HESI Leadership & Management Exam V2
| 2026 Q&A with Rationale (HESI
Leadership & Management Exam 2026)
1. A charge nurse is delegating tasks to a Licensed Practical Nurse (LPN) and an Unlicensed
Assistive Personnel (UAP). Which task is most appropriate for the charge nurse to assign to
the LPN?
A. Initial assessment of a patient newly admitted with chest pain.
B. Administering an intravenous bolus of a high-alert medication.
C. Performing a dressing change on a stable patient with a stage II pressure ulcer.
D. Creating a comprehensive discharge teaching plan for a patient with diabetes.
Correct Answer: C
Rationale: The LPN scope of practice includes performing tasks such as wound care and
dressing changes for stable patients. Initial assessments and complex teaching plans are
responsibilities of the Registered Nurse (RN) because they require clinical judgment. High-
alert IV medications typically fall outside the LPN scope of practice in many jurisdictions or
require RN supervision.
2. A nurse manager is implementing a new electronic health record system using Lewin’s
change theory. During the ‘unfreezing’ stage, which action should the manager take?
A. Provide technical training sessions for all staff members.
,B. Integrate the new system into daily routine policies.
C. Create a sense of urgency by explaining the need for the change.
D. Offer rewards to staff who adopt the system quickly.
Correct Answer: C
Rationale: The unfreezing stage involves preparing the organization for change by
increasing the awareness of the need for it. Creating a sense of urgency helps staff
understand why the status quo is no longer viable. Training occurs during the moving
phase, while rewards and integration are part of the refreezing phase.
3. After a medication error occurs, the nurse manager performs a root cause analysis (RCA).
What is the primary purpose of this process?
A. To identify system failures that contributed to the error.
B. To discipline the nurse who administered the wrong dose.
C. To identify which individual staff member is at fault.
D. To report the facility to the state board of nursing.
Correct Answer: A
Rationale: Root cause analysis is a proactive process designed to look at the underlying
systems and processes that allow errors to happen. It moves away from a culture of blame
and focuses on patient safety improvements. By identifying systemic issues, the
organization can implement changes to prevent recurrence.
, 4. A nurse is caring for four patients on a medical-surgical unit. Which patient should the
nurse assess first?
A. A patient with a blood pressure of 148/92 mmHg awaiting discharge.
B. A patient reporting 6/10 pain who received morphine 30 minutes ago.
C. A patient with a pulse oximetry reading of 94% on room air.
D. A patient with a chest tube who is suddenly experiencing shortness of breath.
Correct Answer: D
Rationale: The nurse must prioritize using the ABC (Airway, Breathing, Circulation)
framework. Sudden shortness of breath in a patient with a chest tube indicates a potential
life-threatening complication such as a tension pneumothorax. The other patients are
relatively stable or have non-emergent needs at this moment.
5. A nurse manager notices conflict between two staff nurses regarding the holiday schedule.
The manager tells them, ‘You both must find a way to work it out yourselves.’ Which conflict
management style is the manager using?
A. Collaboration
B. Compromise
C. Accommodation
D. Avoidance
Correct Answer: D
| 2026 Q&A with Rationale (HESI
Leadership & Management Exam 2026)
1. A charge nurse is delegating tasks to a Licensed Practical Nurse (LPN) and an Unlicensed
Assistive Personnel (UAP). Which task is most appropriate for the charge nurse to assign to
the LPN?
A. Initial assessment of a patient newly admitted with chest pain.
B. Administering an intravenous bolus of a high-alert medication.
C. Performing a dressing change on a stable patient with a stage II pressure ulcer.
D. Creating a comprehensive discharge teaching plan for a patient with diabetes.
Correct Answer: C
Rationale: The LPN scope of practice includes performing tasks such as wound care and
dressing changes for stable patients. Initial assessments and complex teaching plans are
responsibilities of the Registered Nurse (RN) because they require clinical judgment. High-
alert IV medications typically fall outside the LPN scope of practice in many jurisdictions or
require RN supervision.
2. A nurse manager is implementing a new electronic health record system using Lewin’s
change theory. During the ‘unfreezing’ stage, which action should the manager take?
A. Provide technical training sessions for all staff members.
,B. Integrate the new system into daily routine policies.
C. Create a sense of urgency by explaining the need for the change.
D. Offer rewards to staff who adopt the system quickly.
Correct Answer: C
Rationale: The unfreezing stage involves preparing the organization for change by
increasing the awareness of the need for it. Creating a sense of urgency helps staff
understand why the status quo is no longer viable. Training occurs during the moving
phase, while rewards and integration are part of the refreezing phase.
3. After a medication error occurs, the nurse manager performs a root cause analysis (RCA).
What is the primary purpose of this process?
A. To identify system failures that contributed to the error.
B. To discipline the nurse who administered the wrong dose.
C. To identify which individual staff member is at fault.
D. To report the facility to the state board of nursing.
Correct Answer: A
Rationale: Root cause analysis is a proactive process designed to look at the underlying
systems and processes that allow errors to happen. It moves away from a culture of blame
and focuses on patient safety improvements. By identifying systemic issues, the
organization can implement changes to prevent recurrence.
, 4. A nurse is caring for four patients on a medical-surgical unit. Which patient should the
nurse assess first?
A. A patient with a blood pressure of 148/92 mmHg awaiting discharge.
B. A patient reporting 6/10 pain who received morphine 30 minutes ago.
C. A patient with a pulse oximetry reading of 94% on room air.
D. A patient with a chest tube who is suddenly experiencing shortness of breath.
Correct Answer: D
Rationale: The nurse must prioritize using the ABC (Airway, Breathing, Circulation)
framework. Sudden shortness of breath in a patient with a chest tube indicates a potential
life-threatening complication such as a tension pneumothorax. The other patients are
relatively stable or have non-emergent needs at this moment.
5. A nurse manager notices conflict between two staff nurses regarding the holiday schedule.
The manager tells them, ‘You both must find a way to work it out yourselves.’ Which conflict
management style is the manager using?
A. Collaboration
B. Compromise
C. Accommodation
D. Avoidance
Correct Answer: D
