LEADERSHIP MANAGEMENT HESI EXIT EXAM NEWEST
COMPLETE 150 QUESTIONS AND CORRECT DETAILED
ANSWERS
Question 1
A charge nurse receives a report from assistive personnel (AP) that a client
who is 2 days postoperative following a hip arthroplasty has a new onset of
sudden, severe pain in the surgical hip. The client's vital signs are stable.
Which of the following actions should the charge nurse take first?
A) Administer a prescribed oral analgesic.
B) Instruct the AP to apply a warm compress to the hip.
C) Go to the client's room and assess the client.
D) Notify the orthopedic surgeon of the report.
E) Review the client's medication administration record.
Correct Answer: C) Go to the client's room and assess the client.
Rationale: The first step in the nursing process is assessment. A new
onset of sudden, severe pain post-operatively requires immediate
direct assessment by the nurse to determine the client's condition,
identify potential complications (e.g., dislocation), and then plan
appropriate interventions. Delegating care or notifying the provider
without personal assessment is inappropriate.
Question 2
A nurse manager is planning staffing for the next shift. Which of the following
clients should the nurse manager assign to an experienced LPN/LVN?
A) A client who is 1 day postoperative following a gastrectomy and requires
frequent vital sign monitoring.
B) A client admitted with acute myocardial infarction receiving intravenous
thrombolytics.
C) A client with a new tracheostomy who requires frequent suctioning and
respiratory assessment.
D) A client with stable type 2 diabetes mellitus requiring a routine dressing
change for a chronic wound.
E) A client who is receiving continuous IV insulin for diabetic ketoacidosis.
Correct Answer: D) A client with stable type 2 diabetes mellitus
requiring a routine dressing change for a chronic wound.
Rationale: LPN/LVNs are capable of providing care for stable clients
with predictable outcomes. A routine dressing change for a chronic
wound on a stable client with type 2 diabetes falls within their
scope. Clients receiving thrombolytics, with a new tracheostomy, or
on continuous IV insulin require the advanced assessment skills and
critical thinking of an RN.
,Question 3
A charge nurse is observing a newly licensed nurse prepare to administer a
medication. The newly licensed nurse states, "I think this is the right
medication, but I'm not entirely sure." Which of the following actions should
the charge nurse take?
A) Tell the newly licensed nurse to go ahead and administer it.
B) Instruct the newly licensed nurse to look up the medication in the drug
guide.
C) Immediately intervene and verify the medication with the newly licensed
nurse.
D) Document the newly licensed nurse's uncertainty in their performance
review.
E) Ask another newly licensed nurse to double-check.
Correct Answer: C) Immediately intervene and verify the medication
with the newly licensed nurse.
Rationale: Client safety is paramount. Any uncertainty regarding
medication administration poses a significant risk. The charge nurse
must immediately intervene to prevent a potential medication error
by verifying the medication themselves, reinforcing the "right
medication" principle.
Question 4
A nurse manager is addressing a conflict between two staff nurses regarding
workload distribution. One nurse feels consistently overworked. Which of the
following conflict resolution strategies involves both parties working together
to find a mutually agreeable solution that satisfies everyone's concerns?
A) Avoidance
B) Accommodation
C) Competition
D) Collaboration
E) Compromise
Correct Answer: D) Collaboration
Rationale: Collaboration is a "win-win" conflict resolution strategy
where all parties work together to understand the underlying
issues, identify common goals, and develop a creative solution that
fully satisfies the concerns of everyone involved. It fosters respect
and stronger working relationships.
Question 5
A charge nurse is delegating tasks on a busy medical-surgical unit. Which of
the following tasks should the charge nurse delegate to an assistive
,personnel (AP)?
A) Obtaining a blood glucose reading for a client with new-onset confusion.
B) Assessing a client's readiness for discharge.
C) Administering a nebulizer treatment to a client with asthma.
D) Providing post-mortem care for a client who passed away 30 minutes ago.
E) Educating a client about new medication side effects.
Correct Answer: D) Providing post-mortem care for a client who
passed away 30 minutes ago.
Rationale: Post-mortem care is within the scope of practice for an AP.
While APs can obtain blood glucose readings, new-onset confusion
requires RN assessment. Assessing readiness for discharge,
administering medications, and client education are all
responsibilities of the RN.
Question 6
A nurse manager is implementing a new electronic health record (EHR)
system. Several staff nurses express resistance to the change. Which of the
following actions should the nurse manager take to facilitate the change
process?
A) Implement the new system without addressing concerns, as it is
mandatory.
B) Threaten disciplinary action for non-compliance.
C) Provide opportunities for training, address concerns, and explain the
benefits of the new system.
D) Delegate implementation entirely to the IT department.
E) Delay the implementation indefinitely.
Correct Answer: C) Provide opportunities for training, address
concerns, and explain the benefits of the new system.
Rationale: Effective change management involves open
communication, education, and addressing staff concerns. Providing
thorough training, explaining the rationale and benefits (e.g.,
improved efficiency, patient safety), and allowing staff to voice
concerns can reduce resistance and foster acceptance of the new
system.
Question 7
A charge nurse is prioritizing care for four clients. Which of the following
clients should the charge nurse assess first?
A) A client with a chronic wound scheduled for a dressing change.
B) A client with a blood glucose level of 180 mg/dL (10 mmol/L) who reports
feeling well.
, C) A client who reports a sudden onset of shortness of breath and chest pain.
D) A client requiring routine morning medications.
E) A client who needs assistance with ambulation to the bathroom.
Correct Answer: C) A client who reports a sudden onset of shortness of
breath and chest pain.
Rationale: Using the ABC (Airway, Breathing, Circulation) priority
framework, shortness of breath and chest pain indicate a potential
acute compromise of respiratory and/or cardiac function, which is a
life-threatening emergency. This client requires immediate
assessment and intervention.
Question 8
A nurse manager is conducting a staff performance appraisal. Which of the
following statements demonstrates effective feedback for a nurse who
frequently forgets to document interventions?
A) "You're always forgetting to document your care."
B) "Your documentation skills are poor; you need to improve."
C) "You frequently miss documenting interventions, which impacts continuity
of care. Let's discuss strategies to ensure all care is recorded."
D) "Other nurses are complaining about your documentation."
E) "Documentation is not your strong suit."
Correct Answer: C) "You frequently miss documenting interventions,
which impacts continuity of care. Let's discuss strategies to ensure
all care is recorded."
Rationale: Effective feedback is specific, objective, non-judgmental,
and focuses on the behavior and its impact, rather than
personalizing it. It also offers support and a path for improvement.
Option C clearly identifies the behavior ("frequently miss
documenting"), explains the impact ("impacts continuity of care"),
and proposes a collaborative solution ("Let's discuss strategies").
Question 9
A charge nurse is delegating client care tasks. Which of the following
situations represents appropriate delegation?
A) Assigning an AP to administer oral medications to a stable client.
B) Delegating complex wound care to an LPN/LVN.
C) Assigning an AP to obtain initial vital signs on a newly admitted client.
D) Delegating a routine urinary catheter insertion to an LPN/LVN.
E) Assigning an AP to assist a client with feeding who has a history of
aspiration.
Correct Answer: D) Delegating a routine urinary catheter insertion to
COMPLETE 150 QUESTIONS AND CORRECT DETAILED
ANSWERS
Question 1
A charge nurse receives a report from assistive personnel (AP) that a client
who is 2 days postoperative following a hip arthroplasty has a new onset of
sudden, severe pain in the surgical hip. The client's vital signs are stable.
Which of the following actions should the charge nurse take first?
A) Administer a prescribed oral analgesic.
B) Instruct the AP to apply a warm compress to the hip.
C) Go to the client's room and assess the client.
D) Notify the orthopedic surgeon of the report.
E) Review the client's medication administration record.
Correct Answer: C) Go to the client's room and assess the client.
Rationale: The first step in the nursing process is assessment. A new
onset of sudden, severe pain post-operatively requires immediate
direct assessment by the nurse to determine the client's condition,
identify potential complications (e.g., dislocation), and then plan
appropriate interventions. Delegating care or notifying the provider
without personal assessment is inappropriate.
Question 2
A nurse manager is planning staffing for the next shift. Which of the following
clients should the nurse manager assign to an experienced LPN/LVN?
A) A client who is 1 day postoperative following a gastrectomy and requires
frequent vital sign monitoring.
B) A client admitted with acute myocardial infarction receiving intravenous
thrombolytics.
C) A client with a new tracheostomy who requires frequent suctioning and
respiratory assessment.
D) A client with stable type 2 diabetes mellitus requiring a routine dressing
change for a chronic wound.
E) A client who is receiving continuous IV insulin for diabetic ketoacidosis.
Correct Answer: D) A client with stable type 2 diabetes mellitus
requiring a routine dressing change for a chronic wound.
Rationale: LPN/LVNs are capable of providing care for stable clients
with predictable outcomes. A routine dressing change for a chronic
wound on a stable client with type 2 diabetes falls within their
scope. Clients receiving thrombolytics, with a new tracheostomy, or
on continuous IV insulin require the advanced assessment skills and
critical thinking of an RN.
,Question 3
A charge nurse is observing a newly licensed nurse prepare to administer a
medication. The newly licensed nurse states, "I think this is the right
medication, but I'm not entirely sure." Which of the following actions should
the charge nurse take?
A) Tell the newly licensed nurse to go ahead and administer it.
B) Instruct the newly licensed nurse to look up the medication in the drug
guide.
C) Immediately intervene and verify the medication with the newly licensed
nurse.
D) Document the newly licensed nurse's uncertainty in their performance
review.
E) Ask another newly licensed nurse to double-check.
Correct Answer: C) Immediately intervene and verify the medication
with the newly licensed nurse.
Rationale: Client safety is paramount. Any uncertainty regarding
medication administration poses a significant risk. The charge nurse
must immediately intervene to prevent a potential medication error
by verifying the medication themselves, reinforcing the "right
medication" principle.
Question 4
A nurse manager is addressing a conflict between two staff nurses regarding
workload distribution. One nurse feels consistently overworked. Which of the
following conflict resolution strategies involves both parties working together
to find a mutually agreeable solution that satisfies everyone's concerns?
A) Avoidance
B) Accommodation
C) Competition
D) Collaboration
E) Compromise
Correct Answer: D) Collaboration
Rationale: Collaboration is a "win-win" conflict resolution strategy
where all parties work together to understand the underlying
issues, identify common goals, and develop a creative solution that
fully satisfies the concerns of everyone involved. It fosters respect
and stronger working relationships.
Question 5
A charge nurse is delegating tasks on a busy medical-surgical unit. Which of
the following tasks should the charge nurse delegate to an assistive
,personnel (AP)?
A) Obtaining a blood glucose reading for a client with new-onset confusion.
B) Assessing a client's readiness for discharge.
C) Administering a nebulizer treatment to a client with asthma.
D) Providing post-mortem care for a client who passed away 30 minutes ago.
E) Educating a client about new medication side effects.
Correct Answer: D) Providing post-mortem care for a client who
passed away 30 minutes ago.
Rationale: Post-mortem care is within the scope of practice for an AP.
While APs can obtain blood glucose readings, new-onset confusion
requires RN assessment. Assessing readiness for discharge,
administering medications, and client education are all
responsibilities of the RN.
Question 6
A nurse manager is implementing a new electronic health record (EHR)
system. Several staff nurses express resistance to the change. Which of the
following actions should the nurse manager take to facilitate the change
process?
A) Implement the new system without addressing concerns, as it is
mandatory.
B) Threaten disciplinary action for non-compliance.
C) Provide opportunities for training, address concerns, and explain the
benefits of the new system.
D) Delegate implementation entirely to the IT department.
E) Delay the implementation indefinitely.
Correct Answer: C) Provide opportunities for training, address
concerns, and explain the benefits of the new system.
Rationale: Effective change management involves open
communication, education, and addressing staff concerns. Providing
thorough training, explaining the rationale and benefits (e.g.,
improved efficiency, patient safety), and allowing staff to voice
concerns can reduce resistance and foster acceptance of the new
system.
Question 7
A charge nurse is prioritizing care for four clients. Which of the following
clients should the charge nurse assess first?
A) A client with a chronic wound scheduled for a dressing change.
B) A client with a blood glucose level of 180 mg/dL (10 mmol/L) who reports
feeling well.
, C) A client who reports a sudden onset of shortness of breath and chest pain.
D) A client requiring routine morning medications.
E) A client who needs assistance with ambulation to the bathroom.
Correct Answer: C) A client who reports a sudden onset of shortness of
breath and chest pain.
Rationale: Using the ABC (Airway, Breathing, Circulation) priority
framework, shortness of breath and chest pain indicate a potential
acute compromise of respiratory and/or cardiac function, which is a
life-threatening emergency. This client requires immediate
assessment and intervention.
Question 8
A nurse manager is conducting a staff performance appraisal. Which of the
following statements demonstrates effective feedback for a nurse who
frequently forgets to document interventions?
A) "You're always forgetting to document your care."
B) "Your documentation skills are poor; you need to improve."
C) "You frequently miss documenting interventions, which impacts continuity
of care. Let's discuss strategies to ensure all care is recorded."
D) "Other nurses are complaining about your documentation."
E) "Documentation is not your strong suit."
Correct Answer: C) "You frequently miss documenting interventions,
which impacts continuity of care. Let's discuss strategies to ensure
all care is recorded."
Rationale: Effective feedback is specific, objective, non-judgmental,
and focuses on the behavior and its impact, rather than
personalizing it. It also offers support and a path for improvement.
Option C clearly identifies the behavior ("frequently miss
documenting"), explains the impact ("impacts continuity of care"),
and proposes a collaborative solution ("Let's discuss strategies").
Question 9
A charge nurse is delegating client care tasks. Which of the following
situations represents appropriate delegation?
A) Assigning an AP to administer oral medications to a stable client.
B) Delegating complex wound care to an LPN/LVN.
C) Assigning an AP to obtain initial vital signs on a newly admitted client.
D) Delegating a routine urinary catheter insertion to an LPN/LVN.
E) Assigning an AP to assist a client with feeding who has a history of
aspiration.
Correct Answer: D) Delegating a routine urinary catheter insertion to
