Leadership HESI

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Sample questions from Leadership HESI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift, four clients require follow-up. Which client should the charge nurse assess first?

   • A.A client with a stable ankle fracture asking for an ice pack
   • B.A client requesting pain medication for chronic back pain
   • C.A client with new-onset stridor after thyroid surgery
   • D.A client scheduled for discharge who needs transportation

   Rationale: Stridor after thyroid surgery suggests airway obstruction from edema or a hematoma and requires immediate assessment and intervention. The other needs are important but do not pose the same immediate threat to life. Prioritize airway, breathing, and circulation before comfort or discharge needs.

2. 2.A client states, "I want to leave the hospital now," despite the provider recommending continued treatment. Which action should the nurse take first?

   • A.Ask the family to persuade the client to stay
   • B.Ask the client to explain the reasons for wanting to leave
   • C.Document that the client is refusing all future care
   • D.Request that security prevent the client from leaving

   Rationale: The nurse should first explore the client's concerns and assess understanding, decision-making capacity, and the risks the client is willing to accept. A competent adult generally has the right to refuse treatment or leave, and security should not be used to detain the client. Documentation and notification follow discussion of risks and the client's decision.

3. 3.During a home-health visit, a newly licensed nurse asks the preceptor how to delegate care for a stable client. Which tasks are appropriate to assign to unlicensed assistive personnel? Select all that apply.

   • A.Evaluate whether a new medication relieved pain
   • B.Report a change in the client's level of alertness
   • C.Teach the client how to use a new inhaler
   • D.Obtain and record routine vital signs
   • E.Assist the client with bathing and dressing

   Rationale: Routine vital signs and assistance with bathing are appropriate delegated tasks for a stable client when the worker is competent and instructions are clear. Reporting a change in alertness is appropriate, although the licensed nurse must assess and interpret the change. Evaluating medication effectiveness and teaching inhaler use require nursing judgment and cannot be delegated to UAP.

4. 4.In the intensive care unit, a client develops sudden severe dyspnea and an oxygen saturation of 82%. Which team member should the nurse contact first after initiating immediate oxygen and assessment?

   • A.The respiratory therapist to assist with airway and oxygenation support
   • B.The case manager to discuss postdischarge services
   • C.The unit dietitian to review nutritional needs
   • D.The physical therapist to plan early mobility

   Answer and rationale are in the full material.

5. 5.A registered nurse is supervising a practical nurse caring for a client with a new prescription for IV potassium chloride. Which action is appropriate for the registered nurse to take?

   • A.Delegate the initial assessment to the practical nurse
   • B.Ask the practical nurse to administer the potassium by IV push
   • C.Ask UAP to determine whether the infusion is causing an adverse effect
   • D.Assess the client's current cardiac rhythm and laboratory results

   Answer and rationale are in the full material.