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RN HESI LEADERSHIP EXIT ACTUAL
EXAM |Latest Version 2025-2026|
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A new graduate nurse is employed in a small community hospital. The nurse notices practices which seem to be very physician driven and that patients have little input into their care. Families are seen as a nuisance rather than as partners in potential care provision. What is the best approach for the new nurse to use for improving care in this setting? a)Do nothing. They are too new to the organization to make change. b)Share with the physician the recommendations from various IOM reports. c)Share with their team members what they know about the aims of providing health care. d)Report the team members to the chief nursing officer who is unlikely to know the lack of details on this unit. C Mr. Grandion was admitted to a rehabilitation center after discharge from a hospital. He has not walked in the 5 days while he was hospitalized and is provided a wheelchair. Dining with other residents is expected, and staffing is limited on a holiday weekend. What is the best strategy to ensure Mr. Grandion has sufficient nutrition and exercise? a)Tell Mr. Grandion to stay in bed and someone will bring a tray to his room because the staff can't get him to the dining room in time for dinner b)Assist Mr. Grandion into his wheelchair and remind him that in 2 hours he must be in the dining room if he wishes to eat. c)Request help from another unit before dinner and indicate the nature of help needed. d)Order a life device to transfer Mr. Grandion from his bed to the wheelchair. c
When entering the postoperative care unit, the nurse manager notices that the temporary agency nurse has incorrectly entered the rate of infusion for the patient's vasopressor medication, and the arterial line blood pressure has a reading of 76/40 mmHg. After discontinuing the intravenous medication infusion, what is the nurse manager's next intervention? a)Notify the nurse in charge of the unit. b)Ask if there is an assigned resource nurse to serve as mentor for the temporary nurse. c)Ask if there are standing orders for interventions for hypotension. d)Ask if the temporary nurse has had an orientation to the unit. C An incident report of the incident described in the previous question needs to be completed. What is the appropriate wording to be included in the incident report? a)"Patient was noted to have a low arterial blood pressure (76/40), and the vasopressor medication was discontinued." b)"Patient's vasopressor medication was infusing at a higher rate than ordered and the medication was discontinued when the patient's blood pressure dropped to 76/40." c)"Nurse M.J. started the vasopressor medication, the patient subsequently was noted to have a blood pressure reading of 76/40, the medication was discontinued, and the physician was also notified." d)"Patient receiving vasopressor medication intravenously, blood pressure noted to be 76/40, and intravenous infusion discontinued. Physician notified and orders received for 500 mL normal saline administered for hypotension." D The nurse is needing to provide information for Foley catheter insertion to a patient in the patient's primary language. Which action would the nurse follow for the best outcome in this situation? a) Assume the process of translating "word for word" is sufficient when a treatment is ordered for a culturally diverse patient. b) Request an English-speaking family member to provide the translation to the patient about the treatment. c) Create a cross-cultural semantic or word equivalency vocabulary list for the nursing unit to use with patient. D. Request a healthcare professional translator to translate verbally the source language to the target language with the patient regarding the procedure.
frequently reschedules meetings for personal reasons yet gives others a hard time for similar requests for absences. a What is the BEST way that nurse leaders can reduce stress on the job? a) Delegate to others who are unlicensed, whenever possible. b) Support a professional practice model and learn to "let go." c) Be available 24/7 so the staff feel supported. d) Post the Employee Assistance Hotline in the staff lounge. B A very close relationship exists between stress management and time management. What is the best way to define time management? a) "Going with the flow" so that unexpected events don't have a negative impact on the plans for the day b) Using tools and principles to engage others in low-priority needs and objectives in order that the leader may occupy self with high-priority needs c) Using tools, techniques, and principles to achieve personal and professional goals d) Doing things that matter to others, such as supervisors, subordinates, and peers C Two employees disagree about who should work on Christmas Day. The bottom line is that one employee will have to work, and the schedule must be posted tomorrow. What is the best method for the nurse manager to assist in the conflict between the nurses? a) Use your position of power to resolve the conflict. You decide who will work Christmas Day. b) Rely on centralized staffing to resolve the issue. c) Try to arrange a compromise. Have one employee work the first half of the shift and have the other work the second half d) Meet with both employees at the same time. Engage them in the problem-solving process. D
During bedside rounds, a surgeon turns to the charge nurse and says, "The poor nursing care has caused this wound to become infected. Can't nurses at this hospital do anything right?" What is the appropriate response by the charge nurse? a) "The nursing care on this unit has received awards and certainly is not the problem." b) "Let's first decide what to do for Mrs. Johnson and then step into the hall and talk further about your concerns." c) "It is inappropriate to talk to me that way. I will report this to my supervisor." d) Would you like to change the antibiotic Mrs. Johnson is receiving?" b Nurses were long viewed by physicians, legislators, the media, and others as powerless because nurses: a)declined to participate in political activities in the earliest years of the profession in the United States. b)as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-century America. c)and nursing leaders in the mid-20th century did not wish to be viewed by those outside of nursing as pushy or demanding. were subject to nursing practice acts that limited their ability to take political action. B When caring for a patient who had a hip replacement that morning, a nurse is providing what level of care? a)Primary b)Secondary c)Tertiary d)Essential B To maximize the coordination of care, provide seamless transitions, and improve quality of care, organizations are increasingly turning to which organizational structure? a)Academic medical centers b)Public health institutions c)Accountable care organizations d)Proprietary, investor-owned organizations C What is the most effective strategy for an organization to take in order to maximize authority and accountability for all aspects of nursing practice in the nurses responsible for the delivery of care? a)Position management and administrative levels to coordinate and facilitate the work of the practicing nurses. b)Define in specific detail the daily activities of frontline nurses.
c)Administer medication d)Check the five rights d A new nurse wants to be a change agent on the unit. What action listed would be the MOST appropriate for the nurse to take? a)Become an early adopter b)Wait until a more experienced nurse vocalizes support c)Seek help from her nurse manager d)Talk to a peer on another unit about the problems with more experienced nurses A A new staff nurse discovers two of the certified nursing assistants (CNAs) in the utility room speaking loudly and pointing at each other. What is the MOST appropriate action by the nurse? a)Continue walking down the hall, believing they will work it out. b)Walk into the utility room and tell them to stop or they will be reported to HR. c)Make an observation about their behavior and ask them what's going on. d) Get the nurse manager and take her to the utility room. d What type of performance appraisal is based on the employee and manager jointly setting goals? a)Management by objective b)Behaviorally anchored rating scales c)Critical incidents d)Narrative method a Role theory provides one framework for development and evaluation of staff. What term describes when employees are unwilling or unable to meet requirements? a)Role ambiguity b)Role conflict c)Role acquisition d)Role clarity B An 83-year-old white man is admitted to a large suburban nursing home. Today, an African-American nurse's aide is assigned to care for the patient and assist him with a shower. The patient refuses to go with the nurse's aide for the shower. Later in the day, the patient's son arrives and insists that no African Americans be allowed to participate in the patient's care. Only a few nurse's aides and professional staff members in this setting are African American. What is the most appropriate strategy to manage this situation? a)Refer the patient and his son to the administration. b)Because this will be the patient's home, plan the care to accommodate the family's wishes.
c)Offer to have someone else bathe the patient today until someone in administration can talk with the patient. d)Indicate that it is not within the institution's practice to restrict who provides care to patients. D A new graduate is asked to serve on the hospital's Quality Improvement Committee. What does the nurse know is the first step in the quality improvement process? a)Collect data to determine if standards are met b)Implement a plan to correct the problem c)Identify the standard d)Determine if the findings warrant correction C A nurse manager wants to decrease the number of medication errors that occur in the department. The manager arranges a meeting with the staff to discuss the medication error concerns. How does the manager convey a philosophy of total quality management? a) Explaining to the staff that disciplinary action will be taken for further errors b) Recommending that a multidisciplinary team assess the root cause of the medication errors c) Suggesting that the pharmacy department explore their role in the problem d) Changing the unit policy to allow a certain number of medication errors per year without penalty B A nurse manager wants to highlight the accomplishments of the nurses who are providing high-quality care on a medical unit in a tertiary care medical center. What is an example of a nurse-sensitive outcome that could be used for this project? a)Pressure ulcer rate compared with a national benchmark rate b)Patient satisfaction scores compared with other hospitals c)Nurse satisfaction scores compared with other hospitals d)Percentage of patients with heart failure who are prescribed an angiotensin-converting enzyme (ACE) inhibitor on hospital discharge A Recently, a medical center surveyed patients who smoked regarding their desire to quit smoking. A high percentage were "motivated smokers," interested in quitting in the next 30 days, but were not offered resources to help with quitting. The nursing research council wants to introduce an evidence- based protocol for smoking cessation based on patient survey findings. What would be an appropriate initial action? a)Start a journal club to review the protocol. b)Survey nurses to determine barriers and facilitators to using smoking cessation interventions. c)Distribute the protocol to all staff nurses. d)Collaborate with physicians to develop a standard set of orders to be implemented for all patients. B
b)A summary of the verbal resignation discussion with the manager c)A list and full description of co-workers' annoying off-duty behaviors A positive statement about what has been learned from the position c Which of the generations is challenged by sharing leadership with other generations? a)Baby Boomers b)Generation Y c)Generation X d)Generation Z A Which of the following represents outcomes of transformational leadership? a)Deadlines are met. b)Work is completed according to the rules. c)Increased job satisfaction d)Pay tends to be higher. C What is not addressed by managers when effectively implementing organizational change that promotes patient safety? a)Learn quickly as you must complete all tasks before the end of the shift. b)Create and sustain trust. c)Actively manage the change process. Involve the staff in decision making in the redesign of the workflow. a Which objective best reflects the SMART objectives in planning a process? a)To obtain the Beacon Award b)To successfully work as a team and gather all evidence to obtain the Beacon Award by December 2020 c)To conduct a gap analysis for the Beacon Award To think about applying for the Beacon Award B What is the benefit of strategic planning for a healthcare organization? (Select all that apply.) a)It allows an organization to set its vision and goals. b)It allows an organization to assess its strengths, weaknesses, opportunities, and threats. c)It defines the driving forces in the environment. d) All of the above D The new chief nursing officer has asked for volunteers to participate in a strategic thinking activity. What is the rational for volunteering for new opportunity which the person has no experience?
a)Getting ahead in an organization depends on how well you know the leader. b)To represent the voice of your colleagues who don't seem to be well heard. c)This an opportunity to stretch your limits in your position by taking on a safe risk. d) The nurse manager said you need to do this activity to meet the next clinical promotion step. C The staff have been asked to create a new approach to providing care to a group of patients. The unit's patient satisfaction scores are 92. The dashboards indicate the organization is functioning at a high level in terms of desired outcomes. The local city has two other healthcare competitors for the same type of service as this organization provides. What is the BEST approach to take? a)Analyze the patient satisfaction scores to determine why the scores aren't 100. b)Review the literature to determine exactly what the best practices are. c)Do a gap analysis to determine where the organization may differ from the standards expected. d) Peruse a bookstore's magazine section to determine what is going on in the world. D
