COMPREHENSIVE ATI RN LEADERSHIP 2026
PRACTICE EXAM
Original Practice Questions with Detailed
Rationales
QUESTION 1
A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the
following actions should the charge nurse take first?
A. Determine the reasons the nurses are not taking scheduled breaks.
B. Provide coverage for the nurses' breaks.
C. Review facility policies for taking scheduled breaks.
D. Discuss time management strategies with the nurses.
Correct ANSWER: A
Rationale:
Option A (Correct): The charge nurse should first assess the situation by determining why the nurses are
not taking breaks. This follows the nursing process - assessment comes first. There may be legitimate
reasons such as high patient acuity, understaffing, or personal preferences that need to be understood
before implementing solutions.
Option B (Incorrect): While providing coverage might solve the immediate problem, implementing a
solution before understanding the root cause is premature. The charge nurse needs to assess the
situation first.
Option C (Incorrect): Reviewing policies is important but should not be the first action. Understanding
why the nurses are missing breaks will inform whether policy review is even necessary.
Option D (Incorrect): Assuming the issue is related to time management is jumping to conclusions
without assessment. The problem could be related to staffing levels, patient needs, or other factors
beyond time management.
QUESTION 2
,A nurse manager is reviewing the nursing code of ethics with staff nurses. Which of the following
statements by a staff nurse indicates understanding of the teaching? (Select all that apply.)
A. "I have the assistive personnel double-check packed RBCs when other nurses are busy."
B. "I can delegate the removal of an IV catheter to an LPN on the unit."
C. "I will attend continuing education classes for professional growth."
D. "The family of a newly admitted client recently treated me to lunch in the hospital cafeteria."
E. "I administer pain medication to my clients even if they have a history of narcotic addiction."
Correct ANSWERs: B, C, E
Rationale:
Option A (Incorrect): Assistive personnel should never be delegated to double-check blood products.
This is a nursing responsibility that requires licensed nursing judgment and cannot be delegated to
unlicensed personnel. This violates safe delegation principles.
Option B (Correct): Removing an IV catheter is within the scope of practice for an LPN and is an
appropriate delegation. This is a routine, standardized procedure that does not require RN-level
assessment or judgment.
Option C (Correct): Attending continuing education demonstrates commitment to professional
development and maintaining competence, which is an ethical responsibility outlined in the nursing
code of ethics.
Option D (Incorrect): Accepting gifts from clients or their families can create ethical concerns and
boundary issues. While small tokens may be acceptable in some situations, treating a nurse to lunch
could be seen as crossing professional boundaries.
Option E (Correct): Providing pain medication to clients with a history of addiction demonstrates the
ethical principle of beneficence and non-maleficence. Patients with addiction history still deserve
appropriate pain management, though it may require careful monitoring and alternative strategies.
QUESTION 3
A charge nurse is evaluating the implementation of infection control measures by unit nurses when
caring for clients who have Clostridium difficile. The charge nurse should intervene for which of the
following actions by a unit nurse?
A. Places the client in contact precautions
B. Cleans contaminated equipment with bleach-based solution
C. Wears goggles when emptying the bedpan of liquid stool
D. Uses alcohol-based hand sanitizer after removing gloves
Correct ANSWER: D
,Rationale:
Option A (Incorrect): Placing the client in contact precautions is correct for C. difficile. This is the
appropriate isolation precaution to prevent transmission of this organism.
Option B (Incorrect): Using bleach-based solution is correct for C. difficile. Alcohol-based solutions do
not kill C. difficile spores, so bleach (which is sporicidal) is necessary for environmental cleaning.
Option C (Incorrect): Wearing goggles when there is potential for splashing (such as emptying a bedpan
with liquid stool) is appropriate personal protective equipment use and follows standard precautions.
Option D (Correct - Requires Intervention): Using alcohol-based hand sanitizer is ineffective against C.
difficile spores. The nurse should use soap and water for hand hygiene when caring for patients with C.
difficile, as mechanical removal with soap and water is necessary to remove the spores.
QUESTION 4
A nurse is caring for a client who has cancer. The client's adult child asks the nurse for information about
the client's treatment plan. Which of the following responses should the nurse make?
A. "I cannot provide this information to you without your mother's consent."
B. "I will ask your mother's primary care provider to speak with you."
C. "You will have to speak directly to your mother about her treatment."
D. "What would you like to know about your mother's treatment?"
Correct ANSWER: A
Rationale:
Option A (Correct): This response appropriately protects patient confidentiality and privacy rights under
HIPAA. Even though the person is the patient's adult child, healthcare information cannot be shared
without the patient's consent, unless the patient lacks decision-making capacity.
Option B (Incorrect): This response does not address the confidentiality issue. The primary care provider
also cannot share information without the patient's consent. This deflects the issue rather than
addressing it appropriately.
Option C (Incorrect): While this suggests the child should talk to the mother, it doesn't clearly explain
the confidentiality requirements. It may come across as dismissive and doesn't educate the family
member about privacy rights.
Option D (Incorrect): This response is inappropriate because it suggests the nurse might provide
information. The nurse should not engage in discussing the patient's treatment without first ensuring
the patient has given consent for information sharing.
QUESTION 5
A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following
statements by the newly licensed nurse indicates understanding of isolation guidelines?
, A. "I will place a client who has compromised immunity in a negative-pressure airflow room."
B. "I will instruct visitors to wear a mask when visiting a client who is on contact precautions."
C. "I will have a client who is on airborne precautions wear a mask when out of her room."
D. "I will wear an N95 respirator mask when caring for a client who is on droplet precautions."
Correct ANSWER: C
Rationale:
Option A (Incorrect): Clients with compromised immunity need protective (positive-pressure)
environments, not negative-pressure rooms. Negative-pressure rooms are for patients who have
airborne infections that could spread to others. Positive-pressure rooms protect immunocompromised
patients from outside contaminants.
Option B (Incorrect): For contact precautions, visitors typically do not need to wear masks unless there is
anticipated contact with respiratory secretions. Contact precautions primarily require gown and gloves
for anyone entering the room.
Option C (Correct): Clients on airborne precautions should wear a surgical mask when leaving their room
for tests or procedures to prevent spreading airborne pathogens to others in the healthcare facility. This
is a key infection control measure.
Option D (Incorrect): For droplet precautions, a surgical mask is sufficient, not an N95 respirator. N95
respirators are required for airborne precautions (such as tuberculosis, measles, chickenpox), not
droplet precautions (such as influenza, pertussis, meningitis).
QUESTION 6
A nurse manager is planning the client assignments for the shift. Which of the following clients should
the nurse manager assign to an LPN?
A. A client who is 2 hours postoperative following a bowel resection
B. A client who has a new diagnosis of diabetes mellitus and requires teaching
C. A client who has a stage 3 pressure injury requiring a dressing change
D. A client who just returned from the catheterization lab following a cardiac catheterization
Correct ANSWER: C
Rationale:
Option A (Incorrect): A client who is 2 hours postoperative following major surgery requires frequent
assessment and monitoring that is within the RN's scope. This patient is unstable and needs
comprehensive nursing assessment.
Option B (Incorrect): Initial patient teaching, especially for a new diagnosis, should be performed by the
RN. Teaching requires assessment of learning needs, development of teaching plans, and evaluation of
understanding, which are RN responsibilities.
PRACTICE EXAM
Original Practice Questions with Detailed
Rationales
QUESTION 1
A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the
following actions should the charge nurse take first?
A. Determine the reasons the nurses are not taking scheduled breaks.
B. Provide coverage for the nurses' breaks.
C. Review facility policies for taking scheduled breaks.
D. Discuss time management strategies with the nurses.
Correct ANSWER: A
Rationale:
Option A (Correct): The charge nurse should first assess the situation by determining why the nurses are
not taking breaks. This follows the nursing process - assessment comes first. There may be legitimate
reasons such as high patient acuity, understaffing, or personal preferences that need to be understood
before implementing solutions.
Option B (Incorrect): While providing coverage might solve the immediate problem, implementing a
solution before understanding the root cause is premature. The charge nurse needs to assess the
situation first.
Option C (Incorrect): Reviewing policies is important but should not be the first action. Understanding
why the nurses are missing breaks will inform whether policy review is even necessary.
Option D (Incorrect): Assuming the issue is related to time management is jumping to conclusions
without assessment. The problem could be related to staffing levels, patient needs, or other factors
beyond time management.
QUESTION 2
,A nurse manager is reviewing the nursing code of ethics with staff nurses. Which of the following
statements by a staff nurse indicates understanding of the teaching? (Select all that apply.)
A. "I have the assistive personnel double-check packed RBCs when other nurses are busy."
B. "I can delegate the removal of an IV catheter to an LPN on the unit."
C. "I will attend continuing education classes for professional growth."
D. "The family of a newly admitted client recently treated me to lunch in the hospital cafeteria."
E. "I administer pain medication to my clients even if they have a history of narcotic addiction."
Correct ANSWERs: B, C, E
Rationale:
Option A (Incorrect): Assistive personnel should never be delegated to double-check blood products.
This is a nursing responsibility that requires licensed nursing judgment and cannot be delegated to
unlicensed personnel. This violates safe delegation principles.
Option B (Correct): Removing an IV catheter is within the scope of practice for an LPN and is an
appropriate delegation. This is a routine, standardized procedure that does not require RN-level
assessment or judgment.
Option C (Correct): Attending continuing education demonstrates commitment to professional
development and maintaining competence, which is an ethical responsibility outlined in the nursing
code of ethics.
Option D (Incorrect): Accepting gifts from clients or their families can create ethical concerns and
boundary issues. While small tokens may be acceptable in some situations, treating a nurse to lunch
could be seen as crossing professional boundaries.
Option E (Correct): Providing pain medication to clients with a history of addiction demonstrates the
ethical principle of beneficence and non-maleficence. Patients with addiction history still deserve
appropriate pain management, though it may require careful monitoring and alternative strategies.
QUESTION 3
A charge nurse is evaluating the implementation of infection control measures by unit nurses when
caring for clients who have Clostridium difficile. The charge nurse should intervene for which of the
following actions by a unit nurse?
A. Places the client in contact precautions
B. Cleans contaminated equipment with bleach-based solution
C. Wears goggles when emptying the bedpan of liquid stool
D. Uses alcohol-based hand sanitizer after removing gloves
Correct ANSWER: D
,Rationale:
Option A (Incorrect): Placing the client in contact precautions is correct for C. difficile. This is the
appropriate isolation precaution to prevent transmission of this organism.
Option B (Incorrect): Using bleach-based solution is correct for C. difficile. Alcohol-based solutions do
not kill C. difficile spores, so bleach (which is sporicidal) is necessary for environmental cleaning.
Option C (Incorrect): Wearing goggles when there is potential for splashing (such as emptying a bedpan
with liquid stool) is appropriate personal protective equipment use and follows standard precautions.
Option D (Correct - Requires Intervention): Using alcohol-based hand sanitizer is ineffective against C.
difficile spores. The nurse should use soap and water for hand hygiene when caring for patients with C.
difficile, as mechanical removal with soap and water is necessary to remove the spores.
QUESTION 4
A nurse is caring for a client who has cancer. The client's adult child asks the nurse for information about
the client's treatment plan. Which of the following responses should the nurse make?
A. "I cannot provide this information to you without your mother's consent."
B. "I will ask your mother's primary care provider to speak with you."
C. "You will have to speak directly to your mother about her treatment."
D. "What would you like to know about your mother's treatment?"
Correct ANSWER: A
Rationale:
Option A (Correct): This response appropriately protects patient confidentiality and privacy rights under
HIPAA. Even though the person is the patient's adult child, healthcare information cannot be shared
without the patient's consent, unless the patient lacks decision-making capacity.
Option B (Incorrect): This response does not address the confidentiality issue. The primary care provider
also cannot share information without the patient's consent. This deflects the issue rather than
addressing it appropriately.
Option C (Incorrect): While this suggests the child should talk to the mother, it doesn't clearly explain
the confidentiality requirements. It may come across as dismissive and doesn't educate the family
member about privacy rights.
Option D (Incorrect): This response is inappropriate because it suggests the nurse might provide
information. The nurse should not engage in discussing the patient's treatment without first ensuring
the patient has given consent for information sharing.
QUESTION 5
A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following
statements by the newly licensed nurse indicates understanding of isolation guidelines?
, A. "I will place a client who has compromised immunity in a negative-pressure airflow room."
B. "I will instruct visitors to wear a mask when visiting a client who is on contact precautions."
C. "I will have a client who is on airborne precautions wear a mask when out of her room."
D. "I will wear an N95 respirator mask when caring for a client who is on droplet precautions."
Correct ANSWER: C
Rationale:
Option A (Incorrect): Clients with compromised immunity need protective (positive-pressure)
environments, not negative-pressure rooms. Negative-pressure rooms are for patients who have
airborne infections that could spread to others. Positive-pressure rooms protect immunocompromised
patients from outside contaminants.
Option B (Incorrect): For contact precautions, visitors typically do not need to wear masks unless there is
anticipated contact with respiratory secretions. Contact precautions primarily require gown and gloves
for anyone entering the room.
Option C (Correct): Clients on airborne precautions should wear a surgical mask when leaving their room
for tests or procedures to prevent spreading airborne pathogens to others in the healthcare facility. This
is a key infection control measure.
Option D (Incorrect): For droplet precautions, a surgical mask is sufficient, not an N95 respirator. N95
respirators are required for airborne precautions (such as tuberculosis, measles, chickenpox), not
droplet precautions (such as influenza, pertussis, meningitis).
QUESTION 6
A nurse manager is planning the client assignments for the shift. Which of the following clients should
the nurse manager assign to an LPN?
A. A client who is 2 hours postoperative following a bowel resection
B. A client who has a new diagnosis of diabetes mellitus and requires teaching
C. A client who has a stage 3 pressure injury requiring a dressing change
D. A client who just returned from the catheterization lab following a cardiac catheterization
Correct ANSWER: C
Rationale:
Option A (Incorrect): A client who is 2 hours postoperative following major surgery requires frequent
assessment and monitoring that is within the RN's scope. This patient is unstable and needs
comprehensive nursing assessment.
Option B (Incorrect): Initial patient teaching, especially for a new diagnosis, should be performed by the
RN. Teaching requires assessment of learning needs, development of teaching plans, and evaluation of
understanding, which are RN responsibilities.
