NURS 328 ATI LEADERSHIP DELEGATION AND MANAGEMENT QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A nurse manager is reviewing the principles of delegation with a newly licensed nurse. Which of the
following statements by the newly licensed nurse indicates an understanding of the five rights of
delegation?
A. "The right task must be within the delegator's scope of practice."
B. "The right direction and communication must be clear and concise."
C. "The right person is always the most experienced staff member available."
D. "The right supervision is only required for tasks delegated to unlicensed assistive personnel."
🟢B
🔴 RATIONALE: The five rights of delegation include right task, right circumstance, right person, right
direction/communication, and right supervision/evaluation. Clear and concise direction is a critical component.
Option A is incorrect because the task must be within the delegatee's scope, not the delegator's. Option C is
incorrect because the right person is the one with the appropriate skills and knowledge, not necessarily the
most experienced. Option D is incorrect because supervision is required for all delegated tasks, not just those to
UAP.
2. A charge nurse is assigning care for a team of nurses on a medical-surgical unit. Which of the following
clients should the charge nurse assign to the most experienced registered nurse?
A. A client who is 2 hours post-operative from an appendectomy and requesting pain medication.
B. A client with a new diagnosis of diabetes mellitus who needs discharge teaching.
,C. A client with a history of COPD who is exhibiting increased shortness of breath and confusion.
D. A client who needs their morning dose of an anti-hypertensive medication.
🟢C
🔴 RATIONALE: The client with COPD who is acutely decompensating (increased SOB and confusion) is the
most unstable and requires the highest level of clinical judgment and experience. This is a prioritization
question based on the ABCs and the potential for rapid deterioration. The other options represent more stable
clients or tasks that could be safely delegated to or managed by less experienced staff.
3. According to the National Council of State Boards of Nursing (NCSBN), which of the following principles is
essential for safe delegation?
A. The registered nurse is ultimately accountable for the outcomes of the delegated task.
B. The licensed practical nurse can delegate tasks to the unlicensed assistive personnel.
C. The delegating nurse is not responsible for supervising the delegatee.
D. Delegation involves transferring both the task and the accountability for the task.
🟢A
🔴 RATIONALE: The NCSBN clearly states that while a task can be delegated, the RN retains ultimate
accountability for the delegation process and the client outcome. The RN cannot delegate accountability.
Option B is incorrect because delegation is primarily an RN function. Option C is false because supervision is a
key component of delegation. Option D is a common misconception; accountability for the task remains with
the RN.
4. An RN is working on a busy surgical unit and needs to delegate tasks to an LPN and a UAP. Which of the
following tasks is appropriate for the RN to delegate to the LPN?
A. Administering an oral antibiotic to a client with a stable condition.
B. Ambulating a client who is 1-day post-operative following a hip replacement.
C. Inserting a urinary catheter for a client with urinary retention.
,D. Feeding a client who has dysphagia and requires a thickened liquid diet.
🟢C
🔴 RATIONALE: In many states and facilities, LPNs are trained and permitted to perform certain technical skills
such as urinary catheter insertion, provided they have validated competency. Option A is a task suitable for an
LPN, but Option C is a more definitive example of a skill within their scope. Option B and D are tasks
appropriately delegated to UAP.
5. A nurse is preparing to delegate tasks to a UAP. Which of the following actions is the nurse legally
required to perform before delegating?
A. Verify the UAP's competency and training for the specific task.
B. Obtain a written order from the provider for the task to be delegated.
C. Inform the UAP's supervisor of the delegation.
D. Document the delegation process in the client's medical record.
🟢A
🔴 RATIONALE: The RN must assess the competency of the delegatee to ensure they can safely perform the
task. Verification of training and competency is a non-negotiable step in safe delegation. A written order is
required for many nursing tasks (Option B), but not specifically for the act of delegation itself. Options C and D
are not standard legal requirements for the delegation process, though good practice may include
communication.
6. A nurse manager is implementing strategies to improve staff retention on a unit. Which of the following
strategies is an example of a "transformational leadership" approach?
A. Providing a bonus for staff who work extra shifts.
B. Creating a shared governance council to involve staff in decision-making.
C. Implementing a strict policy for all staff to follow without exception.
D. Disciplining staff who do not meet performance metrics.
, 🟢B
🔴 RATIONALE: Transformational leadership focuses on inspiring and motivating staff by involving them in the
vision and decision-making process. Shared governance empowers staff and fosters a sense of ownership.
Options A and D are more transactional leadership styles (rewards and punishments). Option C is an autocratic
approach.
7. A nurse is caring for a client who has a prescription for a blood transfusion. The client states, "I don't want
the blood transfusion. I know I need it, but I can't accept it." Which of the following actions should the nurse
take?
A. Explain the risks and benefits of the transfusion again in greater detail.
B. Call the provider to discuss the client's refusal.
C. Ask the client's family to persuade them to accept the transfusion.
D. Proceed with the transfusion because the client stated they know they need it.
🟢B
🔴 RATIONALE: The nurse must respect the client's autonomy and right to refuse treatment. The nurse's role is
to ensure the client's decision is informed and then to communicate the refusal to the provider. The provider
will then need to discuss alternatives or document the refusal. The nurse should not coerce the client or
proceed against their will.
8. A charge nurse is evaluating the effectiveness of a change made on the unit. According to Kotter's 8-Step
Change Model, which of the following actions represents the "anchoring new approaches in the culture"
step?
A. Forming a group to guide the change initiative.
B. Communicating the vision for the change.
C. Creating new policies and procedures to support the change and rewarding staff who adopt it.
D. Removing barriers to change.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A nurse manager is reviewing the principles of delegation with a newly licensed nurse. Which of the
following statements by the newly licensed nurse indicates an understanding of the five rights of
delegation?
A. "The right task must be within the delegator's scope of practice."
B. "The right direction and communication must be clear and concise."
C. "The right person is always the most experienced staff member available."
D. "The right supervision is only required for tasks delegated to unlicensed assistive personnel."
🟢B
🔴 RATIONALE: The five rights of delegation include right task, right circumstance, right person, right
direction/communication, and right supervision/evaluation. Clear and concise direction is a critical component.
Option A is incorrect because the task must be within the delegatee's scope, not the delegator's. Option C is
incorrect because the right person is the one with the appropriate skills and knowledge, not necessarily the
most experienced. Option D is incorrect because supervision is required for all delegated tasks, not just those to
UAP.
2. A charge nurse is assigning care for a team of nurses on a medical-surgical unit. Which of the following
clients should the charge nurse assign to the most experienced registered nurse?
A. A client who is 2 hours post-operative from an appendectomy and requesting pain medication.
B. A client with a new diagnosis of diabetes mellitus who needs discharge teaching.
,C. A client with a history of COPD who is exhibiting increased shortness of breath and confusion.
D. A client who needs their morning dose of an anti-hypertensive medication.
🟢C
🔴 RATIONALE: The client with COPD who is acutely decompensating (increased SOB and confusion) is the
most unstable and requires the highest level of clinical judgment and experience. This is a prioritization
question based on the ABCs and the potential for rapid deterioration. The other options represent more stable
clients or tasks that could be safely delegated to or managed by less experienced staff.
3. According to the National Council of State Boards of Nursing (NCSBN), which of the following principles is
essential for safe delegation?
A. The registered nurse is ultimately accountable for the outcomes of the delegated task.
B. The licensed practical nurse can delegate tasks to the unlicensed assistive personnel.
C. The delegating nurse is not responsible for supervising the delegatee.
D. Delegation involves transferring both the task and the accountability for the task.
🟢A
🔴 RATIONALE: The NCSBN clearly states that while a task can be delegated, the RN retains ultimate
accountability for the delegation process and the client outcome. The RN cannot delegate accountability.
Option B is incorrect because delegation is primarily an RN function. Option C is false because supervision is a
key component of delegation. Option D is a common misconception; accountability for the task remains with
the RN.
4. An RN is working on a busy surgical unit and needs to delegate tasks to an LPN and a UAP. Which of the
following tasks is appropriate for the RN to delegate to the LPN?
A. Administering an oral antibiotic to a client with a stable condition.
B. Ambulating a client who is 1-day post-operative following a hip replacement.
C. Inserting a urinary catheter for a client with urinary retention.
,D. Feeding a client who has dysphagia and requires a thickened liquid diet.
🟢C
🔴 RATIONALE: In many states and facilities, LPNs are trained and permitted to perform certain technical skills
such as urinary catheter insertion, provided they have validated competency. Option A is a task suitable for an
LPN, but Option C is a more definitive example of a skill within their scope. Option B and D are tasks
appropriately delegated to UAP.
5. A nurse is preparing to delegate tasks to a UAP. Which of the following actions is the nurse legally
required to perform before delegating?
A. Verify the UAP's competency and training for the specific task.
B. Obtain a written order from the provider for the task to be delegated.
C. Inform the UAP's supervisor of the delegation.
D. Document the delegation process in the client's medical record.
🟢A
🔴 RATIONALE: The RN must assess the competency of the delegatee to ensure they can safely perform the
task. Verification of training and competency is a non-negotiable step in safe delegation. A written order is
required for many nursing tasks (Option B), but not specifically for the act of delegation itself. Options C and D
are not standard legal requirements for the delegation process, though good practice may include
communication.
6. A nurse manager is implementing strategies to improve staff retention on a unit. Which of the following
strategies is an example of a "transformational leadership" approach?
A. Providing a bonus for staff who work extra shifts.
B. Creating a shared governance council to involve staff in decision-making.
C. Implementing a strict policy for all staff to follow without exception.
D. Disciplining staff who do not meet performance metrics.
, 🟢B
🔴 RATIONALE: Transformational leadership focuses on inspiring and motivating staff by involving them in the
vision and decision-making process. Shared governance empowers staff and fosters a sense of ownership.
Options A and D are more transactional leadership styles (rewards and punishments). Option C is an autocratic
approach.
7. A nurse is caring for a client who has a prescription for a blood transfusion. The client states, "I don't want
the blood transfusion. I know I need it, but I can't accept it." Which of the following actions should the nurse
take?
A. Explain the risks and benefits of the transfusion again in greater detail.
B. Call the provider to discuss the client's refusal.
C. Ask the client's family to persuade them to accept the transfusion.
D. Proceed with the transfusion because the client stated they know they need it.
🟢B
🔴 RATIONALE: The nurse must respect the client's autonomy and right to refuse treatment. The nurse's role is
to ensure the client's decision is informed and then to communicate the refusal to the provider. The provider
will then need to discuss alternatives or document the refusal. The nurse should not coerce the client or
proceed against their will.
8. A charge nurse is evaluating the effectiveness of a change made on the unit. According to Kotter's 8-Step
Change Model, which of the following actions represents the "anchoring new approaches in the culture"
step?
A. Forming a group to guide the change initiative.
B. Communicating the vision for the change.
C. Creating new policies and procedures to support the change and rewarding staff who adopt it.
D. Removing barriers to change.
