ATI Leadership
Practice
Assessment B -
V3.0 well written
one year 2025
/2026 updated
graded A+ Comprehensive
150-Question Examination
,EXAM OVERVIEW
Title: ATI Leadership Practice Assessment B Version 3.0: Advanced Nursing Leadership and
Management Comprehensive Examination Featuring Complex Clinical Scenarios, Multilayered
Delegation and Supervision Challenges, Ethical-Legal Dilemmas, Healthcare Quality and
Performance Improvement Initiatives, Financial Stewardship and Resource Allocation,
Interprofessional Team Dynamics, Change Management and Organizational Behavior, Conflict
Resolution Strategies, Disaster Preparedness and Emergency Operations, and Professional Role
Development for RN Licensure and Certification Preparation
Difficulty Level: Advanced/Hard/Mixed with Emphasis on Complex Clinical Judgment
Target Audience: Senior Nursing Students, Graduate Nurses, Experienced Clinicians, and
Nurse
Leaders preparing for the ATI RN Leadership Proctored Examination – Form B and Advanced
Certification Examinations
Exam Structure: 150 multiple-choice questions organized across 10 comprehensive content
domains, featuring high-level conceptual questions, complex application-based scenarios,
integrated clinical judgment items, and multilayered decision-making questions with
evidencebased rationales grounded in current nursing leadership and management literature.
SECTION 1: CLINICAL PRIORITIZATION AND ACUITY-BASED
ASSIGNMENT (Questions 1-15)
1. A charge nurse on a 40-bed medical-surgical unit receives shift report and must
prioritize care for the following clients. The unit has two RNs, one LPN, and two APs
scheduled for the shift. Which client should the charge nurse assign to the most
experienced RN and assess personally first?
,A) A 68-year-old client with COPD who has an oxygen saturation of 89% on 2 L/min
nasalcannula and is using pursed-lip breathing
B) A 72-year-old client who is 4 hours post-total knee arthroplasty with a hemoglobin of
7.8g/dL and blood pressure of 88/52 mmHg
C) A 55-year-old client with diabetes who has a blood glucose of 58 mg/dL and is alert
butdiaphoretic
D) A 45-year-old client with a new colostomy who is requesting emotional support
andeducation about stoma care
Correct Answer: B
Rationale: The client with a hemoglobin of 7.8 g/dL and hypotension (88/52 mmHg) is
exhibiting signs of possible postoperative hemorrhage or hemodynamic instability. This client
requires immediate assessment and intervention by the most experienced RN. While the client
with hypoglycemia requires intervention, the client is alert and can be managed quickly. The
client with COPD has expected findings, and the colostomy client requires education but is
stable.
2. A nurse is caring for four clients on a busy cardiac telemetry unit. The nurse receives
the following data during change-of-shift report. Which client requires the nurse's
immediate attention first?
A) A client with heart failure who has gained 2.5 kg since yesterday, has jugular
venousdistention, and reports increasing shortness of breath
B) A client with unstable angina who reports chest pain rated 6/10 that is unrelieved
bysublingual nitroglycerin administered 10 minutes ago
C) A client with a permanent pacemaker who has a heart rate of 72/min in sinus rhythm
withoccasional premature ventricular contractions
D) A client with hypertension who has a blood pressure of 158/94 mmHg and reports
aheadache
Correct Answer: B
Rationale: Chest pain unrelieved by nitroglycerin in a client with unstable angina is a priority
concern that may indicate an acute myocardial infarction. This requires immediate assessment,
additional interventions, and possible provider notification. The client with heart failure has
, signs of fluid overload but is stable; the pacemaker client has expected findings; and the
hypertensive client requires intervention but is stable.
3. A nurse is assigned to care for the following clients on a postoperative surgical unit.
The nurse has just received shift report and is prioritizing morning assessments. Which
client should the nurse assess first?
A) A 62-year-old client who is 2 days post-right hemicolectomy with a nasogastric
tubedraining 250 mL of bile-colored fluid in the past 4 hours
B) A 58-year-old client who is 1 day post-appendectomy and reports incisional pain of
8/10with a heart rate of 102/min and blood pressure of 148/90 mmHg
C) A 70-year-old client who is 3 days post-hip replacement and has a temperature of 38.4°C
(101.1°F) with a wound that appears red and swollen
D) A 45-year-old client who is 1 day post-cholecystectomy and is requesting medication
fornausea
Correct Answer: C
Rationale: The client with a temperature of 38.4°C and red, swollen wound is exhibiting signs
of a possible wound infection. This requires prompt assessment and intervention. The client
with the NGT has expected drainage, the client with pain has stable vital signs (elevated but
expected postoperative), and the client with nausea is stable and can receive PRN medication.
4. A charge nurse is making assignments for a medical-surgical unit during a staffing
shortage. The unit has one RN with 15 years of experience, one RN with 2 years of
experience, one LPN with 8 years of experience, and two APs. Which client assignment is
most appropriate for the LPN?
A) A client with a new tracheostomy who requires frequent suctioning and has an
oxygensaturation of 91%
B) A client with a chest tube who has continuous bubbling in the water seal chamber
andreports shortness of breath
C) A client with diabetes who is stable, requires insulin administration, and has a
scheduledwound dressing change
Practice
Assessment B -
V3.0 well written
one year 2025
/2026 updated
graded A+ Comprehensive
150-Question Examination
,EXAM OVERVIEW
Title: ATI Leadership Practice Assessment B Version 3.0: Advanced Nursing Leadership and
Management Comprehensive Examination Featuring Complex Clinical Scenarios, Multilayered
Delegation and Supervision Challenges, Ethical-Legal Dilemmas, Healthcare Quality and
Performance Improvement Initiatives, Financial Stewardship and Resource Allocation,
Interprofessional Team Dynamics, Change Management and Organizational Behavior, Conflict
Resolution Strategies, Disaster Preparedness and Emergency Operations, and Professional Role
Development for RN Licensure and Certification Preparation
Difficulty Level: Advanced/Hard/Mixed with Emphasis on Complex Clinical Judgment
Target Audience: Senior Nursing Students, Graduate Nurses, Experienced Clinicians, and
Nurse
Leaders preparing for the ATI RN Leadership Proctored Examination – Form B and Advanced
Certification Examinations
Exam Structure: 150 multiple-choice questions organized across 10 comprehensive content
domains, featuring high-level conceptual questions, complex application-based scenarios,
integrated clinical judgment items, and multilayered decision-making questions with
evidencebased rationales grounded in current nursing leadership and management literature.
SECTION 1: CLINICAL PRIORITIZATION AND ACUITY-BASED
ASSIGNMENT (Questions 1-15)
1. A charge nurse on a 40-bed medical-surgical unit receives shift report and must
prioritize care for the following clients. The unit has two RNs, one LPN, and two APs
scheduled for the shift. Which client should the charge nurse assign to the most
experienced RN and assess personally first?
,A) A 68-year-old client with COPD who has an oxygen saturation of 89% on 2 L/min
nasalcannula and is using pursed-lip breathing
B) A 72-year-old client who is 4 hours post-total knee arthroplasty with a hemoglobin of
7.8g/dL and blood pressure of 88/52 mmHg
C) A 55-year-old client with diabetes who has a blood glucose of 58 mg/dL and is alert
butdiaphoretic
D) A 45-year-old client with a new colostomy who is requesting emotional support
andeducation about stoma care
Correct Answer: B
Rationale: The client with a hemoglobin of 7.8 g/dL and hypotension (88/52 mmHg) is
exhibiting signs of possible postoperative hemorrhage or hemodynamic instability. This client
requires immediate assessment and intervention by the most experienced RN. While the client
with hypoglycemia requires intervention, the client is alert and can be managed quickly. The
client with COPD has expected findings, and the colostomy client requires education but is
stable.
2. A nurse is caring for four clients on a busy cardiac telemetry unit. The nurse receives
the following data during change-of-shift report. Which client requires the nurse's
immediate attention first?
A) A client with heart failure who has gained 2.5 kg since yesterday, has jugular
venousdistention, and reports increasing shortness of breath
B) A client with unstable angina who reports chest pain rated 6/10 that is unrelieved
bysublingual nitroglycerin administered 10 minutes ago
C) A client with a permanent pacemaker who has a heart rate of 72/min in sinus rhythm
withoccasional premature ventricular contractions
D) A client with hypertension who has a blood pressure of 158/94 mmHg and reports
aheadache
Correct Answer: B
Rationale: Chest pain unrelieved by nitroglycerin in a client with unstable angina is a priority
concern that may indicate an acute myocardial infarction. This requires immediate assessment,
additional interventions, and possible provider notification. The client with heart failure has
, signs of fluid overload but is stable; the pacemaker client has expected findings; and the
hypertensive client requires intervention but is stable.
3. A nurse is assigned to care for the following clients on a postoperative surgical unit.
The nurse has just received shift report and is prioritizing morning assessments. Which
client should the nurse assess first?
A) A 62-year-old client who is 2 days post-right hemicolectomy with a nasogastric
tubedraining 250 mL of bile-colored fluid in the past 4 hours
B) A 58-year-old client who is 1 day post-appendectomy and reports incisional pain of
8/10with a heart rate of 102/min and blood pressure of 148/90 mmHg
C) A 70-year-old client who is 3 days post-hip replacement and has a temperature of 38.4°C
(101.1°F) with a wound that appears red and swollen
D) A 45-year-old client who is 1 day post-cholecystectomy and is requesting medication
fornausea
Correct Answer: C
Rationale: The client with a temperature of 38.4°C and red, swollen wound is exhibiting signs
of a possible wound infection. This requires prompt assessment and intervention. The client
with the NGT has expected drainage, the client with pain has stable vital signs (elevated but
expected postoperative), and the client with nausea is stable and can receive PRN medication.
4. A charge nurse is making assignments for a medical-surgical unit during a staffing
shortage. The unit has one RN with 15 years of experience, one RN with 2 years of
experience, one LPN with 8 years of experience, and two APs. Which client assignment is
most appropriate for the LPN?
A) A client with a new tracheostomy who requires frequent suctioning and has an
oxygensaturation of 91%
B) A client with a chest tube who has continuous bubbling in the water seal chamber
andreports shortness of breath
C) A client with diabetes who is stable, requires insulin administration, and has a
scheduledwound dressing change
