HESI Leadership & Management Exam V3
| 2026 Q&A with Rationale (HESI
Leadership & Management Exam 2026)
1. A nurse manager is planning to implement a new electronic health record system. Which
action should the nurse take first according to Lewin’s Change Theory?
A. Provide training sessions for all nursing staff on the new system.
B. Schedule a go-live date for the new documentation process.
C. Identify the staff’s perceptions and resistance to the change.
D. Evaluate the effectiveness of the system after one month of use.
Correct Answer: C
Rationale: The first stage of Lewin’s Change Theory is ‘unfreezing,’ which involves creating
readiness for change by identifying problems and assessment of resistance. Identifying
perceptions allows the leader to address concerns before moving forward. Skipping this
step often leads to failed implementation because the staff is not psychologically prepared
for the transition.
2. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an unlicensed
assistive personnel (UAP). Which task is most appropriate for the LPN?
A. Administering an intravenous bolus of morphine for acute pain.
B. Updating the comprehensive care plan for a newly admitted client.
,C. Assisting a client with a history of stroke to use a walker for the first time.
D. Performing a sterile dressing change on a stable post-operative wound.
Correct Answer: D
Rationale: LPNs are trained to perform sterile procedures and care for stable clients with
predictable outcomes. Administering IV push medications is typically reserved for RNs, and
initial ambulation or care plan development requires the advanced assessment skills of an
RN. Delegating a sterile dressing change to an LPN is an efficient and safe use of nursing
resources.
3. Which client should the nurse prioritize for assessment after receiving the morning shift
report?
A. A client receiving a blood transfusion who has developed a new onset of lumbar pain.
B. A client who is two days post-operative and reporting a pain level of 6 out of 10.
C. A client with chronic obstructive pulmonary disease (COPD) with an SpO2 of 90%.
D. A client with diabetes mellitus whose fasting blood glucose is 140 mg/dL.
Correct Answer: A
Rationale: New onset of lumbar or back pain during a blood transfusion is a classic sign of
a hemolytic reaction, which is a life-threatening emergency. The nurse must stop the
transfusion immediately and assess the client. The other clients show expected findings for
their conditions or are stable enough to wait for a brief period.
, 4. A nurse is caring for a client who is scheduled for surgery. The client expresses doubt and
states, ‘I am not sure I want to go through with this.’ Which action should the nurse take?
A. Reassure the client that the surgeon is highly skilled and successful.
B. Inform the surgeon that the client is requesting more information about the procedure.
C. Ask the client’s family to help convince the client to proceed.
D. Proceed with the pre-operative checklist as the consent form is already signed.
Correct Answer: B
Rationale: The nurse’s role in informed consent is to witness the signature and ensure the
client understands the process; however, if the client expresses doubt, the surgeon must be
notified to provide further clarification. It is the surgeon’s legal responsibility to explain the
risks, benefits, and alternatives. The nurse acts as a client advocate by ensuring the client is
fully informed before surgery.
5. A nurse manager observes a staff nurse failing to follow hospital policy regarding needle
disposal. What is the most effective initial approach to address this conflict?
A. Report the incident to the Director of Nursing immediately.
B. Discuss the observation privately with the nurse to understand the reasoning.
C. Post a notice in the breakroom reminding everyone of the policy.
D. Ignore the first incident but monitor the nurse’s behavior closely.
Correct Answer: B
| 2026 Q&A with Rationale (HESI
Leadership & Management Exam 2026)
1. A nurse manager is planning to implement a new electronic health record system. Which
action should the nurse take first according to Lewin’s Change Theory?
A. Provide training sessions for all nursing staff on the new system.
B. Schedule a go-live date for the new documentation process.
C. Identify the staff’s perceptions and resistance to the change.
D. Evaluate the effectiveness of the system after one month of use.
Correct Answer: C
Rationale: The first stage of Lewin’s Change Theory is ‘unfreezing,’ which involves creating
readiness for change by identifying problems and assessment of resistance. Identifying
perceptions allows the leader to address concerns before moving forward. Skipping this
step often leads to failed implementation because the staff is not psychologically prepared
for the transition.
2. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an unlicensed
assistive personnel (UAP). Which task is most appropriate for the LPN?
A. Administering an intravenous bolus of morphine for acute pain.
B. Updating the comprehensive care plan for a newly admitted client.
,C. Assisting a client with a history of stroke to use a walker for the first time.
D. Performing a sterile dressing change on a stable post-operative wound.
Correct Answer: D
Rationale: LPNs are trained to perform sterile procedures and care for stable clients with
predictable outcomes. Administering IV push medications is typically reserved for RNs, and
initial ambulation or care plan development requires the advanced assessment skills of an
RN. Delegating a sterile dressing change to an LPN is an efficient and safe use of nursing
resources.
3. Which client should the nurse prioritize for assessment after receiving the morning shift
report?
A. A client receiving a blood transfusion who has developed a new onset of lumbar pain.
B. A client who is two days post-operative and reporting a pain level of 6 out of 10.
C. A client with chronic obstructive pulmonary disease (COPD) with an SpO2 of 90%.
D. A client with diabetes mellitus whose fasting blood glucose is 140 mg/dL.
Correct Answer: A
Rationale: New onset of lumbar or back pain during a blood transfusion is a classic sign of
a hemolytic reaction, which is a life-threatening emergency. The nurse must stop the
transfusion immediately and assess the client. The other clients show expected findings for
their conditions or are stable enough to wait for a brief period.
, 4. A nurse is caring for a client who is scheduled for surgery. The client expresses doubt and
states, ‘I am not sure I want to go through with this.’ Which action should the nurse take?
A. Reassure the client that the surgeon is highly skilled and successful.
B. Inform the surgeon that the client is requesting more information about the procedure.
C. Ask the client’s family to help convince the client to proceed.
D. Proceed with the pre-operative checklist as the consent form is already signed.
Correct Answer: B
Rationale: The nurse’s role in informed consent is to witness the signature and ensure the
client understands the process; however, if the client expresses doubt, the surgeon must be
notified to provide further clarification. It is the surgeon’s legal responsibility to explain the
risks, benefits, and alternatives. The nurse acts as a client advocate by ensuring the client is
fully informed before surgery.
5. A nurse manager observes a staff nurse failing to follow hospital policy regarding needle
disposal. What is the most effective initial approach to address this conflict?
A. Report the incident to the Director of Nursing immediately.
B. Discuss the observation privately with the nurse to understand the reasoning.
C. Post a notice in the breakroom reminding everyone of the policy.
D. Ignore the first incident but monitor the nurse’s behavior closely.
Correct Answer: B
