Parliament elects; government carries out executive work.
Under the ordinary procedure, the Landtag elects the Ministerpräsident or Ministerpräsidentin by secret ballot with a majority of all its members. The elected person appoints the ministers. Before taking office, the government needs confirmation by the Landtag.
The head of government determines policy guidelines. Within those guidelines, ministers run their own departments on their own responsibility. Leadership therefore does not mean one person personally makes every administrative decision.

The other three answers
Similar leadership words do not replace the established title.
First Minister
First Minister is not the established title for Niedersachsen’s head of government. Being first in the government does not make this wording the correct title.
Prime Minister
Premierminister / Premierministerin is not the German title asked for. In English, prime minister may occur as a general translation; in this catalogue selection, Minister President corresponds to the German Ministerpräsident.
Mayor
A mayor heads a municipal administration. That is a different level from the government of the whole state of Niedersachsen.
The ordinary election procedure has a regulated exception.
Article 30 describes delayed government formation: an initial 21-day period is followed by a further 14-day period for possible dissolution of the Landtag. If it does not dissolve itself, a subsequent election is decided by who receives the most votes. Saying “always an absolute majority” is therefore too broad.
The public elects the Landtag, rather than directly electing this government office. The Landtag’s five-year electoral term also does not guarantee any particular person five years in office. The test question requires the title, rather than the current officeholder’s name.
Articles 29 and 37 · Formation and leadership · Constitution of Niedersachsen ↗Niedersachsen state government → Ministerpräsident / Ministerpräsidentin.
Keep parliament, government and the municipal mayor’s office distinct.
Three words for this question
- die Landesregierungstate government
- The federal state’s executive political body.
- die Richtlinienpolicy guidelines
- The basic political direction for the government’s work.
- das Ressortministerial department
- A minister’s area of responsibility.
