ATI Leadership Practice Assessment A:
Comprehensive 150-
Question Examination Covering Nursing
Leadership and
Management Principles, Delegation,
Prioritization, Ethical-Legal
Responsibilities, Conflict Resolution, Quality
Improvement, and
Clinical Judgment for RN Licensure Preparation
well written one year 2025 /2026 updated
graded A+
,Instructions
This examination consists of 150 multiple-choice questions designed to assess knowledge and
application of nursing leadership and management principles aligned with ATI testing standards. Each
question has one correct answer. Select the best response and review the accompanying rationale for
comprehensive understanding.
Section 1: Leadership and Management Fundamentals (Questions 1–
20)
1. A nurse manager is implementing a new evidence-based protocol for fall prevention on a
medical-surgical unit. Several staff nurses have expressed resistance to the change. Which of the
following strategies should the nurse manager use first to address this resistance?
A) Mandate compliance through disciplinary action
B) Provide factual information and research evidence supporting the change
C) Offer financial incentives for staff who adopt the new protocol
D) Transfer resistant staff to another unit
- detailed answer 100% correct :-B
Rationale: The rational-empirical method involves providing factual information and research
evidence to support change when resistance is minimal. This approach addresses knowledge gaps and
builds understanding before stronger measures are needed. Disciplinary action (A) and transfers (D)
are coercive measures inappropriate as first-line strategies. Financial incentives (C) may be used later
but do not address the underlying resistance to change.
2. A charge nurse is making client care assignments for the upcoming shift. Which of the
following clients should the charge nurse assign to a licensed practical nurse (LPN)?
A) A client who is 1 hour post-cardiac catheterization with stable vital signs
B) A client with Crohn's disease who requires enteral feeding via nasogastric tube
C) A client who requires initial assessment after admission from the emergency department
D) A client who is receiving continuous intravenous infusion of heparin
- detailed answer 100% correct :-B
Rationale: LPNs can care for stable clients with predictable outcomes and perform tasks such as
enteral feeding administration. The LPN cannot perform initial assessments (C) or care for unstable
,clients (A, D). Continuous heparin infusion requires RN monitoring for therapeutic effects and bleeding
complications.
3. A nurse is receiving change-of-shift report. Which of the following clients should the nurse
assess first?
A) A client who had abdominal surgery 6 hours ago and has a heart rate of 120/min for the last 2hours
B) A client requesting pain medication for a pain level of 8/10
C) A client with COPD who is short of breath
D) A client who needs assistance with ambulation
- detailed answer 100% correct :-A
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, the priority finding is an elevated
heart rate following surgery, which may indicate hemorrhage or hypovolemia. While the COPD client
(C) has breathing issues, tachycardia after surgery suggests a potentially life-threatening complication
requiring immediate assessment.
4. A nurse manager who makes decisions independently and then notifies staff of the decision is
demonstrating which leadership style?
A) Democratic leadership
B) Laissez-faire leadership
C) Authoritative leadership
D) Transformational leadership
- detailed answer 100% correct :-C
Rationale: Authoritative (autocratic) leaders make decisions for the group with communication
flowing down the chain of command. Democratic leaders (A) include the group in decision-making.
Laissezfaire leaders (B) make few decisions. Transformational leaders (D) empower followers toward a
shared vision.
, 5. A nurse is caring for a client who is 3 days postoperative following open heart surgery and is
being transferred to the medical-surgical unit. Which of the following should the nurse plan to
include in the verbal handoff report?
A) The client's admission diagnosis
B) The client's level of consciousness
C) The client's dietary preferences
D) The client's room number
- detailed answer 100% correct :-B
Rationale: Verbal handoff reports should include the client's current level of consciousness, as this
reflects neurological status and overall condition. Admission diagnosis (A) is historical information.
Dietary preferences (C) and room number (D) are not priority handoff information.
6. A nurse manager is presenting an inservice about preventing readmission of clients due to
complications after joint replacement surgery. Which of the following leadership tasks is the
nurse manager performing?
A) Advocacy
B) Delegation
C) Supervision
D) Evaluation
- detailed answer 100% correct :-A
Rationale: Advocacy involves speaking and acting on behalf of clients to promote their well-being and
prevent harm. By educating staff to prevent readmissions, the nurse manager is advocating for client
safety and quality outcomes.
7. Which of the following best describes the primary difference between a leader and a manager
in nursing practice?
A) Leaders focus on maintaining the status quo; managers focus on implementing change
B) Leaders influence and inspire others toward a shared vision; managers coordinate resources
andprocesses to achieve organizational goals
Comprehensive 150-
Question Examination Covering Nursing
Leadership and
Management Principles, Delegation,
Prioritization, Ethical-Legal
Responsibilities, Conflict Resolution, Quality
Improvement, and
Clinical Judgment for RN Licensure Preparation
well written one year 2025 /2026 updated
graded A+
,Instructions
This examination consists of 150 multiple-choice questions designed to assess knowledge and
application of nursing leadership and management principles aligned with ATI testing standards. Each
question has one correct answer. Select the best response and review the accompanying rationale for
comprehensive understanding.
Section 1: Leadership and Management Fundamentals (Questions 1–
20)
1. A nurse manager is implementing a new evidence-based protocol for fall prevention on a
medical-surgical unit. Several staff nurses have expressed resistance to the change. Which of the
following strategies should the nurse manager use first to address this resistance?
A) Mandate compliance through disciplinary action
B) Provide factual information and research evidence supporting the change
C) Offer financial incentives for staff who adopt the new protocol
D) Transfer resistant staff to another unit
- detailed answer 100% correct :-B
Rationale: The rational-empirical method involves providing factual information and research
evidence to support change when resistance is minimal. This approach addresses knowledge gaps and
builds understanding before stronger measures are needed. Disciplinary action (A) and transfers (D)
are coercive measures inappropriate as first-line strategies. Financial incentives (C) may be used later
but do not address the underlying resistance to change.
2. A charge nurse is making client care assignments for the upcoming shift. Which of the
following clients should the charge nurse assign to a licensed practical nurse (LPN)?
A) A client who is 1 hour post-cardiac catheterization with stable vital signs
B) A client with Crohn's disease who requires enteral feeding via nasogastric tube
C) A client who requires initial assessment after admission from the emergency department
D) A client who is receiving continuous intravenous infusion of heparin
- detailed answer 100% correct :-B
Rationale: LPNs can care for stable clients with predictable outcomes and perform tasks such as
enteral feeding administration. The LPN cannot perform initial assessments (C) or care for unstable
,clients (A, D). Continuous heparin infusion requires RN monitoring for therapeutic effects and bleeding
complications.
3. A nurse is receiving change-of-shift report. Which of the following clients should the nurse
assess first?
A) A client who had abdominal surgery 6 hours ago and has a heart rate of 120/min for the last 2hours
B) A client requesting pain medication for a pain level of 8/10
C) A client with COPD who is short of breath
D) A client who needs assistance with ambulation
- detailed answer 100% correct :-A
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, the priority finding is an elevated
heart rate following surgery, which may indicate hemorrhage or hypovolemia. While the COPD client
(C) has breathing issues, tachycardia after surgery suggests a potentially life-threatening complication
requiring immediate assessment.
4. A nurse manager who makes decisions independently and then notifies staff of the decision is
demonstrating which leadership style?
A) Democratic leadership
B) Laissez-faire leadership
C) Authoritative leadership
D) Transformational leadership
- detailed answer 100% correct :-C
Rationale: Authoritative (autocratic) leaders make decisions for the group with communication
flowing down the chain of command. Democratic leaders (A) include the group in decision-making.
Laissezfaire leaders (B) make few decisions. Transformational leaders (D) empower followers toward a
shared vision.
, 5. A nurse is caring for a client who is 3 days postoperative following open heart surgery and is
being transferred to the medical-surgical unit. Which of the following should the nurse plan to
include in the verbal handoff report?
A) The client's admission diagnosis
B) The client's level of consciousness
C) The client's dietary preferences
D) The client's room number
- detailed answer 100% correct :-B
Rationale: Verbal handoff reports should include the client's current level of consciousness, as this
reflects neurological status and overall condition. Admission diagnosis (A) is historical information.
Dietary preferences (C) and room number (D) are not priority handoff information.
6. A nurse manager is presenting an inservice about preventing readmission of clients due to
complications after joint replacement surgery. Which of the following leadership tasks is the
nurse manager performing?
A) Advocacy
B) Delegation
C) Supervision
D) Evaluation
- detailed answer 100% correct :-A
Rationale: Advocacy involves speaking and acting on behalf of clients to promote their well-being and
prevent harm. By educating staff to prevent readmissions, the nurse manager is advocating for client
safety and quality outcomes.
7. Which of the following best describes the primary difference between a leader and a manager
in nursing practice?
A) Leaders focus on maintaining the status quo; managers focus on implementing change
B) Leaders influence and inspire others toward a shared vision; managers coordinate resources
andprocesses to achieve organizational goals
