure success and should not criticize them. Making excuses for the negative outcome
4 Accepts failure and gains experience from it is not the correct action of the effective leader. The effective leader should take
responsibility for the failure and the growth he or she will gain from it.
The nursing manager wants to implement 1, 3, 4
transformational leadership qualities. Which actions best Transformational leaders provide intellectual stimulation and encourage follower
describe this style of leadership? Select all that apply. creativity. They experiment with systems redesign, empower staff, create
enthusiasm for practice, and promote scholarship of practice in client care. They
1 Providing intellectual stimulation use motivator factors liberally to inspire work performance.
2 Intervening only when problems exist
3 Performing experiments with system redesign Intervening only when problems exist is a behavior related to transactional
4 Using motivator factors to inspire work performance leadership. Monitoring performance and taking corrective action is a transactional
5 Monitoring performance and taking action to correct leadership quality.
Which component of delegation is defined as the ability 1
to perform duties in a specific role? Authority is the ability to perform duties in a specific role.
1 Authority Supervision is the provision of guidance and oversight of a delegated task.
2 Supervision Responsibility refers to reliability, dependability, and obligation to accomplish
3 Responsibility work. Accountability involves determining whether the actions are appropriate
4 Accountability and providing a detailed explanation of what has occurred.
The healthcare team is caring for a client with 2
neutropenia. Which task is delegated to unlicensed Unlicensed assistive personnel assisting with the client's personal hygiene.
assistive personnel?
The licensed practical nurse administers antibiotics. Monitoring for signs and
1 Administering antibiotics symptoms is performed by the licensed practical nurse. The registered nurse
2 Assisting with personal hygiene teaches the client and caregivers how to avoid infection.
3 Monitoring for signs and symptoms of infection
4 Teaching the client and caregivers about how to avoid
infection
A client's serum potassium level has increased to 5.8 2
mEq/L (5.8 mmol/L). What action should the nurse Vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac
implement first? dysrhythmias. The healthcare provider should be notified because medical
intervention may be necessary.
1 Call the laboratory to repeat the test.
2 Take vital signs and notify the healthcare provider. A repeat laboratory test will take time and probably reaffirm the original results;
3 Inform the cardiac arrest team to place them on alert. the client needs immediate attention. The cardiac arrest team is always on alert
4 Take an electrocardiogram and have lidocaine and will respond when called for a cardiac arrest. Taking an electrocardiogram
available. and having lidocaine available are insufficient interventions.
, The nurse has accepted a position as a navigator. What 2, 3, 4, 5
should the nurse expect to learn during training for this Navigators are responsible for overcoming health system barriers, providing
role? Select all that apply. health education about diseases from prevention to treatment, addressing
barriers to care, and providing psychosocial support. These are the areas the
1 Approaches to reduce the cost of health care nurse should expect to focus on when being trained in the role.
2 Learning ways to work through the health systems
3 Strategies to teach clients about disease, including Learning approaches to reduce the cost of health care would be appropriate for
prevention and treatment a case manager to learn.
4 Assessing barriers that clients have encountered while
attempting to receive care
5 Helping clients cope with delays in receiving treatment
until barriers are overcome
What aspect of total client care needs to be taken into 1 Cost of nurses
consideration if used on a 24-bed care area?
Since total client care is provided by a registered nurse (RN) it can be very
1 Cost of nurses expensive and not realistic to use a highly skilled and extremely knowledgeable
2 Training needs professional nurse to provide all the care required in a unit of 24 clients.
3 Documentation
4 Time commitment There are no particular issues with training, documentation, or time commitment
with total client care.
For which situations would total client care be an 2, 3, 4
appropriate delivery system? Select all that apply. Total client care is used in critical care settings where one nurse provides total
care to one or two critically ill clients. The client with an endotracheal tube for
1 Client scheduled for lithotripsy for renal calculi pulmonary sepsis and the client recovering from cardiovascular bypass graft
2 Client with an endotracheal tube for pulmonary sepsis surgery are considered acutely ill and will be receiving care in a critical care area.
3 Client recovering from cardiovascular bypass graft The client recovering from cranial surgery to place a cerebrospinal fluid shunt
surgery would be appropriate for total client care.
4 Client recovering from the placement of a
cerebrospinal fluid shunt Total client care would not be an ideal care approach for the client scheduled for
5 Client transferring to a rehabilitation unit after total hip lithotripsy or the client being transferred to a rehabilitation unit.
replacement surgery
Which intervention should the charge nurse perform to 3 Provide additional support and temporarily lower expectations.
manage a task when the unlicensed nursing personal
(UNP) is lacking competence? The charge nurse should manage a task by temporarily lowering expectations and
providing additional support to an unlicensed nursing personal (UNP) who is
1 Provide constructive feedback and assign another task. lacking competence. This strategy allows the UNP to build on strengths, minimize
2 Provide open vocal feedback and withdraw the UNP weaknesses, and gain confidence.
from task.
3 Provide additional support and temporarily lower Providing constructive feedback and assigning another task may not improve the
expectations. strategy of the UNP and may affect the productivity of the new task. Withdrawing
4 Provide accountability to the organization and undergo the UNP from the task and providing open vocal feedback may weaken the
training again. working relationship and the UNP may lose confidence or become frustrated. The
charge nurse should be aware of accountability to the organization in case of a
failure of the delegation, but assigning the UNP for further training may lead to
high risk for legal liability.
