ATI Leadership
Practice
Assessment B -
V2.0 well written
one year 2025
/2026 updated
graded A+ Comprehensive
150-Question Practice Examination
,EXAM OVERVIEW
Title: ATI Leadership Practice Assessment B Version 2.0: Advanced Nursing Leadership and
Management Examination Covering Clinical Prioritization, Delegation and Supervision, Legal
and Ethical Dimensions, Healthcare Quality and Safety, Financial Resource Management,
Interprofessional Collaboration, Change Management, Conflict Resolution, Emergency
Preparedness, and Professional Role Development for RN Licensure Preparation
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Nursing Students, Graduate Nurses, and Experienced Clinicians preparing
for the ATI RN Leadership Proctored Examination – Form B
Exam Structure: 150 multiple-choice questions organized across 10 core content domains,
featuring high-level conceptual questions, complex application-based scenarios, and
integrated clinical judgment items with detailed evidence-based rationales.
SECTION 1: CLINICAL PRIORITIZATION AND ACUITY (Questions
1-15)
1. A nurse on a cardiac step-down unit receives report on four clients. Which client
should the nurse assess first?
A) A client with heart failure who has 2+ pitting edema and crackles in the lung bases
B) A client with unstable angina who reports chest pain that is unrelieved by nitroglycerin
,C) A client with a pacemaker who has a heart rate of 76/min and is in sinus rhythm
D) A client with hypertension who has a blood pressure of 148/92 mmHg
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
and intervention. While the client with heart failure has signs of fluid overload, this is a stable
chronic finding that does not require immediate attention.
2. A charge nurse is making assignments for a medical-surgical unit. Which client should
be assigned to the most experienced RN?
A) A client with diabetes who requires insulin administration
B) A client with a newly placed chest tube and continuous bubbling in the water seal chamber
C) A client with a urinary tract infection who is receiving IV antibiotics
D) A client with osteoarthritis who requires assistance with ambulation
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air
leak, which is a complication requiring immediate assessment and intervention. The most
experienced RN should be assigned to this unstable client. The other clients are stable and
have predictable care needs.
3. A nurse is caring for four clients on a busy surgical unit. Which client requires
immediate nursing intervention?
A) A client who is 2 days post-colectomy and has a nasogastric tube draining 200 mL of
greenfluid
B) A client who is 4 hours post-appendectomy and reports incisional pain of 7 on a 0–10 scale
C) A client who is 1 day post-hip replacement and has a hemoglobin level of 8.2 g/dL
D) A client who is 3 days post-cholecystectomy and has a temperature of 38.1°C (100.6°F)
Correct Answer: C
, Rationale: A hemoglobin level of 8.2 g/dL in a postoperative client is critically low and may
indicate hemorrhage. This requires immediate assessment and intervention. The client with
pain can receive PRN medication, the NG tube drainage is within expected parameters, and
the temperature elevation is mild and may be expected postoperatively.
4. A nurse receives shift report and is prioritizing care for the following clients. Which
client should the nurse see FIRST?
A) A client with an epidural infusion who reports numbness in both legs
B) A client with a wound infection who needs a dressing change
C) A client with a fractured tibia who requests pain medication
D) A client with diabetes who has a blood glucose of 210 mg/dL
Correct Answer: A
Rationale: Numbness in both legs in a client with an epidural infusion may indicate a
complication such as epidural hematoma or nerve compression. This requires immediate
neurological assessment. The other findings are stable and can be addressed after the priority
client.
5. A nurse is caring for a client who is receiving a blood transfusion and develops chills,
back pain, and dyspnea. What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Notify the provider
D) Administer prescribed antihistamines
Correct Answer: B
Rationale: The client is exhibiting signs of a possible transfusion reaction (chills, back pain,
dyspnea). The nurse should stop the transfusion immediately to prevent further complications.
Practice
Assessment B -
V2.0 well written
one year 2025
/2026 updated
graded A+ Comprehensive
150-Question Practice Examination
,EXAM OVERVIEW
Title: ATI Leadership Practice Assessment B Version 2.0: Advanced Nursing Leadership and
Management Examination Covering Clinical Prioritization, Delegation and Supervision, Legal
and Ethical Dimensions, Healthcare Quality and Safety, Financial Resource Management,
Interprofessional Collaboration, Change Management, Conflict Resolution, Emergency
Preparedness, and Professional Role Development for RN Licensure Preparation
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Nursing Students, Graduate Nurses, and Experienced Clinicians preparing
for the ATI RN Leadership Proctored Examination – Form B
Exam Structure: 150 multiple-choice questions organized across 10 core content domains,
featuring high-level conceptual questions, complex application-based scenarios, and
integrated clinical judgment items with detailed evidence-based rationales.
SECTION 1: CLINICAL PRIORITIZATION AND ACUITY (Questions
1-15)
1. A nurse on a cardiac step-down unit receives report on four clients. Which client
should the nurse assess first?
A) A client with heart failure who has 2+ pitting edema and crackles in the lung bases
B) A client with unstable angina who reports chest pain that is unrelieved by nitroglycerin
,C) A client with a pacemaker who has a heart rate of 76/min and is in sinus rhythm
D) A client with hypertension who has a blood pressure of 148/92 mmHg
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
and intervention. While the client with heart failure has signs of fluid overload, this is a stable
chronic finding that does not require immediate attention.
2. A charge nurse is making assignments for a medical-surgical unit. Which client should
be assigned to the most experienced RN?
A) A client with diabetes who requires insulin administration
B) A client with a newly placed chest tube and continuous bubbling in the water seal chamber
C) A client with a urinary tract infection who is receiving IV antibiotics
D) A client with osteoarthritis who requires assistance with ambulation
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air
leak, which is a complication requiring immediate assessment and intervention. The most
experienced RN should be assigned to this unstable client. The other clients are stable and
have predictable care needs.
3. A nurse is caring for four clients on a busy surgical unit. Which client requires
immediate nursing intervention?
A) A client who is 2 days post-colectomy and has a nasogastric tube draining 200 mL of
greenfluid
B) A client who is 4 hours post-appendectomy and reports incisional pain of 7 on a 0–10 scale
C) A client who is 1 day post-hip replacement and has a hemoglobin level of 8.2 g/dL
D) A client who is 3 days post-cholecystectomy and has a temperature of 38.1°C (100.6°F)
Correct Answer: C
, Rationale: A hemoglobin level of 8.2 g/dL in a postoperative client is critically low and may
indicate hemorrhage. This requires immediate assessment and intervention. The client with
pain can receive PRN medication, the NG tube drainage is within expected parameters, and
the temperature elevation is mild and may be expected postoperatively.
4. A nurse receives shift report and is prioritizing care for the following clients. Which
client should the nurse see FIRST?
A) A client with an epidural infusion who reports numbness in both legs
B) A client with a wound infection who needs a dressing change
C) A client with a fractured tibia who requests pain medication
D) A client with diabetes who has a blood glucose of 210 mg/dL
Correct Answer: A
Rationale: Numbness in both legs in a client with an epidural infusion may indicate a
complication such as epidural hematoma or nerve compression. This requires immediate
neurological assessment. The other findings are stable and can be addressed after the priority
client.
5. A nurse is caring for a client who is receiving a blood transfusion and develops chills,
back pain, and dyspnea. What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Notify the provider
D) Administer prescribed antihistamines
Correct Answer: B
Rationale: The client is exhibiting signs of a possible transfusion reaction (chills, back pain,
dyspnea). The nurse should stop the transfusion immediately to prevent further complications.
