Download HESI Leadership & Management (NGN) & Evolve HESI Leadership/Management 2026/2027 and more Exams Medicine in PDF only on Docsity!
https://www.stuvia.com/user/profgoodluck
HESI Leadership & Management (NGN) &
Evolve HESI Leadership/Management
2026/2027 | Complete Practice Questions with
Answers | Next Generation Nursing Leadership
Review
A RN, PN and UAP are working as team to provide care for a acutely ill client requiring immediate bedside insertion of a chest tube. Which assignment is the best use of each person's skills? The UAP obtains an O2 sat level while the RN reports the findings to the HCP The nurse caring for a client with bacterial meningitis is preparing report for the oncoming nurse. It is most important to include which assessment finding in the report? Increasing pulse pressure. The nurse is assigned to care for four clients. After receiving the change of shift report, which client should the nurse assess first? A client with diabetes and a history of coronary artery disease who is complaining of increased SOB A 10 year old with sickle cell disease who has a PCA pump and is complaining of pain2-3/ A 29 year old who has had CKD for the past year and had an AV fistula placed yesterday An older client with COPD who is experiencing SOB and who O2 sat is 88% on RA A client with diabetes and a history of coronary artery disease who is complaining of increased SOB A HCP notifies the nurse that new prescriptions have been written for a client. Which is the first action the nurse should implement? Read all of the new prescriptions for the client written by the provider The nurse calls the surgeon to report that a male client who has transitioned from a PCA to PO analgesic one hour ago is now complaining in a loud voice and asking for the PCA pump. The nurse explains that the client's behavior is disturbing his roommate. The client's BP has increased from 120/72 to 150/98. Which question is best to include in the recommendation component of the SBAR report the the surgeon? Could the behavior be a manifestation of drug seeking?
An older woman with a long history of HTN is transferred from a long term care unit because of HF. She has a signed and witnessed DNR in her record. What action should the nurse take? Confirm current resuscitation wishes with client and family When caring for an older adult with septic shock, which intervention is most important for the nurse to include in this client's plan of care? Assess warmth of extremities A client is admitted with exacerbation of COPD and reports that it is difficult to eat due to SOB. Which tasks should the nurse delegate to UAP? Select all that apply. Assist the client with eating small, frequent high calorie meals Offer high caloric foods such as milk and ice cream Maintain a clean and pleasant environment during meals Set up the food and drink containers within easy reach The nurse watches the UAP bring soap, washcloths, towel and a basin into the room of a male client who had a suprapubic catheter inserted earlier that day. Which action should the nurse implement? Tell the UAP that the nurse will perform the client's catheter care while the UAP assists with his personal care The nurse observes a PN placing a client on the right side with left leg bent in prep for lumbar puncture. Which action should the RN take? Demonstrate to the PN how to position the client more effectively for the procedure The charge nurse observes a newly employed nurse begin to administered liquid meds via the clients gastrostomy feeding tube system via the bag hanging at above delivery pump. What action should the charge nurse take? Direct the nurse to stop medication administration The nurse assigns a UAP to apply sequential compression devices to a client. Which instruction should the nurse include when assigning this task? Report changes in color in the client's feet or legs The nurse hears new UAP who is working in long term care facility calling adult residents "honey" and "dearie." Which is the best action the nurse should take? Meet with the UAP to discuss respectful client care strategies A nationally known management consultant, whose fee is very high, is scheduled to speak at a day long hospital education conference. The head nurses wants the information presented at the meeting to be disseminated among the staff. Which plan will be most useful in achieving this goal?
An adult who has a collapsed lung related to a fall from a ladder 8 hours ago and now has 100 mL chest tube drainage An adult who has a collapsed lung related to a fall from a ladder 8 hours ago and now has 100 mL chest tube drainage The charge nurse observes that a client with an NG tube applied to low intermittent suction is drinking a glass of water immediately after the UAP left the room. Which action should the nurse take? Remove the glass of water and speak to the UAP An experienced PN and a UAP are working together to assist neurologically compromised clients at mealtime. Which task is best for the PN to perform? Feed a quadriplegic client who has trouble chewing and swallowing. A client with severe bilateral crush injuries to the lower extremities is informed by the HCP that amputation is the only option for the client to live. The client request no life saving measure to be taken. The HCP refuses to write the DNR order. Which action should the nurse take? Initiate a review of the situation by the hospital's ethics committee One hour after the nurse administers an analgesic, the UAP reports the client refuses to turn in bed because of continued pain. Which action should the nurse take? Asses the client's current pain level and response to the analgesic Which older client should the charge nurse assign to the most experienced nurse? A 72 year old client with type 1 diabetes who is newly diagnosed and scheduled for discharge today Aspirin 81 mg at 0900 daily is prescribed for an older client. At 0800 the client asks for something for low back pain, but does not have a PRN order for analgesics prescribed. Which action is best for the nurse to take? Obtain a prescription for a PRN analgesic When making assignments for the day, which information provided during the change of shift report is most important for the charge nurse to consider? An elderly female client who refuses to be cared for by a male nurse An older male client who lives alone has a history of HF and is admitted to the hospital after passing out while walking to the mailbox. The nurse notes multiple bruises in various stages of healing. He is being treated with a cardiac glycoside, diuretic, and restricted sodium diet. Which intervention is most important for the nurse to include in the client's plan of care? Continuous EKG monitoring The RN is gathering supplies to assist HCP with thoracentesis at the bedside when the ED nurse calls in report on a client with unstable angina. A PN and UAP are able to assist the RN. How
should the RN assign the necessary tasks? Assign PN to assist with the thoracentesis while the nurse obtains report and the UAP prepares the room for the new client A client with leukemia is hospitalized for weakness, fatigue, and anemia. The client is restless and tachycardic. Which intervention is most important for the nurse to include in the plan of care? Maintain protective isolation. After receiving morning report on an acute care unit, which client should be assessed first? A client sitting close to the nurse's station who has been restrained for the past six hours. To facilitate the success of a new fall prevention program, which action should the nurse manager implement? Involve the staff in developing interventions for the program The charge nurse in an emergency center is planning client care assignments for the staff. Which action may be safely delegated to the PN? Remove peripheral IV catheter The nurse is inserting an indwelling catheter for a client experiencing urinary retention when a code blue is called for another client on the who unit who became unresponsive. Which action should the nurse take? Finish the procedure The nurse manager conducts regular audits of patient care medication records and notices that the amount of narcotic pain medication administer on the evening shift in post surgical unit is inconsistent. Which action should the manger take next? Conduct a closer examination of the staff nurse's distribution of pain medication from the evening shift The nurse is caring for a group of clients with the help of an experienced unlicensed assistive personnel UAP. Several specimens need to be collected and sent to the lab. Which specimen collection can the nurse delegate to the UAP? SATA Urine from indwelling catheter. Fecal drainage sample. The nurse manger observes that the staff nurse has used wrist restraints to help secure an elderly female to her wheel chair. What is the priority action by the nurse manager? Advise the nurse to remove the restraints from the clients wrists the nurse calls the surgeon about a male client who is having abdominal pain after a bowel resection. He received hydromorphone 2 hours ago and is not requesting additional pain medication. VS include temp 97.8, HR 112 bpm, RR 24, BP 98/62, which is lower than an hour
single lumen central venous catheter inserted in the subclavian vein of a client has come loose and the insertion site is inflamed. Which action should the charge nurse implement? Confirm the findings of the PN while securing the transparent dressing and notify the healthcare provider. In planning care for a group of clients, which task should the nurse delegate to the UAP? Reinforce teaching provided by the nurse about using the call bell The nurse notes the toes of a clients casted leg are cold and turning blue. The HCP is notified by phone three times, but four hours after the first notification the HCP has not come to see the client who is now complaining of severe pain. Which action is most important for the nurse to take? Have the nursing supervisor report the situation immediately to the medical chief of staff An experienced PN is hired to work on the surgical unit of a tertiary hospital. the first day she is working on the unit, the PN tells the nurse that she has excellent wound care skills. It is a busy day and a post op client needs to have a sterile dressing change. Which action is best for the charge nurse to take? Watch the PN perform sterile wound care to validate her skill level To help prevent litigation by a dissatisfied client, which objective is most important to include in the orientation classes for staff nurses? New nursing staff members will Discuss how to handle complains from clients and/or their families In assigning client care to a RN and a PN, it is most important to assign which client to the RN? The client who is exhibiting signs of Addison's crisis after corticosteroids were discontinued Which staff assignment, made by the primary nurse, requires the most immediate follow-up action by the charge nurse on a medical unit? An unlicensed assistive personnel (UAP) is assigned to check a client for fecal impaction. Two clients in the ICU are assigned to an oncoming nurse at shift change. One client has pneumonia and is being mechanically ventilated and the other had a thoracotomy yesterday is is currently complaining of incisional discomfort. Which action should the nurse take next? Assess LOC and VS for both A client with life threatening injuries from a gunshot wound to the abdomen is mechanically ventilated and sedated. the client has a large family present who are asking multiple and repetitive questions. Which intervention should the nurse implement first? Ask the family to identify a specific spokesperson? A group of nurse-managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organization's budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?
How many departments can use this equipment A fire is reported in the kitchen on the first floor of a three floor community hospital and the operator notifies the charge nurse of the third floor to start evacuation procedures. Which intervention should the charge nurse implement? Instruct nursing staff to evacuate ambulatory client to the nearest fire exits? an older female client who was recently widowed has become increasing confused and disoriented. Her family tells the healthcare provider's office nurse that it is imperative for their mother to be admitted to the hospital for medical evaluation. The client is a member of a managed health plan. Which information is best for the nurse to provide the family? Managed care providers have mandatory pre certification requirements for hospitalization The UAP reports to the nurse that a male client with fluid volume overload will not allow the UAP to obtain his daily weight. Which action should the nurse implement? Instruct the UAP to weight the client using the bed scale Which actions of the nurse exhibit transactional leadership? Select all that apply. Meeting the targets within the deadline, Working according to organizational rules, Correcting the errors in a reactive manner The unit nurse manager comes to work obviously intoxicated. Which action is the staff nurse ethically obligated to take? Have the supervisor validate the observation. Which aspects are considered when determining the willingness of a nursing assistant before delegating a task? Select all that apply. Attitude, Confidence, Commitment Which performance appraisal method is used by nurse managers to measure the performance of the nurse both qualitatively and quantitatively? Behaviorally anchored rating scales The healthcare team is caring for clients in an emergency department. How soon should the clients triaged as an emergency severity index-3 (ESI-3) be seen by the physician according to the five level triage system? Within 1 hour
For which situations would total client care be an appropriate delivery system? Select all that apply. Client with an endotracheal tube for pulmonary sepsis, Client recovering from cardiovascular bypass graft surgery, Client recovering from the placement of a cerebrospinal fluid shunt Which intervention should the charge nurse perform to manage a task when the unlicensed nursing personal (UNP) is lacking competence? Provide additional support and temporarily lower expectations. Which statement would most likely be made by a client who is receiving care through the functional method? "I have to wait until the medication nurse is available for a pain pill." Which constructive aspects of conflict does the nurse leader identify? Select all that apply. Releases pent-up emotions, Helps individuals grow personally, Builds cohesiveness among people When does delegation become more challenging? Select all that apply. When the client is pregnant, When school children are receiving care A client reports severe pain 2 days after surgery. After assessing the characteristics of the pain, which initial action should the nurse take next? Obtain vital signs. A nurse leader, along with the team, is caring for a client who is scheduled for colonoscopy. Which delegated task requires the leader's supervision? Assisting the client with an enema Which comment by a team leader exemplifies team nursing the way it was intended? "(Registered Nurse 1), check all of the intravenous (IV) sites and give the IV medications." The registered nurse finds that two nursing students are arguing with each other. Which action by the registered nurse best represents a leadership quality? Assessing the condition and strategizing to resolve the matter by reducing the difference
Which point should the nurse exclude when developing strategies to project a powerful image? Using authoritative language Which statement of the nurse leader reflects the actions suggested by the Joint Commission for disruptive behavior by a direct care nurse? "You are terminated, effective now." According to the three-tiered triage system, which client requires urgent treatment? Select all that apply. A client with renal colic A client with strains and sprains A client with respiratory distress A client with severe abdominal pain A client with multiple displaced fractures A client with renal colic, A client with severe abdominal pain, A client with multiple displaced fractures The nurse finds the respiratory rate is 8 breaths per minute in a client who is on intravenous morphine sulfate. What should the nurse do immediately in this situation? Stop administering the medication. A client is admitted to the emergency department following a motor vehicle accident. The client's wounds are extensive. Which healthcare team member is best suited to care for this client in the emergency ward? Registered nurse A registered nurse (RN) delegates the task of foot care for a client to an unlicensed nursing personnel (UNP). The UNP is skillful and willing to perform the given task, but was recently hired and is unfamiliar with the client's condition. What should the RN do in this situation? Establish mutual expectations and conditions. Which characteristics of a licensed practical nurse should be considered before delegation of tasks? Select all that apply. Critical thinking, Diagnostic reasoning, Synthesizing information
The nurse is teaching breathing exercises to a client who underwent surgery. Which member of the healthcare team is most suitable for reinforcement of teaching in the client? Licensed vocational nurse (LVN) The charge nurse is assigning client care to oncoming staff. The new nurse on the unit expresses an inability to care for the assigned client and is requesting to be reassigned. What should the delegator do in this situation? Understand the delegatee's motivation in the situation. Who acts as a delegator in the absence of the registered nurse? Charge nurse The registered nurse (RN) delegates the collection of respiratory rate data to a licensed practical nurse (LPN) for a client who is experiencing severe dehydration and whose condition is unstable. The LPN reports the data to the RN. The RN rechecks the data and finds that the report no longer reflects the client's current condition. Which characteristic of communication has interfered with the delegation process? Information decay The registered nurse (RN) and unlicensed assistive personnel (UAP) have been working together for two years. Which statement made by the RN would be appropriate after delegating a task to the UAP? "You know what to do and when to report." The registered nurse (RN) is caring for a client with renal calculi. Which healthcare professional is most suitable to be delegated the task of administering urinary alkalinizer by mouth to the client? Licensed practical nurse Which client's care is least likely to be delegated to unlicensed nursing personnel (UNP)? Client A - paraplegia, home care Client B - femur fracture in cast, extended care Client C - Alzheimer's, long-term care Client D - accidental poisoning, emergency care Client D - accidental poisoning, emergency care The emergency department (ED) nurse is providing care to a burn trauma client. Which is the priority for the nurse to monitor for after removing the client's clothing? Bradypnea
Bradycardia Hypotension Hypothermia Hypothermia Which nursing action allows for a thorough assessment of a trauma client to prioritize the client's care? Cutting fabric that is stuck to the client's skin with scissors The nurse is teaching a client how to teach the supraglottic method of swallowing. Arrange the prioritizing order of statements by the nurse for teaching the client. a. "Swallow twice." b. "Hold your breath." c. "Clear your throat." d. "Take a deep breath." e. "Place yourself in an upright position." f. "Place a half to 1 teaspoon of food into your mouth." e."Place yourself in an upright position." c."Clear your throat." d."Take a deep breath." f."Place a half to 1 teaspoon of food into your mouth." b."Hold your breath." a."Swallow twice." Which order of steps would the nurse teach the client to follow while performing expansion breathing? a. Place hands on each side of lower ribcage, just above the waist. b. Sit in an upright position with knees slightly bent. c. Exhale, first moving the chest and then lower ribs inward while gently squeezing the ribcage, forcing air out of the base of lungs. d. Take a deep breath through your nose, using shoulder muscles to expand your lower ribcage outward during inhalation. b. Sit in an upright position with knees slightly bent. a. Place hands on each side of lower ribcage, just above the waist. d. Take a deep breath through your nose, using shoulder muscles to expand your lower ribcage outward during inhalation. c. Exhale, first moving the chest and then lower ribs inward while gently squeezing the ribcage, forcing air out of the base of lungs. A client's chest tube has accidentally dislodged. What is the nursing action of highest priority? Place the client in a left side-lying position. Apply oxygen via nonrebreather mask. Apply a petroleum gauze dressing over the site.
Critical thinking Case management Clinical decision-making Assessment, Critical thinking, Clinical decision-making The nurse is performing resuscitation interventions for airway, breathing, and circulation as part of a primary survey in a client. Which order of actions should the nurse follow for this client? a. Use direct pressure for external bleeding. b. Prepare for chest decompression if needed. c. Assess breath sounds and respiratory effort. d. Establish airway by positioning, suctioning, and oxygen as needed. e. Maintain vascular access using a large-bore catheter. d. Establish airway by positioning, suctioning, and oxygen as needed. c. Assess breath sounds and respiratory effort. b. Prepare for chest decompression if needed. e. Maintain vascular access using a large-bore catheter. a. Use direct pressure for external bleeding. What is the priority nursing care for a client who is prescribed hydroxychloroquine (Plaquenil)? Teaching the client to report blurred vision A case manager telephones a client with lung disease to evaluate respiratory function with home oxygen use and then contacts the primary care provider. What is the purpose of this communication? Evaluate expected outcomes Which statement describes the practice partnership model of care delivery? Nurse and unlicensed assistive personnel work the same shifts and days. Which actions indicate that a manager is helping staff adjust to functional nursing? Select all that apply. Staff meeting conducted every Tuesday at 1 pm, Assigned tasks rotated among same category of care providers The nurse is assisting a client out of bed. Which is the priority nursing action? Monitoring the client's blood pressure Assessing the client's level of consciousness
Ensuring the call bell is within the client's reach Assisting the client from a supine to an upright position Assisting the client from a supine to an upright position A hospital management team has conducted a randomized controlled trial to decrease the occurrence of ventilator-associated pneumonia. The trial was successful and had positive outcomes. The nurse manager, in collaboration with other hospital management staff, conducted the same trial in another hospital, but the results were different. Which research strategy implementation would the nurse manager consider to be beneficial in preventing dramatic differences in trial results? Practice-based evidence (PBE) A nurse leader is teaching about the functional model of nursing to a student nurse. Which statements made by the student nurse indicate effective learning? Select all that apply. "I will focus on tasks and activities allotted to me.", "I will coordinate the unlicensed personnel to provide care to a large group of clients." The nurse leader noticed that the staff nurse recently promoted to the surgical unit is lacking confidence at work and is worried about a pending review by the nursing director. Which source of power is applicable in this situation? Coercive power The nurse as a leader assists multidisciplinary leaders to achieve optimal functioning to benefit client care delivery. Which Gardner's task is the nurse applying? Achieving workable unity Which responsibility of the nurse manager differs from the responsibilities of a nurse leader? Planning the budget The chief operating officer (COO) discusses the performance of a newly appointed leader with the nursing staff. The team communicates that the practical approach of the leader fulfills the quantum theory. What type of work environment does the COO understand that the leader creates at the workplace? An environment that is rapidly changing and dynamic The nurse leader actively participates in the quality improvement process. Arrange the steps in a sequence that the nurse leader will follow while implementing the quality improvement process? a. Select a plan to meet the outcomes. b. Collect the data for evaluating the plan. c. Establish the outcomes and quality indicators. d. Identify the important needs of the consumer. e. Collect the data on the current status of the service. f. Collaborate with the interprofessional team to review needs.
Patient-benefit model Which type of behavior by the registered nurse results in a low-to-stable level of commitment? Punitive The leader encounters a situation where the nursing outcomes are unpredictable. Which attributes or approaches should the leader utilize to navigate this situation? Select all that apply. Creativity, Experience, Group process The nurse manager orders the direct care nurse to assist in providing tertiary care to a client. Which type of treatment would the direct care nurse be involved in? Rehabilitation. The nurse leader arranges a meeting with the staff members to learn how satisfied they are with their jobs. Which approach by the nurse leader would outline effective leadership? Select all that apply. Seeking feedback from the team, Motivating the team to reach the desired goals, Asking the team to participate in decision making During a peer review, the manager finds that a newly appointed nurse leader encourages "bottom up" interaction among the workers. To which statement of the staff does the manager relate this? "He/she involves us in shaping policies for client care." The registered nurse (RN) is getting ready to leave the client care unit for a lunch break. The RN asks the LPN to take care of a client during the lunch break. Which concept is emphasized in this situation? Delegation A healthcare team is caring for a client with diabetes insipidus. According to the functional model, which healthcare personnel would the nurse state is qualified to perform all hygienic tasks? Unlicensed assistive personnel The registered nurse is teaching a newly hired nurse about communicating with delegatees during delegation. Which statement made by the newly hired nurse indicates the need for further learning? "I should provide examples of each delegation."
Before assigning a task, the registered nurse makes sure that the prospective delegatee is willing to complete the task. Which delegation right does this situation reference? Person A registered nurse (RN) is sent to a rehabilitation center because of chemical impairment issues. Which member of the healthcare team will be asked to provide feedback about the RN's progress? Nurse manager After caring for a client who underwent a cesarean section, the delegatee failed to report results and findings of vital signs to the delegator due to improper understanding. Which action of the delegator is the reason for the delegatee's failure? Unclear directions to the delegatee What factors are most important for the nurse to consider when delegating responsibilities? Staff member's level of education and expertise While delegating a task, the registered nurse says to the delegatee, "Please tell me how you go about performing this procedure, and I will share with you my perspective about how frequently and under what conditions we need to communicate with and report to each other." What does this indicate? The delegatee and delegator are creating mutual expectations. Which statement about the delegatee condition is true regarding "selling"? The delegatee has ongoing relationships; however, the task is new. Which healthcare professionals would the nurse say work under active delegation? Select all that apply. Licensed practical nurse (LPN) administering oral medications as delegated by the registered nurse (RN), Unlicensed nursing practitioner (UNP) maintaining oral hygiene of the clients as delegated by the registered nurse The nurse notifies the health care provider of a change in client condition. Which of the following reports given by the nurse includes the most appropriate and complete information? "A 43-year-old client with pneumonia in room 343 has wheezing, crackles, and diminished breath sounds. Temperature is 101.2 F (38.4 C), respirations are 36/min, and pulse oximeter shows 90%. I think the client may need arterial blood gas testing." "A 75-year-old client in room 474 is in respiratory distress. The respiratory therapist (RT) gave a breathing treatment, but the client is deteriorating rapidly. The RT did not hear left side breath sounds and recommends a chest x-ray." "An 80-year-old client in room 234 with a history of heart failure was admitted today for pneumonia and is receiving oxygen and antibiotics. The client is dyspneic and restless, and oxygen saturation is now 89%. Would you like me to increase the oxygen flow rat "An 80-year-old client in room 234 with a history of heart failure was admitted today for pneumonia and is receiving oxygen and antibiotics. The client is dyspneic and restless, and
