ATI RN Greenlight Retake Examination Actual Exam 2026/2027
Complete Exam-Style Questions with Detailed Rationales | 100%
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SECTION 1: Management of Care and Delegation
Question 1
A nurse manager is reviewing assignments for the medical-surgical unit. Which task is
appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
A. Administering an oral antihypertensive medication to a stable client
B. Performing a sterile dressing change on a postoperative client
C. Obtaining a set of vital signs on a client admitted 2 hours ago with pneumonia
D. Teaching a newly diagnosed diabetic client about blood glucose monitoring
Correct Answer: C
Rationale:
CORRECT ANSWER EXPLANATION: Obtaining vital signs on a stable client admitted 2
hours ago is within the scope of practice for a UAP. The client is stable, the task is
routine, and the UAP has been trained to perform this activity. Vital signs collection does
not require nursing judgment or assessment skills, making it appropriate for delegation.
DISTRACTOR ANALYSIS: Option A is incorrect because medication administration,
including oral medications, is outside the scope of practice for UAPs and requires a
licensed nurse. Option B is incorrect because sterile dressing changes require sterile
technique, wound assessment, and clinical judgment that falls within the scope of
professional nursing practice. Option D is incorrect because client education requires
teaching, evaluation of learning, and therapeutic communication skills that must be
performed by a licensed nurse.
,CLINICAL JUDGMENT FRAMEWORK: This question assesses the nurse's ability to
recognize appropriate delegation based on the five rights of delegation: right task, right
circumstance, right person, right direction/communication, and right supervision. The
nurse must analyze the complexity and stability of the client to determine
appropriateness.
EVIDENCE-BASED SUPPORT: The National Council of State Boards of Nursing (NCSBN)
and state nurse practice acts define UAP scope as activities that do not require nursing
judgment, including routine vital signs on stable clients.
SAFETY CONSIDERATIONS: Improper delegation can lead to adverse events. The nurse
remains accountable for delegated tasks and must verify that the UAP is competent and
the client is stable.
REMEDIATION TEACHING POINTS: Review the five rights of delegation and the
differences between RN, LPN, and UAP scopes of practice. Focus on tasks that require
assessment, planning, evaluation, and teaching versus tasks that are routine and
predictable.
NURSING INTERVENTIONS: Before delegating, the nurse should assess the client's
stability, verify the UAP's competency, provide clear instructions, and follow up on
results.
Question 2
A charge nurse receives report on four clients. Which client should the nurse assess
first?
A. A client with a nasogastric tube who has 50 mL of dark green aspirate in the past 4
hours
B. A client 2 hours post-thyroidectomy with a blood pressure of 142/88 mmHg and mild
restlessness
C. A client with heart failure who reports a 2-pound weight gain since yesterday
,D. A client with pneumonia who has a temperature of 38.2°C (100.8°F) and is coughing
Correct Answer: B
Rationale:
CORRECT ANSWER EXPLANATION: The client 2 hours post-thyroidectomy with mild
restlessness and elevated blood pressure is the priority. Restlessness in the immediate
postoperative period following neck surgery may indicate airway compromise,
hematoma formation, or respiratory distress. This requires immediate assessment to
rule out life-threatening complications such as tracheal compression from bleeding.
DISTRACTOR ANALYSIS: Option A is incorrect because dark green nasogastric aspirate
is expected and normal; 50 mL over 4 hours is not excessive. Option C is incorrect
because a 2-pound weight gain in a client with heart failure, while concerning, does not
represent an immediate life threat compared to potential airway compromise. Option D
is incorrect because a low-grade fever and cough in pneumonia are expected findings
and not emergent.
CLINICAL JUDGMENT FRAMEWORK: This question requires recognizing cues
(post-thyroidectomy status, restlessness, hypertension), analyzing the significance
(possible airway compromise), and prioritizing the hypothesis (hematoma/respiratory
distress) over other less acute conditions.
EVIDENCE-BASED SUPPORT: Post-thyroidectomy complications include hemorrhage,
hematoma, and airway obstruction. The American Thyroid Association guidelines
emphasize immediate evaluation of neck swelling, respiratory distress, or voice
changes in the postoperative period.
SAFETY CONSIDERATIONS: Airway compromise is a life-threatening emergency. The
nurse must apply the ABCs (Airway, Breathing, Circulation) prioritization framework.
, REMEDIATION TEACHING POINTS: Review prioritization frameworks including Maslow's
hierarchy, ABCs, and the nursing process. Focus on postoperative complications
specific to neck surgery and signs of airway obstruction.
NURSING INTERVENTIONS: The nurse should immediately assess the neck incision,
check for swelling or hematoma, evaluate respiratory effort and oxygen saturation, and
notify the surgeon if airway compromise is suspected.
Question 3
A nurse is caring for a client who is refusing a blood transfusion based on religious
beliefs. The client's family insists the transfusion be given. What is the nurse's most
appropriate action?
A. Administer the transfusion because it is medically necessary
B. Honor the client's refusal and notify the health care provider
C. Ask the family to convince the client to accept the treatment
D. Obtain a court order to override the client's refusal
Correct Answer: B
Rationale:
CORRECT ANSWER EXPLANATION: The nurse must honor the client's refusal and notify
the health care provider. A competent adult has the right to refuse treatment based on
religious or personal beliefs. The nurse's role is to advocate for the client's autonomy
while ensuring the provider is aware of the refusal to explore alternative treatment
options.
DISTRACTOR ANALYSIS: Option A is incorrect because administering a treatment
against a competent client's wishes constitutes battery and violates the client's right to
self-determination. Option C is incorrect because involving family to coerce the client
undermines the client's autonomy and may constitute undue influence. Option D is
incorrect because a court order is only appropriate when the client lacks
decision-making capacity; there is no indication this client is incompetent.
Complete Exam-Style Questions with Detailed Rationales | 100%
Verified Pass Guaranteed – A+ Graded
SECTION 1: Management of Care and Delegation
Question 1
A nurse manager is reviewing assignments for the medical-surgical unit. Which task is
appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
A. Administering an oral antihypertensive medication to a stable client
B. Performing a sterile dressing change on a postoperative client
C. Obtaining a set of vital signs on a client admitted 2 hours ago with pneumonia
D. Teaching a newly diagnosed diabetic client about blood glucose monitoring
Correct Answer: C
Rationale:
CORRECT ANSWER EXPLANATION: Obtaining vital signs on a stable client admitted 2
hours ago is within the scope of practice for a UAP. The client is stable, the task is
routine, and the UAP has been trained to perform this activity. Vital signs collection does
not require nursing judgment or assessment skills, making it appropriate for delegation.
DISTRACTOR ANALYSIS: Option A is incorrect because medication administration,
including oral medications, is outside the scope of practice for UAPs and requires a
licensed nurse. Option B is incorrect because sterile dressing changes require sterile
technique, wound assessment, and clinical judgment that falls within the scope of
professional nursing practice. Option D is incorrect because client education requires
teaching, evaluation of learning, and therapeutic communication skills that must be
performed by a licensed nurse.
,CLINICAL JUDGMENT FRAMEWORK: This question assesses the nurse's ability to
recognize appropriate delegation based on the five rights of delegation: right task, right
circumstance, right person, right direction/communication, and right supervision. The
nurse must analyze the complexity and stability of the client to determine
appropriateness.
EVIDENCE-BASED SUPPORT: The National Council of State Boards of Nursing (NCSBN)
and state nurse practice acts define UAP scope as activities that do not require nursing
judgment, including routine vital signs on stable clients.
SAFETY CONSIDERATIONS: Improper delegation can lead to adverse events. The nurse
remains accountable for delegated tasks and must verify that the UAP is competent and
the client is stable.
REMEDIATION TEACHING POINTS: Review the five rights of delegation and the
differences between RN, LPN, and UAP scopes of practice. Focus on tasks that require
assessment, planning, evaluation, and teaching versus tasks that are routine and
predictable.
NURSING INTERVENTIONS: Before delegating, the nurse should assess the client's
stability, verify the UAP's competency, provide clear instructions, and follow up on
results.
Question 2
A charge nurse receives report on four clients. Which client should the nurse assess
first?
A. A client with a nasogastric tube who has 50 mL of dark green aspirate in the past 4
hours
B. A client 2 hours post-thyroidectomy with a blood pressure of 142/88 mmHg and mild
restlessness
C. A client with heart failure who reports a 2-pound weight gain since yesterday
,D. A client with pneumonia who has a temperature of 38.2°C (100.8°F) and is coughing
Correct Answer: B
Rationale:
CORRECT ANSWER EXPLANATION: The client 2 hours post-thyroidectomy with mild
restlessness and elevated blood pressure is the priority. Restlessness in the immediate
postoperative period following neck surgery may indicate airway compromise,
hematoma formation, or respiratory distress. This requires immediate assessment to
rule out life-threatening complications such as tracheal compression from bleeding.
DISTRACTOR ANALYSIS: Option A is incorrect because dark green nasogastric aspirate
is expected and normal; 50 mL over 4 hours is not excessive. Option C is incorrect
because a 2-pound weight gain in a client with heart failure, while concerning, does not
represent an immediate life threat compared to potential airway compromise. Option D
is incorrect because a low-grade fever and cough in pneumonia are expected findings
and not emergent.
CLINICAL JUDGMENT FRAMEWORK: This question requires recognizing cues
(post-thyroidectomy status, restlessness, hypertension), analyzing the significance
(possible airway compromise), and prioritizing the hypothesis (hematoma/respiratory
distress) over other less acute conditions.
EVIDENCE-BASED SUPPORT: Post-thyroidectomy complications include hemorrhage,
hematoma, and airway obstruction. The American Thyroid Association guidelines
emphasize immediate evaluation of neck swelling, respiratory distress, or voice
changes in the postoperative period.
SAFETY CONSIDERATIONS: Airway compromise is a life-threatening emergency. The
nurse must apply the ABCs (Airway, Breathing, Circulation) prioritization framework.
, REMEDIATION TEACHING POINTS: Review prioritization frameworks including Maslow's
hierarchy, ABCs, and the nursing process. Focus on postoperative complications
specific to neck surgery and signs of airway obstruction.
NURSING INTERVENTIONS: The nurse should immediately assess the neck incision,
check for swelling or hematoma, evaluate respiratory effort and oxygen saturation, and
notify the surgeon if airway compromise is suspected.
Question 3
A nurse is caring for a client who is refusing a blood transfusion based on religious
beliefs. The client's family insists the transfusion be given. What is the nurse's most
appropriate action?
A. Administer the transfusion because it is medically necessary
B. Honor the client's refusal and notify the health care provider
C. Ask the family to convince the client to accept the treatment
D. Obtain a court order to override the client's refusal
Correct Answer: B
Rationale:
CORRECT ANSWER EXPLANATION: The nurse must honor the client's refusal and notify
the health care provider. A competent adult has the right to refuse treatment based on
religious or personal beliefs. The nurse's role is to advocate for the client's autonomy
while ensuring the provider is aware of the refusal to explore alternative treatment
options.
DISTRACTOR ANALYSIS: Option A is incorrect because administering a treatment
against a competent client's wishes constitutes battery and violates the client's right to
self-determination. Option C is incorrect because involving family to coerce the client
undermines the client's autonomy and may constitute undue influence. Option D is
incorrect because a court order is only appropriate when the client lacks
decision-making capacity; there is no indication this client is incompetent.
