ATI RN Leadership 2025/2026 – Updated NGN Exam-Style Practice Guide with and Accuracy-Reviewed Rationales Exam

ATI RN Leadership 2025/2026 –
Updated NGN Exam-Style Practice
Guide with and Accuracy-Reviewed
Rationales
EXAM
Topic 1: Delegation & Scope of Practice (Questions 1-20)

Question 1
An RN is delegating tasks to an LPN and an AP. Which of the
following tasks should the RN delegate to the LPN?

 A. Ambulating a client who had a stroke with unilateral
weakness
 B. Performing the initial admission assessment on a new
client
 C. Administering a tube feeding to a stable client
 D. Teaching a client about insulin administration

Correct Answer: C

Rationale: LPNs can administer enteral feedings to stable clients
with established care plans. Initial assessments (B) and teaching
(D) are RN responsibilities. Ambulating a client with a stroke (A)
can be delegated to an AP under RN supervision.

,Question 2
The RN delegates vital signs to an AP. Which client's vital sign
finding requires the RN to reassess the AP's measurement?

 A. Post-operative day 2, afebrile, stable
 B. Newly admitted with pneumonia, SpO2 89% on room air
 C. Chronic hypertension, BP 138/88
 D. Hip replacement, pain reported as 3 out of 10

Correct Answer: B

Rationale: An oxygen saturation of 89% is abnormal and
indicates hypoxia, requiring immediate RN assessment. Options A,
C, and D represent stable findings that do not require the RN to
override the AP's measurement.




Question 3
A charge nurse is assigning clients to an RN and an LPN. Which
client should be assigned to the LPN?

 A. Client requiring tracheostomy suctioning every 4 hours
 B. Client with a chest tube and continuous bubbling in the
water seal chamber
 C. Client requiring a blood transfusion
 D. Newly admitted client requiring an initial assessment

Correct Answer: A

Rationale: LPNs can perform stable, standard procedures like
tracheostomy suctioning. Initial assessments (D), unstable clients

,with chest tube air leaks (B), and blood transfusions (C) require an
RN.




Question 4
A nurse is making shift assignments. Which task can be delegated
to an AP?

 A. Assessing a client's post-operative incision
 B. Ambulating a client who had a stroke with unilateral
weakness
 C. Administering a medication
 D. Performing a sterile dressing change

Correct Answer: B

Rationale: APs can ambulate stable clients under RN supervision.
They cannot perform assessments (A), administer medications (C),
or perform sterile procedures (D).




Question 5
The RN is supervising a new graduate nurse. Which action by the
new graduate requires the RN to intervene?

 A. Administering an IM injection without verifying the client's
identity
 B. Documenting a client's vital signs
 C. Reporting a change in client status to the provider

,  D. Ambulating a client with assistance

Correct Answer: A

Rationale: Client identification requires two identifiers before any
medication administration. Skipping this step is a safety violation
requiring immediate intervention and teaching.




Question 6
An RN is delegating care to an AP. Which statement by the AP
indicates a need for further teaching?

 A. "I will report any change in the client's condition to the
RN."
 B. "I can take vital signs on stable clients."
 C. "I can teach the client how to use the call light."
 D. "I can assist the client with meals."

Correct Answer: C

Rationale: Teaching is beyond the scope of practice for an AP.
APs can report changes (A), take vital signs (B), and assist with
meals (D).




Question 7
Which of the following tasks is appropriate for the RN to delegate
to an LPN?