HESI PN LEADERSHIP EXIT EXAM 2026 | 200
VERIFIED REAL EXAM QUESTIONS & ANSWERS |
PRACTICAL NURSING LEADERSHIP STUDY GUIDE
| GUARANTEED A+ PREP
• This is a comprehensive 200-question HESI PN Leadership Exit Exam prep guide
with verified answers, designed to mirror the real exam format and boost your
confidence before test day.
• Study tip: Work through each question independently before checking the
highlighted correct answer and EXPERT RATIONALE — this active recall method
maximizes retention and prepares you for exam-day pressure.
HESI PN LEADERSHIP EXIT EXAM 2026 200 VERIFIED QUESTIONS & ANSWERS
1. A charge nurse observes a newly licensed PN administering medication
without performing the five rights of medication administration. What should
the charge nurse do first?
A. Document the observation in the nurse's personnel file
B. Report the PN to the nurse manager immediately
C. Intervene and review the five rights with the PN
D. Allow the PN to complete the task and correct later
E. Notify the physician about the potential medication error
C. Intervene and review the five rights with the PN
EXPERT RATIONALE: Patient safety is the priority. The charge nurse must intervene
immediately to prevent a potential medication error and use the moment as a teaching
opportunity for the new PN.
2. A PN is caring for a client who refuses a blood transfusion due to religious
beliefs. What is the most appropriate nursing action?
A. Administer the transfusion as ordered because the physician ordered it
,B. Consult the ethics committee without informing the client
C. Encourage the family to convince the client to accept the transfusion
D. Document the refusal and notify the charge nurse and physician
E. Reassure the client and administer the transfusion anyway
D. Document the refusal and notify the charge nurse and physician
EXPERT RATIONALE: Clients have the right to refuse treatment, including blood
transfusions, based on religious or personal beliefs. The PN must respect autonomy,
document the refusal, and notify the appropriate team members.
3. The charge nurse is delegating tasks for the shift. Which task is most
appropriate to delegate to unlicensed assistive personnel (UAP)?
A. Assessing a client's wound drainage
B. Administering oral medications to a stable client
C. Measuring and recording intake and output
D. Changing a sterile dressing on a surgical wound
E. Educating a client about a new diagnosis
C. Measuring and recording intake and output
EXPERT RATIONALE: Measuring and recording intake and output is a routine, non-
invasive task within the UAP's scope of practice. Assessment, medication administration,
sterile dressing changes, and client education require licensed nursing judgment.
4. A PN notices a coworker removing medications from the automated
dispensing cabinet for a client who was discharged. What should the PN do?
A. Confront the coworker directly in the hallway
B. Assume there is a valid explanation and ignore the behavior
C. Report the observation to the charge nurse immediately
,D. Document the behavior and wait to see if it happens again
E. Ask other coworkers if they have noticed similar behavior
C. Report the observation to the charge nurse immediately
EXPERT RATIONALE: Removing medications for a discharged client is a serious concern
for drug diversion. The PN has a professional and ethical obligation to report this
behavior immediately to protect clients and uphold facility policy.
5. A client tells the PN, "I don't want my daughter to know anything about my
condition." The PN should:
A. Inform the daughter because she is next of kin
B. Document and respect the client's request for confidentiality
C. Ask the physician to speak with the daughter
D. Share only basic information to keep the family informed
E. Tell the daughter the client is not ready to discuss it
B. Document and respect the client's request for confidentiality
EXPERT RATIONALE: HIPAA protects clients' rights to privacy and confidentiality. Unless
the client provides consent, no health information should be shared with family
members, regardless of their relationship to the client.
6. The PN is preparing to administer insulin. Which action best demonstrates
safe medication practice?
A. Prepare the insulin at the nurses' station without checking the MAR
B. Ask a colleague to verify the dose and have two nurses sign off
C. Compare the medication label to the MAR three times during preparation
D. Draw up the insulin from memory based on previous doses given
E. Administer the dose and document it after the shift ends
, C. Compare the medication label to the MAR three times during
preparation
EXPERT RATIONALE: The triple-check method — checking the label when retrieving,
preparing, and prior to administration — is a standard safe medication practice to
reduce errors, especially with high-alert medications like insulin.
7. A PN is caring for a postoperative client who reports pain of 8/10. The PN
reviews the MAR and notes the client is due for a PRN analgesic. What is the
priority action?
A. Reposition the client and reassess in 30 minutes
B. Notify the charge nurse before administering anything
C. Administer the PRN analgesic as ordered and reassess
D. Apply a cold pack to the incision site first
E. Document the pain score and continue the current care plan
C. Administer the PRN analgesic as ordered and reassess
EXPERT RATIONALE: The client has a valid PRN order and is reporting significant pain.
The PN should administer the medication within the scope of practice and reassess
effectiveness after an appropriate interval.
8. Which leadership style is most effective in an emergency situation
requiring immediate action?
A. Democratic leadership
B. Laissez-faire leadership
C. Transformational leadership
D. Autocratic leadership
E. Servant leadership
VERIFIED REAL EXAM QUESTIONS & ANSWERS |
PRACTICAL NURSING LEADERSHIP STUDY GUIDE
| GUARANTEED A+ PREP
• This is a comprehensive 200-question HESI PN Leadership Exit Exam prep guide
with verified answers, designed to mirror the real exam format and boost your
confidence before test day.
• Study tip: Work through each question independently before checking the
highlighted correct answer and EXPERT RATIONALE — this active recall method
maximizes retention and prepares you for exam-day pressure.
HESI PN LEADERSHIP EXIT EXAM 2026 200 VERIFIED QUESTIONS & ANSWERS
1. A charge nurse observes a newly licensed PN administering medication
without performing the five rights of medication administration. What should
the charge nurse do first?
A. Document the observation in the nurse's personnel file
B. Report the PN to the nurse manager immediately
C. Intervene and review the five rights with the PN
D. Allow the PN to complete the task and correct later
E. Notify the physician about the potential medication error
C. Intervene and review the five rights with the PN
EXPERT RATIONALE: Patient safety is the priority. The charge nurse must intervene
immediately to prevent a potential medication error and use the moment as a teaching
opportunity for the new PN.
2. A PN is caring for a client who refuses a blood transfusion due to religious
beliefs. What is the most appropriate nursing action?
A. Administer the transfusion as ordered because the physician ordered it
,B. Consult the ethics committee without informing the client
C. Encourage the family to convince the client to accept the transfusion
D. Document the refusal and notify the charge nurse and physician
E. Reassure the client and administer the transfusion anyway
D. Document the refusal and notify the charge nurse and physician
EXPERT RATIONALE: Clients have the right to refuse treatment, including blood
transfusions, based on religious or personal beliefs. The PN must respect autonomy,
document the refusal, and notify the appropriate team members.
3. The charge nurse is delegating tasks for the shift. Which task is most
appropriate to delegate to unlicensed assistive personnel (UAP)?
A. Assessing a client's wound drainage
B. Administering oral medications to a stable client
C. Measuring and recording intake and output
D. Changing a sterile dressing on a surgical wound
E. Educating a client about a new diagnosis
C. Measuring and recording intake and output
EXPERT RATIONALE: Measuring and recording intake and output is a routine, non-
invasive task within the UAP's scope of practice. Assessment, medication administration,
sterile dressing changes, and client education require licensed nursing judgment.
4. A PN notices a coworker removing medications from the automated
dispensing cabinet for a client who was discharged. What should the PN do?
A. Confront the coworker directly in the hallway
B. Assume there is a valid explanation and ignore the behavior
C. Report the observation to the charge nurse immediately
,D. Document the behavior and wait to see if it happens again
E. Ask other coworkers if they have noticed similar behavior
C. Report the observation to the charge nurse immediately
EXPERT RATIONALE: Removing medications for a discharged client is a serious concern
for drug diversion. The PN has a professional and ethical obligation to report this
behavior immediately to protect clients and uphold facility policy.
5. A client tells the PN, "I don't want my daughter to know anything about my
condition." The PN should:
A. Inform the daughter because she is next of kin
B. Document and respect the client's request for confidentiality
C. Ask the physician to speak with the daughter
D. Share only basic information to keep the family informed
E. Tell the daughter the client is not ready to discuss it
B. Document and respect the client's request for confidentiality
EXPERT RATIONALE: HIPAA protects clients' rights to privacy and confidentiality. Unless
the client provides consent, no health information should be shared with family
members, regardless of their relationship to the client.
6. The PN is preparing to administer insulin. Which action best demonstrates
safe medication practice?
A. Prepare the insulin at the nurses' station without checking the MAR
B. Ask a colleague to verify the dose and have two nurses sign off
C. Compare the medication label to the MAR three times during preparation
D. Draw up the insulin from memory based on previous doses given
E. Administer the dose and document it after the shift ends
, C. Compare the medication label to the MAR three times during
preparation
EXPERT RATIONALE: The triple-check method — checking the label when retrieving,
preparing, and prior to administration — is a standard safe medication practice to
reduce errors, especially with high-alert medications like insulin.
7. A PN is caring for a postoperative client who reports pain of 8/10. The PN
reviews the MAR and notes the client is due for a PRN analgesic. What is the
priority action?
A. Reposition the client and reassess in 30 minutes
B. Notify the charge nurse before administering anything
C. Administer the PRN analgesic as ordered and reassess
D. Apply a cold pack to the incision site first
E. Document the pain score and continue the current care plan
C. Administer the PRN analgesic as ordered and reassess
EXPERT RATIONALE: The client has a valid PRN order and is reporting significant pain.
The PN should administer the medication within the scope of practice and reassess
effectiveness after an appropriate interval.
8. Which leadership style is most effective in an emergency situation
requiring immediate action?
A. Democratic leadership
B. Laissez-faire leadership
C. Transformational leadership
D. Autocratic leadership
E. Servant leadership
