HESI Evolve Leadership/Management Practice Exam with Answers (114 Solved Questions)

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Evolve HESI Leadership/Management1.Which actions of the nurseexhibit transactional lead-ership? Select all that ap-ply.1 Motivating or inspiringthe employees2 Meeting the targets withinthe deadline3 Working according to or-ganizational rules4 Correcting the errors in areactive manner5 Increasing the employeecommitment of an organi-zation2, 3, 4The characteristics of transactional leadershipinclude valuing the orders and structures of anorganization. The nurse who exhibits transac-tional leadership will meet the targets withinthe deadline given by the organization. Thenurse will also follow the rules of an organiza-tion and will correct the errors of an employeein a reactive manner.Motivating or inspiring the employees and in-creasing employee commitment are the char-acteristics of transformational leadership.2.The unit nurse managercomes to work obviouslyintoxicated.Which action isthe staff nurse ethically ob-ligated to take?1 Call the security guard.2 Tell the nurse manager togo home.3 Have the supervisor vali-date the observation.4 Offer the nurse managera large cup of coffee3 Have the supervisor validate the observa-tion.The staff nurse should call the hospital super-visor to confirm and handle the problem. Thesecurity guard has no authority in this situation.Although sending the nurse manager homeremoves the nurse manager from the clinicalsetting, this action misses an opportunity fordocumenting the situation and the nurse man-ager is in no condition to drive safely. Drinkingcoffee does not make a person less intoxicat-ed.3.Which aspects are consid-ered when determining thewillingness of a nursing as-sistant before delegating atask? Select all that apply.1 Ability2 Attitude2, 4, 5An individual's willingness is related to attitude,confidence, and commitment.Ability is related to knowledge and skills ina specific situation. Personality characteristics1 / 64

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Evolve HESI Leadership/Management3 Personality4 Confidence5 Commitmentcan influence the effectiveness of the delega-tor.4.Which performance ap-praisal method is used bynurse managers to mea-sure the performance ofthe nurse both qualitativelyand quantitatively?1 Narrative method2 Critical incidents method3 Graphic rating scale form4 Behaviorally anchoredrating scales4The behaviorally anchored rating scale is aperformance appraisal method that providesan overview of nursing standards by determin-ing performance both qualitatively and quanti-tatively.The narrative method requires a manager towrite a statement about the nurse's perfor-mance. The critical incidents type is a perfor-mance appraisal method in which a managerkeeps a written record of positive and negativeperformance. The graphic rating scale form isa performance appraisal checklist on which amanager rates the nurse's performance on acontinuum such as excellent, good, average,and poor.5.The healthcare team is car-ing for clients in an emer-gency department. Howsoon should the clientstriaged as an emergencyseverity index-3 (ESI-3) beseen by the physician ac-cording to the five leveltriage system?1 Immediately2 Within 1 hour3 Could be delayed4 Within 10 minutes2 Within 1 hourThe clients triaged as an ESI-3 should be seenby the physician within an hour.The clients with life-threatening problems aretriaged as ESI-1, and they should be providedwith immediate care. The care of the clients inESI-4 and ESI-5 can be delayed for some timebecause the condition of the clients in this levelis stable. Clients with major injuries are triagedas an ESI-2 and require treatment within 10minutes.6.Which question does theregistered nurse recognize1 "Is the delegation appropriate to the situa-tion?"2 / 64

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Evolve HESI Leadership/Managementas related to the right of cir-cumstance when delegat-ing?1 "Is the delegation appro-priate to the situation?"2 "Is the task within thedelegatee's scope of prac-tice?"3 "Is the prospective dele-gate a willing and able em-ployee?"4 "Is the delegator able tomonitor and evaluate theclient appropriately?"The question, "Is the delegation appropriate tothe situation?" is related to right circumstance.The question, "Is the task within the delega-tee's scope of practice?" is related to right task.The question, "Is the prospective delegate awilling and able employee?" is related to rightperson. The question, "Is the delegator able tomonitor and evaluate the client appropriately?"is related to right supervision.7.Which factors does the reg-istered nurse consider inthe decision to delegateprocess? Select all that ap-ply.1 Evaluation2 Nursing judgment3 Predictability of out-comes4 Pervasive functions of as-sessment5 Complexity of the task tobe performed3, 5Two factors responsible for the decision to del-egate process are predictability of outcomesand complexity of the task to be performed.Evaluation, nursing judgment, and pervasivefunctions are not factors in the decision to del-egate process.8.Under a leader, a teamof followers has failedto achieve success inconducting research. Whatdoes an effective leader doin this situation?1 Criticizes the team mem-4 Accepts failure and gains experience from itAn effective leader should accept the failureand gain experience from it to avoid repetitionof the same errors.The effective leader should counsel and mo-tivate the team members for future success3 / 64

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Evolve HESI Leadership/Managementbers for failure2 Provides excuses for thenegative outcome3 Refuses to take the re-sponsibility for failure4 Accepts failure and gainsexperience from itand should not criticize them. Making excusesfor the negative outcome is not the correct ac-tion of the effective leader. The effective leadershould take responsibility for the failure and thegrowth he or she will gain from it.9.The nursing manag-er wants to implementtransformational leader-ship qualities. Which ac-tions best describe thisstyle of leadership? Selectall that apply.1 Providing intellectualstimulation2 Intervening only whenproblems exist3 Performing experimentswith system redesign4 Using motivator factorsto inspire work perfor-mance5 Monitoring performanceand taking action to correct1, 3, 4Transformational leaders provide intellectualstimulation and encourage follower creativity.They experiment with systems redesign, em-power staff, create enthusiasm for practice,and promote scholarship of practice in clientcare. They use motivator factors liberally toinspire work performance.Intervening only when problems exist is abehavior related to transactional leadership.Monitoring performance and taking correctiveaction is a transactional leadership quality.10.Which component of del-egation is defined as theability to perform duties ina specific role?1 Authority2 Supervision3 Responsibility4 Accountability1Authority is the ability to perform duties in aspecific role.Supervision is the provision of guidance andoversight of a delegated task. Responsibilityrefers to reliability, dependability, and oblig-ation to accomplish work. Accountability in-volves determining whether the actions are ap-propriate and providing a detailed explanationof what has occurred.4 / 64

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Evolve HESI Leadership/Management11.The healthcare team is car-ing for a client with neu-tropenia. Which task is del-egated to unlicensed assis-tive personnel?1 Administering antibiotics2 Assisting with personalhygiene3 Monitoring for signs andsymptoms of infection4 Teaching the client andcaregivers about how toavoid infection2Unlicensed assistive personnel assisting withthe client's personal hygiene.The licensed practical nurse administers an-tibiotics. Monitoring for signs and symptomsis performed by the licensed practical nurse.The registered nurse teaches the client andcaregivers how to avoid infection.12.A client's serum potassiumlevel has increased to 5.8mEq/L (5.8 mmol/L). Whataction should the nurse im-plement first?1 Call the laboratory to re-peat the test.2 Take vital signs and notifythe healthcare provider.3 Inform the cardiac arrestteam to place them on alert.4 Take an electrocardio-gram and have lidocaineavailable.2Vital signs monitor cardiorespiratory status;hyperkalemia causes cardiac dysrhythmias.The healthcare provider should be notified be-cause medical intervention may be necessary.A repeat laboratory test will take time andprobably reaffirm the original results; the clientneeds immediate attention. The cardiac arrestteam is always on alert and will respond whencalled for a cardiac arrest. Taking an electro-cardiogram and having lidocaine available areinsufficient interventions.13.The nurse has accepteda position as a navigator.What should the nurse ex-pect to learn during train-ing for this role? Select allthat apply.1 Approaches to reduce the2, 3, 4, 5Navigators are responsible for overcominghealth system barriers, providing health edu-cation about diseases from prevention to treat-ment, addressing barriers to care, and provid-ing psychosocial support. These are the areasthe nurse should expect to focus on when be-ing trained in the role.5 / 64

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Evolve HESI Leadership/Managementcost of health care2 Learning ways to workthrough the health systems3 Strategies to teachclients about disease, in-cluding prevention andtreatment4 Assessing barriers thatclients have encounteredwhile attempting to receivecare5 Helping clients cope withdelays in receiving treat-ment until barriers areovercomeLearning approaches to reduce the cost ofhealth care would be appropriate for a casemanager to learn.14.What aspect of total clientcare needs to be taken intoconsideration if used on a24-bed care area?1 Cost of nurses2 Training needs3 Documentation4 Time commitment1 Cost of nursesSince total client care is provided by a reg-istered nurse (RN) it can be very expensiveand not realistic to use a highly skilled andextremely knowledgeable professional nurseto provide all the care required in a unit of 24clients.There are no particular issues with training,documentation, or time commitment with totalclient care.15.For which situations wouldtotal client care be an ap-propriate delivery system?Select all that apply.1 Client scheduled forlithotripsy for renal calculi2 Client with an endotra-cheal tube for pulmonarysepsis2, 3, 4Total client care is used in critical care settingswhere one nurse provides total care to one ortwo critically ill clients. The client with an en-dotracheal tube for pulmonary sepsis and theclient recovering from cardiovascular bypassgraft surgery are considered acutely ill and willbe receiving care in a critical care area. Theclient recovering from cranial surgery to placea cerebrospinal fluid shunt would be appropri-6 / 64

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Evolve HESI Leadership/Management3 Client recoveringfrom cardiovascular by-pass graft surgery4 Client recovering fromthe placement of a cere-brospinal fluid shunt5 Client transferring to a re-habilitation unit after totalhip replacement surgeryate for total client care.Total client care would not be an ideal careapproach for the client scheduled for lithotripsyor the client being transferred to a rehabilitationunit.16.Which intervention shouldthe charge nurse performto manage a task whenthe unlicensed nursing per-sonal (UNP) is lacking com-petence?1 Provide constructivefeedback and assign an-other task.2 Provide open vocal feed-back and withdraw the UNPfrom task.3 Provide additional sup-port and temporarily lowerexpectations.4 Provide accountability tothe organization and un-dergo training again.3 Provide additional support and temporarilylower expectations.The charge nurse should manage a task bytemporarily lowering expectations and provid-ing additional support to an unlicensed nurs-ing personal (UNP) who is lacking compe-tence. This strategy allows the UNP to buildon strengths, minimize weaknesses, and gainconfidence.Providing constructive feedback and assigninganother task may not improve the strategy ofthe UNP and may affect the productivity ofthe new task. Withdrawing the UNP from thetask and providing open vocal feedback mayweaken the working relationship and the UNPmay lose confidence or become frustrated.The charge nurse should be aware of account-ability to the organization in case of a failureof the delegation, but assigning the UNP forfurther training may lead to high risk for legalliability.17.Which statement wouldmost likely be made bya client who is receivingcare through the functionalmethod?3 "I have to wait until the medication nurse isavailable for a pain pill."In the functional method, staff are assignedtasks according to scope of practice. In this7 / 64

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Evolve HESI Leadership/Management1 "My nurse's name isAmy."2 "Susan will be caring forme until 7 pm."3 "I have to wait until themedication nurse is avail-able for a pain pill."4 "Barbara coordinated allof my care but I might re-ceive the care from othernurses."approach a medication nurse will be identified.Knowing the nurse's name would more likelybe a characteristic of team or primary nursing.Knowing which nurse will provide care for aspecific period of time would indicate the caseapproach to care. Knowing which nurse coordi-nated the care that might be provided by otherswould more likely indicate primary nursing orcase management.18.Which constructive as-pects of conflict does thenurse leader identify? Se-lect all that apply.1 Polarizes groups2 Releases pent-up emo-tions3 Promotes ineffectivecommunication4 Helps individuals growpersonally5 Builds cohesivenessamong people2, 4, 5Conflict serves as a release for pent-up emo-tion, anxiety, and stress. It helps individuals togrow personally and apply what they learn tofuture situations. It helps to build cohesivenessamong people sharing the conflict, celebratingin its settlement and learning more about eachother.It polarizes groups so they increase internalcohesiveness and reduce intergroup coopera-tion; this is a destructive aspect of conflict. Au-thentic communication is an aspect of conflictbut not improbable communication.19.When does delegation be-come more challenging?Select all that apply.1 When the client is stable2 When the client is preg-nant3 When the geographicarea is small4 When the resources areabundant2 When the client is pregnant, 5 When schoolchildren are receiving careThe delegation process becomes more chal-lenging when vulnerable populations such aspregnant women and school children are re-ceiving care.Delegation can be safely and successfully car-ried out in the stable client. Delegation canbe accomplished successfully when the ge-8 / 64

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Evolve HESI Leadership/Management5 When school children arereceiving careographical area is small and resources areabundant.20.A client reports severe pain2 days after surgery. Afterassessing the characteris-tics of the pain, which ini-tial action should the nursetake next?1 Encourage rest.2 Obtain vital signs.3 Administer the pre-scribed analgesic.4 Document the client'spain response.2 Obtain vital signs.Immediately before administration of an anal-gesic, an assessment of vital signs is neces-sary to determine whether any contraindica-tions to the medication exist (e.g., hypotension,respirations d12 breaths/min).Pain prevents both psychological and physi-ologic rest. Before administration of an anal-gesic, the nurse must check the healthcareprovider's prescription, the time of the last ad-ministration, and the client's vital signs. A com-plete assessment, including vital signs, shouldbe done before documenting the client's painresponse.21.A nurse leader, along withthe team, is caring for aclient who is scheduled forcolonoscopy. Which dele-gated task requires theleader's supervision?1 Assisting the client withan enema2 Assisting the client withbathing3 Assisting the client withfeeding4 Assisting the client withambulating1 Assisting the client with an enemaA client who is scheduled for colonoscopy re-quires having the gastrointestinal tract emp-tied, mainly the colon. Before undergoing thisprocedure the client is assisted with an enemaand other laxatives to expel all bowel contentspresent in the gastrointestinal tract. A nurseleader should supervise this procedure, as aninadequately emptied colon may cause com-plications.Assisting the client with bathing, feeding, andambulating are easy tasks and may not requiresupervision.22.Which comment by a teamleader exemplifies teamnursing the way it was in-2 "(Registered Nurse 1), check all of the intra-venous (IV) sites and give the IV medications."9 / 64

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Evolve HESI Leadership/Managementtended?1 "(Unlicensed assistivepersonnel), I need you tomeasure all vital signs."2 "(Registered Nurse 1),check all of the intravenous(IV) sites and give the IVmedications."3 "(Licensed PracticalNurse), you pass all ofthe oral medications to theclients today."4 "(Registered Nurse 2), Mr.Jones has a foot wound,two IV meds, and needsmorning insulin."The team leader must have excellent com-munication skills, delegation, and effective de-cision-making abilities to provide a working"team" environment for members. When theteam leader is not prepared for this role, theteam method becomes a miniature version ofthe functional method. The assignment givento RN 1 takes the nurse's experience and skillsinto consideration and exemplifies team nurs-ing.The statements made to the UAP, LPN, andRN 2 exemplify functional nursing.23.The registered nurse findsthat two nursing studentsare arguing with each oth-er. Which action by the reg-istered nurse best repre-sents a leadership quality?1 Complaining to manage-ment and asking the stu-dents to go outside2 Letting them continue ar-guing until they resolve thematter themselves3 Assessing the conditionand strategizing to resolvethe matter by reducing thedifference4 Asking the reason fortheir argument and repri-manding them for having3Visioning is required by an efficient leader toengage others to assess the current reality.This skill includes determining and specifyinga desired end-point state and then strategizingto reduce the differences.Letting them continue arguing and waiting untilthey resolve the matter may allow the argu-ment to escalate. Complaining to managementwould pass off responsibility for a resolutionand would not indicate leadership. Reprimand-ing the nurses may stop the argument, butwould not be a constructive approach.10 / 64

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Evolve HESI Leadership/Managementthe argument in the hospi-tal24.Which point should thenurse exclude when devel-oping strategies to projecta powerful image?1 Using authoritative lan-guage2 Maintaining good bodyposture3 Making good eye contactwith clients4 Ensuring that clothingand hair are appropriate tothe situation1 Using authoritative languageThe nurse should treat people with courtesyand respect. The use of authoritative languagedoes not help in developing a powerful image.The nurse should also maintain good bodyposture because it conveys self-confidence.Good eye contact helps in developing trust.Appropriate dress and hair help convey a pow-erful image.25.Which statement of thenurse leader reflects theactions suggested by theJoint Commission for dis-ruptive behavior by a directcare nurse?1 "This is the last warningfor you."2 "You are terminated, ef-fective now."3 "This will affect your as-sessment markings."4 "You should not behavethis way because you arevery talented."2 "You are terminated, effective now."According to the actions suggested by theJoint Commission, there is "zero" tolerance foran intimidating and/or disruptive behavior. Theaction to be taken for this type of behaviorshould be suspension, termination, loss of clin-ical privileges, and reporting to professionallicensure bodies.The actions suggested by the Joint Commis-sion do not include giving last a warning. Thenurse who has behaved disruptively is not eligi-ble for any assessment. By saying, "You shouldnot behave this way because as you are verytalented," the actions suggested by Joint Com-mission are not being carried out.26.According to thethree-tiered triage system,which client requires ur-1, 4, 5According to the three-tiered triage system, re-nal colic, severe abdominal pain, and multiple11 / 64

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Evolve HESI Leadership/Managementgent treatment? Select allthat apply.1 A client with renal colic2 A client with strains andsprains3 A client with respiratorydistress4 A client with severe ab-dominal pain5 A client with multiple dis-placed fracturesdisplaced fractures require urgent treatment.Strains and sprains require nonurgent treat-ment and respiratory distress requires emer-gent treatment.27.The nurse finds the respi-ratory rate is 8 breaths perminute in a client who is onintravenous morphine sul-fate. What should the nursedo immediately in this situ-ation?1 Measure other vital signs.2 Stop administering themedication.3 Elevate the head of theclient's bed.4 Report to the primaryhealthcare provider2 Stop administering the medication.Morphine sulfate is an opioid analgesic andcan depress the central nervous system,which results in respiratory depression. A res-piratory rate of 8 breaths per minute indicatesrespiratory depression, and the nurse shouldstop the medication immediately.The nurse can measure the other vital signsafter discontinuing the medication administra-tion. Elevating the head of the client's bed en-sures proper breathing. Therefore the nurseshould elevate the client's bed after discontinu-ing the medication. The nurse should report tothe primary healthcare provider for an appro-priate antidote after stopping the medicationadministration.28.A client is admitted tothe emergency depart-ment following a mo-tor vehicle accident. Theclient's wounds are ex-tensive. Which healthcareteam member is best suited2 Registered nurseA registered nurse should be the healthcareteam member to care for the client in the emer-gency department. The charge nurse's role in-cludes making client assignments, schedulingbreaks for staff members, and serving as a12 / 64

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Evolve HESI Leadership/Managementto care for this client in theemergency ward?1 Charge nurse2 Registered nurse3 Licensed practical nurse4 Unlicensed nursing per-sonnelstaff resource person. The licensed practicalnurse is involved in fast-track emergency care.Unlicensed nursing personnel perform all hy-gienic tasks and are not required in the emer-gency care unit.29.A registered nurse (RN)delegates the task of footcare for a client to an un-licensed nursing personnel(UNP). The UNP is skillfuland willing to perform thegiven task, but was recent-ly hired and is unfamiliarwith the client's condition.What should the RN do inthis situation?1 Provide guidance to theUNP.2 Observe and motivate theUNP.3 Establish mutual expec-tations and conditions.4 Explain what to do andhow to perform the task.3 Establish mutual expectations and condi-tions.If the delegatee is new to the workplace, buthas the ability and willingness to perform atask, the RN should establish mutual expecta-tions and conditions of performance to estab-lish a good relationship.If the delegatee has limited knowledge andability to perform a task, the delegator is ex-pected to guide the UNP. The RN is expectedto observe and monitor the task performed bythe delegate to ensure the delegatee has theability and willingness to establish a relation-ship and accomplish the work. The RN canalso explain the task and how to execute it if thesituation involves a new task and relationshipis ongoing.30.Which characteristics ofa licensed practical nurseshould be considered be-fore delegation of tasks?Select all that apply.1 Critical thinking2 Effective client care3 Diagnostic reasoning1, 3, 4Critical thinking, diagnostic reasoning, and theability to synthesize information from varioussources are three factors that are characteris-tics of the licensed practical nurse that shouldbe considered before delegating tasks.Planning effective client care is the role ofa registered nurse. Accountability for an as-13 / 64

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Evolve HESI Leadership/Management4 Synthesizing information5 Accountability of as-signed tasksigned task is the basic responsibility of anurse.31.The registered nurse is car-ing for a client admitted tothe hospital with chronicobstructive pulmonary dis-ease. Which assessmentby the registered nurse be-fore delegating would helpto determine the principleof "right person"?1 "Is the environment con-ducive for completing thetask safely?"2 "Does the licensed practi-cal nurse (LPN) know aboutpolices of the institution?"3 "Can the nursing assis-tive personnel (NAP) eval-uate the client's' conditionappropriately?"4 "Does the nursing assis-tive personnel (NAP) havethe knowledge and exper-tise to perform the task?"4 "Does the nursing assistive personnel (NAP)have the knowledge and expertise to performthe task?"In this situation, "Does the NAP have knowl-edge and expertise to perform the task?" isrelated to the right person for delegation. Theright person deals with expertise and experi-ence, knowledge and skills.The assessment, "Is the environment con-ducive for completing the task safely?" is relat-ed to right circumstance.The assessment, "Does the LPN know aboutpolices of the institution?" is related to righttask.The assessment, "Can the NAP evaluate theclient's condition appropriately?"is related toright supervision.32.The nurse delegates thetasks of caring for a post-partum client. During as-sessment, the nurse ob-serves an infection in theclient caused by lack ofhygiene. Which member ofthe health care team ismost likely responsible forthe client's condition? Se-2, 5The registered nurse may delegate the tasksof basic client care to the unlicensed assistivepersonnel (UAP), but is responsible and ac-countable for the outcome of the task. UAP areresponsible for the client's basic hygiene andcomfort.A physician may delegate the task of clientcare to the registered nurse and other assistive14 / 64

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Evolve HESI Leadership/Managementlect all that apply.1 Physician2 Registered nurse3 Licensed practical nurse4 Licensed vocationalnurse5 Unlicensed assistive per-sonnelpersonnel. A licensed practical nurse (LPN)or licensed vocational nurse (LVN) generallycarries out tasks such as administering oralmedication, but is not typically responsible forclient hygiene if UAP are available.33.Why does a nurse manag-er assign a resource per-son in a healthcare organi-zation?1 To delegate tasks2 To supervise actions3 To serve as a mentor4 To reassign duties toworkers3 To serve as a mentorThe nurse manager assigns a resource personin a healthcare organization to serve as a men-tor for the agency nurse to prevent potentialproblems that could arise if the staff memberdoes not know the institutional routine.The nurse manager also delegates a task,supervises actions, and reassigns duties toworkers.34.A nurse is assisting anoth-er registered nurse in theintensive care unit who iscaring for a client with un-controlled blood pressure.Which action on the part ofthe nurse indicates "offer-ing" during delegation de-cisions?1 "Did you check theclient's blood pressure thismorning?"2 "You can use thisstethoscope and sphyg-momanometer to take theblood pressure."2 "You can use this stethoscope and sphygmo-manometer to take the blood pressure."Offering involves making a suggestion to facili-tate the achievement of a desirable client careoutcome. The statement, "You can use thisstethoscope and sphygmomanometer to takethe blood pressure," is an example of offering.Asking begins with questions related to theproblem or issue regarding client care. "Didyou check the client's blood pressure thismorning?" is an example of asking.Doing involves demonstrating the specific taskor behavior needed to improve client care."Would you fetch me the client's laboratory15 / 64

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