ATI RN LEADERSHIP 2025/2026 – 70
UPDATED NGN EXAM STYLE PRACTICE
GUIDE WITH ACCURACY-REVIEWED
RATIONALES
SECTION 1: DELEGATION & SCOPE OF PRACTICE
Question 1: The RN delegates vital signs to an assistive personnel (AP). Which
client 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 2: Which task is appropriate for the RN to delegate to a licensed
practical nurse (LPN)?
A) Performing the initial admission assessment
B) Teaching a client about insulin administration
C) Administering a tube feeding to a stable client
D) Evaluating the client's response to pain medication
Correct Answer: C
Rationale: LPNs can administer enteral feedings to stable clients with established
,plans. Initial assessment (A), teaching (B), and evaluation (D) are the RN's legal
responsibility .
Question 3: The charge nurse observes an LPN preparing to administer IV push
potassium. What should the charge nurse do first?
A) Report the LPN to the board of nursing
B) Stop the LPN immediately
C) Review the facility policy on IV push medications
D) Complete an incident report
Correct Answer: B
Rationale: IV push potassium is dangerous and can cause fatal cardiac
arrhythmias. The charge nurse must stop the LPN immediately to prevent patient
harm. Reporting and education would follow .
Question 4: A charge nurse is assigning clients to an RN and an LPN. Which client
should the charge nurse assign to the LPN?
A) Client with a chest tube and continuous bubbling in the water seal chamber
B) Client requiring tracheostomy suctioning every 4 hours
C) Client with new stroke symptoms
D) Client receiving a blood transfusion
Correct Answer: B
Rationale: LPNs can perform stable, standard procedures like tracheostomy
suctioning. Initial assessments, unstable clients, blood transfusions, and patient
education require an RN .
Question 5: Which task is outside the scope of practice for an assistive personnel
(AP)?
A) Emptying a Foley catheter bag
B) Feeding a client without dysphagia
C) Applying a sterile dressing
D) Reporting a temperature of 38.5°C (101.3°F)
, Correct Answer: C
Rationale: Sterile dressings require LPN or RN skills. APs can empty Foley bags (A),
feed stable clients (B), and report findings (D) .
Question 6: The RN delegates ambulation to an AP. The client falls. Who is legally
responsible?
A) AP only
B) RN only
C) RN and AP both
D) Hospital administration only
Correct Answer: C
Rationale: The RN is accountable for appropriate delegation (right task, right
circumstance, right person). The AP is accountable for safe performance. Both
share legal responsibility .
Question 7: Which client should the charge nurse assign to an RN rather than an
LPN?
A) Client needing routine morning medications
B) Client with a chest tube and continuous bubbling in the water seal chamber
C) Client with a stage 2 pressure injury requiring dressing change
D) Client with chronic pain requesting PRN acetaminophen
Correct Answer: B
Rationale: Continuous bubbling in a chest tube indicates an air leak requiring
troubleshooting and assessment. This complex client requires the most
experienced nurse .
Question 8: An LPN reports a client's blood glucose is 45 mg/dL. What should the
RN do first?
A) Tell the LPN to give orange juice
B) Assess the client for hypoglycemia symptoms
C) Call the provider
D) Recheck the glucose yourself
UPDATED NGN EXAM STYLE PRACTICE
GUIDE WITH ACCURACY-REVIEWED
RATIONALES
SECTION 1: DELEGATION & SCOPE OF PRACTICE
Question 1: The RN delegates vital signs to an assistive personnel (AP). Which
client 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 2: Which task is appropriate for the RN to delegate to a licensed
practical nurse (LPN)?
A) Performing the initial admission assessment
B) Teaching a client about insulin administration
C) Administering a tube feeding to a stable client
D) Evaluating the client's response to pain medication
Correct Answer: C
Rationale: LPNs can administer enteral feedings to stable clients with established
,plans. Initial assessment (A), teaching (B), and evaluation (D) are the RN's legal
responsibility .
Question 3: The charge nurse observes an LPN preparing to administer IV push
potassium. What should the charge nurse do first?
A) Report the LPN to the board of nursing
B) Stop the LPN immediately
C) Review the facility policy on IV push medications
D) Complete an incident report
Correct Answer: B
Rationale: IV push potassium is dangerous and can cause fatal cardiac
arrhythmias. The charge nurse must stop the LPN immediately to prevent patient
harm. Reporting and education would follow .
Question 4: A charge nurse is assigning clients to an RN and an LPN. Which client
should the charge nurse assign to the LPN?
A) Client with a chest tube and continuous bubbling in the water seal chamber
B) Client requiring tracheostomy suctioning every 4 hours
C) Client with new stroke symptoms
D) Client receiving a blood transfusion
Correct Answer: B
Rationale: LPNs can perform stable, standard procedures like tracheostomy
suctioning. Initial assessments, unstable clients, blood transfusions, and patient
education require an RN .
Question 5: Which task is outside the scope of practice for an assistive personnel
(AP)?
A) Emptying a Foley catheter bag
B) Feeding a client without dysphagia
C) Applying a sterile dressing
D) Reporting a temperature of 38.5°C (101.3°F)
, Correct Answer: C
Rationale: Sterile dressings require LPN or RN skills. APs can empty Foley bags (A),
feed stable clients (B), and report findings (D) .
Question 6: The RN delegates ambulation to an AP. The client falls. Who is legally
responsible?
A) AP only
B) RN only
C) RN and AP both
D) Hospital administration only
Correct Answer: C
Rationale: The RN is accountable for appropriate delegation (right task, right
circumstance, right person). The AP is accountable for safe performance. Both
share legal responsibility .
Question 7: Which client should the charge nurse assign to an RN rather than an
LPN?
A) Client needing routine morning medications
B) Client with a chest tube and continuous bubbling in the water seal chamber
C) Client with a stage 2 pressure injury requiring dressing change
D) Client with chronic pain requesting PRN acetaminophen
Correct Answer: B
Rationale: Continuous bubbling in a chest tube indicates an air leak requiring
troubleshooting and assessment. This complex client requires the most
experienced nurse .
Question 8: An LPN reports a client's blood glucose is 45 mg/dL. What should the
RN do first?
A) Tell the LPN to give orange juice
B) Assess the client for hypoglycemia symptoms
C) Call the provider
D) Recheck the glucose yourself
