HESI Leadership & Management Exam V1
| 2026 Q&A with Rationale (HESI
Leadership & Management Exam 2026)
1. A nurse manager is observing a staff nurse who is consistently late to work. Which action
should the nurse manager take first to address this behavior?
A. Issue a formal written warning to the nurse.
B. Report the nurse’s behavior to the human resources department.
C. Schedule a private meeting to discuss the attendance issue.
D. Wait for a pattern of three absences before taking action.
Correct Answer: C
Rationale: The first step in managing staff performance issues is to communicate directly
with the individual to identify potential causes and set expectations. Scheduling a private
meeting allows for open communication and ensures the nurse is aware of the policy and
the impact of their behavior. Formal warnings or reporting to HR usually occur after initial
verbal interventions have failed.
2. A charge nurse on a medical-surgical unit is assigning tasks for the shift. Which task is most
appropriate to delegate to an Unlicensed Assistive Personnel (UAP)?
A. Recording intake and output for a patient with heart failure.
B. Updating the care plan for a patient with new-onset diabetes.
,C. Assisting a stable patient with a simple dressing change.
D. Evaluating the effectiveness of pain medication for a post-operative patient.
Correct Answer: A
Rationale: Recording intake and output is a routine, non-invasive task that does not
require clinical judgment and falls within the scope of a UAP. Evaluating medication or
updating care plans requires the assessment and planning skills of a registered nurse.
Simple dressing changes may be delegated to an LPN/LVN, but the UAP should focus on
basic ADLs and data collection.
3. A nurse manager is implementing a new bedside reporting policy. According to Lewin’s
Change Theory, which action represents the ‘Unfreezing’ stage?
A. Conducting a meeting to explain the benefits of bedside reporting to current staff.
B. Monitoring staff adherence to the new protocol over the first month.
C. Providing incentives to nurses who perform bedside reports correctly.
D. Updating the hospital’s policy manual to include bedside reporting.
Correct Answer: A
Rationale: Unfreezing involves creating readiness for change by helping staff let go of old
behaviors and understanding the need for something new. Conducting a meeting to explain
benefits helps create a sense of urgency and awareness. Monitoring and updating manuals
are parts of the moving and refreezing stages respectively.
, 4. Which of the following actions by the nurse demonstrates the ethical principle of Justice?
A. Keeping a promise to return to a patient’s room in ten minutes with a warm blanket.
B. Ensuring a patient with no health insurance receives the same quality of care as a patient
with private insurance.
C. Providing a patient with all the information needed to make an informed decision about
surgery.
D. Performing a prescribed procedure correctly to avoid harming the patient.
Correct Answer: B
Rationale: Justice refers to the fair and equitable distribution of resources and treatment
regardless of a patient’s socioeconomic status. Options B, C, and D represent fidelity,
autonomy, and nonmaleficence respectively. Promoting justice ensures that clinical
decisions are not biased by external factors like insurance or social standing.
5. A nurse is caring for a group of patients and receives four new prescriptions. Which
prescription should the nurse implement first?
A. Administering a routine dose of an oral antihypertensive.
B. Collecting a midstream urine specimen for a patient with a suspected UTI.
C. Starting a nebulizer treatment for a patient with audible wheezing and dyspnea.
D. Initiating a referral for a home health evaluation for a patient being discharged
tomorrow.
| 2026 Q&A with Rationale (HESI
Leadership & Management Exam 2026)
1. A nurse manager is observing a staff nurse who is consistently late to work. Which action
should the nurse manager take first to address this behavior?
A. Issue a formal written warning to the nurse.
B. Report the nurse’s behavior to the human resources department.
C. Schedule a private meeting to discuss the attendance issue.
D. Wait for a pattern of three absences before taking action.
Correct Answer: C
Rationale: The first step in managing staff performance issues is to communicate directly
with the individual to identify potential causes and set expectations. Scheduling a private
meeting allows for open communication and ensures the nurse is aware of the policy and
the impact of their behavior. Formal warnings or reporting to HR usually occur after initial
verbal interventions have failed.
2. A charge nurse on a medical-surgical unit is assigning tasks for the shift. Which task is most
appropriate to delegate to an Unlicensed Assistive Personnel (UAP)?
A. Recording intake and output for a patient with heart failure.
B. Updating the care plan for a patient with new-onset diabetes.
,C. Assisting a stable patient with a simple dressing change.
D. Evaluating the effectiveness of pain medication for a post-operative patient.
Correct Answer: A
Rationale: Recording intake and output is a routine, non-invasive task that does not
require clinical judgment and falls within the scope of a UAP. Evaluating medication or
updating care plans requires the assessment and planning skills of a registered nurse.
Simple dressing changes may be delegated to an LPN/LVN, but the UAP should focus on
basic ADLs and data collection.
3. A nurse manager is implementing a new bedside reporting policy. According to Lewin’s
Change Theory, which action represents the ‘Unfreezing’ stage?
A. Conducting a meeting to explain the benefits of bedside reporting to current staff.
B. Monitoring staff adherence to the new protocol over the first month.
C. Providing incentives to nurses who perform bedside reports correctly.
D. Updating the hospital’s policy manual to include bedside reporting.
Correct Answer: A
Rationale: Unfreezing involves creating readiness for change by helping staff let go of old
behaviors and understanding the need for something new. Conducting a meeting to explain
benefits helps create a sense of urgency and awareness. Monitoring and updating manuals
are parts of the moving and refreezing stages respectively.
, 4. Which of the following actions by the nurse demonstrates the ethical principle of Justice?
A. Keeping a promise to return to a patient’s room in ten minutes with a warm blanket.
B. Ensuring a patient with no health insurance receives the same quality of care as a patient
with private insurance.
C. Providing a patient with all the information needed to make an informed decision about
surgery.
D. Performing a prescribed procedure correctly to avoid harming the patient.
Correct Answer: B
Rationale: Justice refers to the fair and equitable distribution of resources and treatment
regardless of a patient’s socioeconomic status. Options B, C, and D represent fidelity,
autonomy, and nonmaleficence respectively. Promoting justice ensures that clinical
decisions are not biased by external factors like insurance or social standing.
5. A nurse is caring for a group of patients and receives four new prescriptions. Which
prescription should the nurse implement first?
A. Administering a routine dose of an oral antihypertensive.
B. Collecting a midstream urine specimen for a patient with a suspected UTI.
C. Starting a nebulizer treatment for a patient with audible wheezing and dyspnea.
D. Initiating a referral for a home health evaluation for a patient being discharged
tomorrow.
