HESI LEADERSHIP/MANAGEMENT NEW
COMPREHENSIVE
ACTUAL EXAM PRACTICE QUESTION WITH
ANSWERS RATIONALE A LEVEL EXAM LATEST
UPDATE
HESI Leadership/Management
11. The nurse is preparing to discharge a client. Which task can be delegated to the LPN?
A. Teaching the client about new medications
B. Evaluating the client's understanding of discharge instructions
C. Reinforcing teaching previously provided by the RN
D. Completing the discharge summary
Answer: C
*Rationale: * LPNs can reinforce teaching provided by the RN. Initial teaching (A), evaluation
of learning (B), and discharge summary (D) are RN responsibilities .
12. The nurse is caring for four clients. Which client requires the most frequent assessments?
A. A client with pneumonia who is stable on day 3 of antibiotics
B. A client with a new tracheostomy who is 2 hours post-operative
C. A client with a urinary tract infection receiving oral antibiotics
D. A client with hypertension with stable blood pressures
Answer: B
*Rationale: * The client with a new tracheostomy is at risk for airway compromise and bleeding
and requires frequent assessments. Stable pneumonia (A) and UTI (C) clients are less acute .
,13. The charge nurse is making assignments. Which client should be assigned to a float nurse
from a medical-surgical unit? A. A client on a ventilator in the ICU
B. A client with stable angina on telemetry
C. A client requiring continuous cardiac monitoring after a myocardial infarction D. A client
with unstable ventricular tachycardia
Answer: B
*Rationale: * A float nurse from med-surg can care for a stable client with angina on telemetry.
ICU clients (A, D) require critical care expertise. Unstable cardiac clients (C, D) need
specialized cardiac nurses .
14. The nurse observes a UAP taking a blood pressure on the same arm where a client has an
IV infusion running. What should the nurse do? A. Ignore the action since the UAP is
experienced
B. Immediately correct the UAP and explain the reason
C. Report the UAP to the nurse manager
D. Document the incident in the UAP's file
Answer: B
*Rationale: * Taking BP on an arm with an IV can cause inaccurate readings and may dislodge
the IV or cause infiltration. The nurse should immediately correct the UAP and provide
education. Reporting (C) is not necessary for a first incident if corrected .
15. The nurse is prioritizing interventions for a client with chest pain. Which intervention should
the nurse perform first?
A. Start an IV line
B. Administer oxygen
C. Obtain a 12-lead ECG
D. Administer nitroglycerin
,Answer: B
*Rationale: * Airway and breathing are priority. Administering oxygen to maximize oxygenation
is the first step. ECG (C) and nitroglycerin (D) are important but follow oxygen administration .
16. The nurse is caring for a group of clients. Which client should the nurse assess after receiving
a change-of-shift report?
A. A client who is post-operative day 2 and reports mild nausea
B. A client with a fever who received an antibiotic 2 hours ago
C. A client who is 2 hours post-cardiac catheterization with a stable groin site
D. A client who is requesting pain medication for a headache
Answer: B
*Rationale: * The client who received an antibiotic for fever should be assessed for response to
therapy and possible allergic reaction. This takes priority over stable post-op clients (A, C) and
pain requests (D) .
17. The nurse is making assignments for a team that includes an RN, an LPN, and a UAP.
Which client is most appropriate for the UAP to assist with activities of daily living?
A. A client with unstable angina on bed rest
B. A client requiring a sterile dressing change
C. A stable client needing a bed bath
D. A client with new-onset confusion
Answer: C
*Rationale: * A stable client needing a bed bath is appropriate for UAP assistance. Unstable
angina (A), sterile procedures (B), and confused clients (D) require nursing assessment and
intervention .
18. The nurse is caring for a client who suddenly becomes unresponsive and pulseless.
What should the nurse do first?
A. Call a code and begin chest compressions
, B. Check the client's blood pressure
C. Notify the healthcare provider
D. Obtain the crash cart
Answer: A
*Rationale: * In cardiac arrest, the priority is to call for help and begin chest compressions
immediately. Obtaining the crash cart (D) is important but does not precede starting CPR .
19. The nurse is prioritizing care for four clients. Which client should the nurse see first?
A. A client with a blood glucose of 350 mg/dL who is alert
B. A client with an oxygen saturation of 91% on room air
C. A client with a potassium level of 6.5 mEq/L
D. A client with a wound that has purulent drainage
Answer: C
*Rationale: * *A potassium level of 6.5 is critically high (severe hyperkalemia) and can cause
life-threatening cardiac dysrhythmias. This requires immediate intervention. Hypoxemia (B) is
concerning but 91% is not critical. Hyperglycemia (A) and wound drainage (D) are important but
not immediately life-threatening .*
20. The nurse is making assignments. Which client should be assigned to the most experienced
nurse?
A. A client with pneumonia requiring IV antibiotics every 6 hours
B. A client with heart failure who is unstable and requires titration of multiple IV medications
C. A client with a urinary tract infection receiving oral antibiotics
D. A client with a fractured hip awaiting surgery
Answer: B
*Rationale: * The unstable client with heart failure requiring complex medication titration has
the highest acuity and needs the most experienced nurse. Stable clients (A, C, D) can be assigned
to less experienced nurses .
COMPREHENSIVE
ACTUAL EXAM PRACTICE QUESTION WITH
ANSWERS RATIONALE A LEVEL EXAM LATEST
UPDATE
HESI Leadership/Management
11. The nurse is preparing to discharge a client. Which task can be delegated to the LPN?
A. Teaching the client about new medications
B. Evaluating the client's understanding of discharge instructions
C. Reinforcing teaching previously provided by the RN
D. Completing the discharge summary
Answer: C
*Rationale: * LPNs can reinforce teaching provided by the RN. Initial teaching (A), evaluation
of learning (B), and discharge summary (D) are RN responsibilities .
12. The nurse is caring for four clients. Which client requires the most frequent assessments?
A. A client with pneumonia who is stable on day 3 of antibiotics
B. A client with a new tracheostomy who is 2 hours post-operative
C. A client with a urinary tract infection receiving oral antibiotics
D. A client with hypertension with stable blood pressures
Answer: B
*Rationale: * The client with a new tracheostomy is at risk for airway compromise and bleeding
and requires frequent assessments. Stable pneumonia (A) and UTI (C) clients are less acute .
,13. The charge nurse is making assignments. Which client should be assigned to a float nurse
from a medical-surgical unit? A. A client on a ventilator in the ICU
B. A client with stable angina on telemetry
C. A client requiring continuous cardiac monitoring after a myocardial infarction D. A client
with unstable ventricular tachycardia
Answer: B
*Rationale: * A float nurse from med-surg can care for a stable client with angina on telemetry.
ICU clients (A, D) require critical care expertise. Unstable cardiac clients (C, D) need
specialized cardiac nurses .
14. The nurse observes a UAP taking a blood pressure on the same arm where a client has an
IV infusion running. What should the nurse do? A. Ignore the action since the UAP is
experienced
B. Immediately correct the UAP and explain the reason
C. Report the UAP to the nurse manager
D. Document the incident in the UAP's file
Answer: B
*Rationale: * Taking BP on an arm with an IV can cause inaccurate readings and may dislodge
the IV or cause infiltration. The nurse should immediately correct the UAP and provide
education. Reporting (C) is not necessary for a first incident if corrected .
15. The nurse is prioritizing interventions for a client with chest pain. Which intervention should
the nurse perform first?
A. Start an IV line
B. Administer oxygen
C. Obtain a 12-lead ECG
D. Administer nitroglycerin
,Answer: B
*Rationale: * Airway and breathing are priority. Administering oxygen to maximize oxygenation
is the first step. ECG (C) and nitroglycerin (D) are important but follow oxygen administration .
16. The nurse is caring for a group of clients. Which client should the nurse assess after receiving
a change-of-shift report?
A. A client who is post-operative day 2 and reports mild nausea
B. A client with a fever who received an antibiotic 2 hours ago
C. A client who is 2 hours post-cardiac catheterization with a stable groin site
D. A client who is requesting pain medication for a headache
Answer: B
*Rationale: * The client who received an antibiotic for fever should be assessed for response to
therapy and possible allergic reaction. This takes priority over stable post-op clients (A, C) and
pain requests (D) .
17. The nurse is making assignments for a team that includes an RN, an LPN, and a UAP.
Which client is most appropriate for the UAP to assist with activities of daily living?
A. A client with unstable angina on bed rest
B. A client requiring a sterile dressing change
C. A stable client needing a bed bath
D. A client with new-onset confusion
Answer: C
*Rationale: * A stable client needing a bed bath is appropriate for UAP assistance. Unstable
angina (A), sterile procedures (B), and confused clients (D) require nursing assessment and
intervention .
18. The nurse is caring for a client who suddenly becomes unresponsive and pulseless.
What should the nurse do first?
A. Call a code and begin chest compressions
, B. Check the client's blood pressure
C. Notify the healthcare provider
D. Obtain the crash cart
Answer: A
*Rationale: * In cardiac arrest, the priority is to call for help and begin chest compressions
immediately. Obtaining the crash cart (D) is important but does not precede starting CPR .
19. The nurse is prioritizing care for four clients. Which client should the nurse see first?
A. A client with a blood glucose of 350 mg/dL who is alert
B. A client with an oxygen saturation of 91% on room air
C. A client with a potassium level of 6.5 mEq/L
D. A client with a wound that has purulent drainage
Answer: C
*Rationale: * *A potassium level of 6.5 is critically high (severe hyperkalemia) and can cause
life-threatening cardiac dysrhythmias. This requires immediate intervention. Hypoxemia (B) is
concerning but 91% is not critical. Hyperglycemia (A) and wound drainage (D) are important but
not immediately life-threatening .*
20. The nurse is making assignments. Which client should be assigned to the most experienced
nurse?
A. A client with pneumonia requiring IV antibiotics every 6 hours
B. A client with heart failure who is unstable and requires titration of multiple IV medications
C. A client with a urinary tract infection receiving oral antibiotics
D. A client with a fractured hip awaiting surgery
Answer: B
*Rationale: * The unstable client with heart failure requiring complex medication titration has
the highest acuity and needs the most experienced nurse. Stable clients (A, C, D) can be assigned
to less experienced nurses .
