1
HESI Specialty Exam Bank: Delegation & Team
Coordination in High Acuity Units
Table of Contents
Subtopic 1: Principles of Safe Delegation in Critical Care Settings .................................... 2
Subtopic 2: Communication and Feedback in Interdisciplinary Teams .............................. 9
Subtopic 3: Prioritization and Delegation During Patient Deterioration ............................ 17
Subtopic 4: Delegation Ethics, Legal Accountability, and Scope of Practice ..................... 25
Subtopic 5: Leadership Roles, Chain of Command, and Conflict Resolution (Q81–Q100) . 32
, 2
Subtopic 1: Principles of Safe Delegation in Critical Care
Settings
(Questions 1–20)
Question 1
A critical care nurse is assigning tasks during a code blue. Which task is most appropriate
to delegate to a licensed practical nurse (LPN)?
A. Administering IV epinephrine push
B. Recording time and interventions during the code
C. Performing endotracheal intubation
D. Leading the code and making ACLS decisions
Correct Answer: B. Recording time and interventions during the code
Rationale: LPNs can assist with documentation during emergencies but cannot perform
advanced procedures or make clinical decisions.
Question 2
Which action demonstrates effective delegation by the ICU charge nurse?
A. Assigning a new graduate nurse to care for a stable post-op patient
B. Asking a nursing assistant to assess pain levels
C. Delegating a central line dressing change to a CNA
D. Delegating interpretation of ABGs to an LPN
Correct Answer: A. Assigning a new graduate nurse to care for a stable post-op patient
Rationale: New graduate nurses should be assigned stable patients initially. Assessment
and interpretation of ABGs are RN responsibilities.
Question 3
, 3
Which task should not be delegated to an unlicensed assistive personnel (UAP) in a cardiac
step-down unit?
A. Assisting a patient to the restroom
B. Monitoring telemetry strips for arrhythmias
C. Documenting intake and output
D. Helping with feeding
Correct Answer: B. Monitoring telemetry strips for arrhythmias
Rationale: Interpretation of telemetry is outside the scope of a UAP; it requires clinical
judgment by a licensed nurse.
Question 4
Which statement by a nurse reflects understanding of appropriate delegation principles?
A. “I can delegate my nursing judgment.”
B. “I can assign sterile dressing changes to a UAP.”
C. “I am accountable for the outcome of tasks I delegate.”
D. “Delegation means the task becomes their full responsibility.”
Correct Answer: C. “I am accountable for the outcome of tasks I delegate.”
Rationale: The nurse retains accountability even after delegating tasks.
Question 5
A patient in the ICU is on contact precautions. Which task can the RN delegate to a UAP?
A. Administering a rectal suppository
B. Obtaining a urine sample
C. Performing peritoneal dialysis
D. Initiating enteral tube feeding
Correct Answer: B. Obtaining a urine sample
, 4
Rationale: UAPs can collect specimens, including urine samples, as long as the task is
within their training.
Question 6
When assigning care in a high-acuity unit, which task should the RN retain and not
delegate?
A. Assessment of neurological status in a stroke patient
B. Transporting a patient for a CT scan
C. Measuring blood glucose
D. Turning and repositioning
Correct Answer: A. Assessment of neurological status in a stroke patient
Rationale: Patient assessment requires critical thinking and should be performed by an RN.
Question 7
What is the best method for the nurse to ensure a delegated task was completed properly?
A. Reassign the task to another nurse
B. Follow up and evaluate the outcome
C. Ask another team member to check
D. Avoid giving that task again
Correct Answer: B. Follow up and evaluate the outcome
Rationale: The nurse is responsible for ensuring delegated care is completed effectively
and safely.
Question 8
A nurse manager is mentoring a novice nurse about delegation. Which concept should the
manager emphasize?
A. Delegation relieves the RN of all accountability
HESI Specialty Exam Bank: Delegation & Team
Coordination in High Acuity Units
Table of Contents
Subtopic 1: Principles of Safe Delegation in Critical Care Settings .................................... 2
Subtopic 2: Communication and Feedback in Interdisciplinary Teams .............................. 9
Subtopic 3: Prioritization and Delegation During Patient Deterioration ............................ 17
Subtopic 4: Delegation Ethics, Legal Accountability, and Scope of Practice ..................... 25
Subtopic 5: Leadership Roles, Chain of Command, and Conflict Resolution (Q81–Q100) . 32
, 2
Subtopic 1: Principles of Safe Delegation in Critical Care
Settings
(Questions 1–20)
Question 1
A critical care nurse is assigning tasks during a code blue. Which task is most appropriate
to delegate to a licensed practical nurse (LPN)?
A. Administering IV epinephrine push
B. Recording time and interventions during the code
C. Performing endotracheal intubation
D. Leading the code and making ACLS decisions
Correct Answer: B. Recording time and interventions during the code
Rationale: LPNs can assist with documentation during emergencies but cannot perform
advanced procedures or make clinical decisions.
Question 2
Which action demonstrates effective delegation by the ICU charge nurse?
A. Assigning a new graduate nurse to care for a stable post-op patient
B. Asking a nursing assistant to assess pain levels
C. Delegating a central line dressing change to a CNA
D. Delegating interpretation of ABGs to an LPN
Correct Answer: A. Assigning a new graduate nurse to care for a stable post-op patient
Rationale: New graduate nurses should be assigned stable patients initially. Assessment
and interpretation of ABGs are RN responsibilities.
Question 3
, 3
Which task should not be delegated to an unlicensed assistive personnel (UAP) in a cardiac
step-down unit?
A. Assisting a patient to the restroom
B. Monitoring telemetry strips for arrhythmias
C. Documenting intake and output
D. Helping with feeding
Correct Answer: B. Monitoring telemetry strips for arrhythmias
Rationale: Interpretation of telemetry is outside the scope of a UAP; it requires clinical
judgment by a licensed nurse.
Question 4
Which statement by a nurse reflects understanding of appropriate delegation principles?
A. “I can delegate my nursing judgment.”
B. “I can assign sterile dressing changes to a UAP.”
C. “I am accountable for the outcome of tasks I delegate.”
D. “Delegation means the task becomes their full responsibility.”
Correct Answer: C. “I am accountable for the outcome of tasks I delegate.”
Rationale: The nurse retains accountability even after delegating tasks.
Question 5
A patient in the ICU is on contact precautions. Which task can the RN delegate to a UAP?
A. Administering a rectal suppository
B. Obtaining a urine sample
C. Performing peritoneal dialysis
D. Initiating enteral tube feeding
Correct Answer: B. Obtaining a urine sample
, 4
Rationale: UAPs can collect specimens, including urine samples, as long as the task is
within their training.
Question 6
When assigning care in a high-acuity unit, which task should the RN retain and not
delegate?
A. Assessment of neurological status in a stroke patient
B. Transporting a patient for a CT scan
C. Measuring blood glucose
D. Turning and repositioning
Correct Answer: A. Assessment of neurological status in a stroke patient
Rationale: Patient assessment requires critical thinking and should be performed by an RN.
Question 7
What is the best method for the nurse to ensure a delegated task was completed properly?
A. Reassign the task to another nurse
B. Follow up and evaluate the outcome
C. Ask another team member to check
D. Avoid giving that task again
Correct Answer: B. Follow up and evaluate the outcome
Rationale: The nurse is responsible for ensuring delegated care is completed effectively
and safely.
Question 8
A nurse manager is mentoring a novice nurse about delegation. Which concept should the
manager emphasize?
A. Delegation relieves the RN of all accountability
