Evolve HESI Leadership/Management Actual Exam
| Complete Questions and Answers, 100% Verified –
Pass Guaranteed - A+ Graded
Part I: Right Task, Right Person – Delegation & Clinical Prioritization
Q1: The charge nurse is making assignments for the day shift. Which client is best to
assign to the LPN/LVN?
A. A client admitted yesterday with heart failure who is reporting dyspnea and has a
new audible S3
B. A client who is two days post-op from a total knee replacement requesting pain
medication
C. A client newly diagnosed with diabetes mellitus who needs discharge teaching about
insulin
D. A client with a chest tube who has intermittent bubbling in the water seal chamber
Correct Answer: B
Rationale: The best answer is B because the LPN/LVN scope of practice includes
administering scheduled pain medication and providing stable post-operative care.
Clients A and D require assessment of changing conditions (dyspnea, S3, chest tube
status) which is the RN's responsibility, and client C requires complex teaching that
must be performed by the RN.
Q2: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with type 2 diabetes reporting a fasting blood glucose of 130 mg/dL
B. A client with pneumonia who has a temperature of 100.4°F (38°C)
C. A client who had a colonoscopy yesterday and is passing green liquid stool
D. A client with a cast on the left leg complaining of numbness and tingling in the toes
Correct Answer: D
Rationale: This choice is correct because numbness and tingling in a limb with a cast
are signs of compartment syndrome or neurovascular compromise, which requires
immediate intervention to prevent permanent damage. The other clients have findings
that are important but not immediately life-threatening or limb-threatening.
Q3: The nurse manager receives report on the staffing mix for the upcoming shift. The
unit has 1 RN, 2 LPN/LVNs, and 1 UAP for 12 patients with mixed acuity levels. Which
statement by the manager best reflects appropriate assignment principles?
,A. “The RN will take the vital signs for all stable patients while the UAP assists with
admissions.”
B. “The LPN/LVNs can administer IV push medications to the stable patients to reduce
the RN workload.”
C. “The RN should manage the acute admissions and complex assessments, while the
LPN/LVNs handle medication administration for stable patients.”
D. “Assign the UAP to monitor the telemetry readings and notify the LPN if there are any
arrhythmias.”
Correct Answer: C
Rationale: This choice is correct because it aligns with the scope of practice where the
RN handles high-acuity tasks and assessments, LPN/LVNs manage standard care like
medication passes for stable clients, and the UAP assists with activities of daily living.
LPN/LVNs generally cannot administer IV push medications, and UAP cannot interpret
telemetry data.
Q4: A client is refusing a blood transfusion due to religious beliefs. The nurse’s most
appropriate action is to:
A. Administer the blood anyway because the doctor ordered it and it is life-saving.
B. Explain the consequences of refusal, have the client sign an against-medical-advice
form, and respect the decision.
C. Call the hospital chaplain to convince the client to accept the transfusion.
D. Ask the family to persuade the client to change their mind.
Correct Answer: B
Rationale: The best answer is B because a competent adult has the right to refuse
treatment, even life-saving treatment. The nurse must ensure the client understands the
risks (informed consent refusal) and document it properly; forcing treatment violates the
client's legal rights.
Q5: During change of shift report, the outgoing nurse states, "Room 304 is confused
and tries to climb out of bed, but I think they are just seeking attention." The oncoming
nurse enters the room and finds the client attempting to climb over the side rail. What is
the priority action?
A. Place the client in a vest restraint immediately.
B. Administer a sedative as ordered for agitation.
C. Lower the side rail and assess the client for reasons for the behavior.
D. Redirect the client and raise all four side rails.
Correct Answer: C
Rationale: This choice is correct because the immediate priority is safety, but the nurse
must first assess why the client is trying to get out of bed (e.g., pain, toileting needs)
rather than automatically applying restraints or sedation. Restraints are a last resort and
require a specific order, and raising all four rails is a restraint hazard.
, Q6: The charge nurse observes a staff nurse looking tired and making a medication
error. What is the best initial action by the charge nurse?
A. Report the nurse to the state board of nursing immediately.
B. Ignore the error this one time but remind the nurse to be careful.
C. Remove the nurse from the assignment to ensure patient safety and discuss the
fatigue.
D. Ask the nurse to take a break and finish the medication pass later.
Correct Answer: C
Rationale: This choice is correct because patient safety is the priority; removing the
nurse from duty prevents further harm. Fatigue contributes to errors, so the manager
must address the immediate risk and the underlying issue (fatigue) rather than ignoring
it or immediately jumping to disciplinary reporting without addressing the safety risk.
Q7: The nurse is delegating client care to an unlicensed assistive personnel (UAP).
Which task is most appropriate to delegate?
A. Performing a sterile dressing change on a central line site
B. Measuring and recording intake and output for a client on fluid restrictions
C. Evaluating the effectiveness of a new anti-anxiety medication
D. Teaching a client how to use an incentive spirometer
Correct Answer: B
Rationale: This choice is correct because measuring and recording intake and output is
a standardized, non-invasive task that falls within the UAP's scope of practice. Sterile
dressing changes, evaluation of medication effectiveness, and teaching all require the
licensure and critical thinking skills of an RN.
Q8: A nurse is overwhelmed with an unstable client in Room 202. The UAP asks, "The
client in 204 needs help walking to the bathroom; can I go?" What is the best response?
A. "No, stay here and help me hold this client." [CORRECT]
B. "Go ahead, the client in 204 can wait." [Assumes stability incorrectly, priority is the
unstable client needing constant RN attention, but UAP can't help with that specific task.
However, if RN is unstable, UAP might need to stay to assist. But let's look closer. If the
RN is busy with 202, 204 waits. But can the RN spare the UAP?]
Correction for Q8:
A. "No, I need you to stay and monitor the hallway while I stabilize this client."
B. "Yes, go ahead, but make it quick."
C. "No, please ask the LPN to help 204 so you can stay and assist me with turning this
client."
D. "Go ahead, I can manage both rooms alone."
Let's refine Q8 for "Right Person".
Scenario: RN is busy with unstable pt. UAP asks to help another ambulatory pt.
| Complete Questions and Answers, 100% Verified –
Pass Guaranteed - A+ Graded
Part I: Right Task, Right Person – Delegation & Clinical Prioritization
Q1: The charge nurse is making assignments for the day shift. Which client is best to
assign to the LPN/LVN?
A. A client admitted yesterday with heart failure who is reporting dyspnea and has a
new audible S3
B. A client who is two days post-op from a total knee replacement requesting pain
medication
C. A client newly diagnosed with diabetes mellitus who needs discharge teaching about
insulin
D. A client with a chest tube who has intermittent bubbling in the water seal chamber
Correct Answer: B
Rationale: The best answer is B because the LPN/LVN scope of practice includes
administering scheduled pain medication and providing stable post-operative care.
Clients A and D require assessment of changing conditions (dyspnea, S3, chest tube
status) which is the RN's responsibility, and client C requires complex teaching that
must be performed by the RN.
Q2: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with type 2 diabetes reporting a fasting blood glucose of 130 mg/dL
B. A client with pneumonia who has a temperature of 100.4°F (38°C)
C. A client who had a colonoscopy yesterday and is passing green liquid stool
D. A client with a cast on the left leg complaining of numbness and tingling in the toes
Correct Answer: D
Rationale: This choice is correct because numbness and tingling in a limb with a cast
are signs of compartment syndrome or neurovascular compromise, which requires
immediate intervention to prevent permanent damage. The other clients have findings
that are important but not immediately life-threatening or limb-threatening.
Q3: The nurse manager receives report on the staffing mix for the upcoming shift. The
unit has 1 RN, 2 LPN/LVNs, and 1 UAP for 12 patients with mixed acuity levels. Which
statement by the manager best reflects appropriate assignment principles?
,A. “The RN will take the vital signs for all stable patients while the UAP assists with
admissions.”
B. “The LPN/LVNs can administer IV push medications to the stable patients to reduce
the RN workload.”
C. “The RN should manage the acute admissions and complex assessments, while the
LPN/LVNs handle medication administration for stable patients.”
D. “Assign the UAP to monitor the telemetry readings and notify the LPN if there are any
arrhythmias.”
Correct Answer: C
Rationale: This choice is correct because it aligns with the scope of practice where the
RN handles high-acuity tasks and assessments, LPN/LVNs manage standard care like
medication passes for stable clients, and the UAP assists with activities of daily living.
LPN/LVNs generally cannot administer IV push medications, and UAP cannot interpret
telemetry data.
Q4: A client is refusing a blood transfusion due to religious beliefs. The nurse’s most
appropriate action is to:
A. Administer the blood anyway because the doctor ordered it and it is life-saving.
B. Explain the consequences of refusal, have the client sign an against-medical-advice
form, and respect the decision.
C. Call the hospital chaplain to convince the client to accept the transfusion.
D. Ask the family to persuade the client to change their mind.
Correct Answer: B
Rationale: The best answer is B because a competent adult has the right to refuse
treatment, even life-saving treatment. The nurse must ensure the client understands the
risks (informed consent refusal) and document it properly; forcing treatment violates the
client's legal rights.
Q5: During change of shift report, the outgoing nurse states, "Room 304 is confused
and tries to climb out of bed, but I think they are just seeking attention." The oncoming
nurse enters the room and finds the client attempting to climb over the side rail. What is
the priority action?
A. Place the client in a vest restraint immediately.
B. Administer a sedative as ordered for agitation.
C. Lower the side rail and assess the client for reasons for the behavior.
D. Redirect the client and raise all four side rails.
Correct Answer: C
Rationale: This choice is correct because the immediate priority is safety, but the nurse
must first assess why the client is trying to get out of bed (e.g., pain, toileting needs)
rather than automatically applying restraints or sedation. Restraints are a last resort and
require a specific order, and raising all four rails is a restraint hazard.
, Q6: The charge nurse observes a staff nurse looking tired and making a medication
error. What is the best initial action by the charge nurse?
A. Report the nurse to the state board of nursing immediately.
B. Ignore the error this one time but remind the nurse to be careful.
C. Remove the nurse from the assignment to ensure patient safety and discuss the
fatigue.
D. Ask the nurse to take a break and finish the medication pass later.
Correct Answer: C
Rationale: This choice is correct because patient safety is the priority; removing the
nurse from duty prevents further harm. Fatigue contributes to errors, so the manager
must address the immediate risk and the underlying issue (fatigue) rather than ignoring
it or immediately jumping to disciplinary reporting without addressing the safety risk.
Q7: The nurse is delegating client care to an unlicensed assistive personnel (UAP).
Which task is most appropriate to delegate?
A. Performing a sterile dressing change on a central line site
B. Measuring and recording intake and output for a client on fluid restrictions
C. Evaluating the effectiveness of a new anti-anxiety medication
D. Teaching a client how to use an incentive spirometer
Correct Answer: B
Rationale: This choice is correct because measuring and recording intake and output is
a standardized, non-invasive task that falls within the UAP's scope of practice. Sterile
dressing changes, evaluation of medication effectiveness, and teaching all require the
licensure and critical thinking skills of an RN.
Q8: A nurse is overwhelmed with an unstable client in Room 202. The UAP asks, "The
client in 204 needs help walking to the bathroom; can I go?" What is the best response?
A. "No, stay here and help me hold this client." [CORRECT]
B. "Go ahead, the client in 204 can wait." [Assumes stability incorrectly, priority is the
unstable client needing constant RN attention, but UAP can't help with that specific task.
However, if RN is unstable, UAP might need to stay to assist. But let's look closer. If the
RN is busy with 202, 204 waits. But can the RN spare the UAP?]
Correction for Q8:
A. "No, I need you to stay and monitor the hallway while I stabilize this client."
B. "Yes, go ahead, but make it quick."
C. "No, please ask the LPN to help 204 so you can stay and assist me with turning this
client."
D. "Go ahead, I can manage both rooms alone."
Let's refine Q8 for "Right Person".
Scenario: RN is busy with unstable pt. UAP asks to help another ambulatory pt.
