ATI Leadership
Practice
Assessment B well
written one year
2025 /2026
updated graded
A+ Comprehensive 150-Question Practice
Examination
,EXAM OVERVIEW
Title: ATI Leadership Practice Assessment B: Comprehensive 150-Question Examination Covering
Delegation, Prioritization, Conflict Resolution, Ethical and Legal Responsibilities, Quality Improvement,
Resource Management, Staff Development, Disaster Preparedness, and Professional Nursing
Leadership Principles for Advanced Nursing Practice
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Nursing Students, Professional Nurses, and Healthcare Leaders preparing for ATI RN
Leadership Proctored Examination – Form B
Exam Structure: 150 multiple-choice questions organized across 10 core content domains, featuring
conceptual, application-based, and scenario-based questions with detailed rationales for each correct
answer.
SECTION 1: PRIORITIZATION AND CLINICAL JUDGMENT (Questions 1-
15)
1. A nurse on a medical-surgical unit receives change-of-shift report for four clients. Which
client should the nurse assess first?
A) A client who had abdominal surgery 6 hours ago and has had a heart rate of 120/min for the last
2hours
B) A client with COPD and an oxygen saturation of 88% on room air
C) A client with diabetes who has a blood glucose of 180 mg/dL
D) A client with a fractured hip who reports pain of 6 on a 0–10 scale
Correct Answer: A
Rationale: A heart rate of 120/min in a postoperative patient may indicate hypovolemia, hemorrhage,
or infection. Tachycardia with no clear cause in a postoperative patient is a warning sign requiring
,immediate assessment. While oxygen saturation of 88% is concerning, it is stable; pain and glucose
elevation are not emergent priorities.
2. A nurse is assigned to four patients. Which patient should the nurse see first?
A) A patient with COPD who has a respiratory rate of 24/min and uses accessory muscles
B) A patient with a fractured femur who received morphine 30 minutes ago and reports itching
C) A patient with diabetes who has a blood glucose of 60 mg/dL and is alert
D) A patient with a wound vac who has a low continuous alarm sounding
Correct Answer: A
Rationale: Increased work of breathing (accessory muscle use) indicates respiratory distress, a high
priority. Using the ABCs (airway, breathing, circulation), a patient demonstrating respiratory
compromise should be assessed first. The blood glucose of 60 mg/dL requires intervention but the
patient is alert.
3. A client reports shortness of breath. According to the ABC framework, when should this client
be assessed?
A) After the client with a pressure ulcer
B) After the client requesting pain medication
C) Before all other clients
D) After completing medication passes
Correct Answer: C
Rationale: The ABC framework prioritizes airway, breathing, and circulation. A client with shortness of
breath has a breathing problem that requires immediate assessment before addressing other concerns
such as pain, skin integrity, or scheduled medications.
4. A charge nurse is making assignments for the shift. Which client should be assigned to the
most experienced RN?
A) A client who is 2 days post-operative hip replacement and is ambulating with assistance
B) A client with diabetes who requires insulin administration
C) A client with a new tracheostomy who is unstable and requires frequent suctioning
D) A client with a urinary tract infection who is receiving oral antibiotics
Correct Answer: C
Rationale: The most unstable client with complex care needs (new tracheostomy with instability)
should be assigned to the most experienced RN. Stable, predictable clients can be assigned to less
experienced staff or LPNs with appropriate supervision.
, 5. A nurse receives report on four clients. Which client should the nurse assess first?
A) A client with a fever of 38.3°C (101°F) who is requesting antipyretics
B) A client with chest pain rated 7/10 who has a history of myocardial infarction
C) A client with a new onset of confusion and lethargy
D) A client with a wound infection requiring dressing change
Correct Answer: B
Rationale: Chest pain in a client with a history of MI is a priority concern that may indicate acute
coronary syndrome. This requires immediate assessment and intervention. While new onset confusion
is concerning, chest pain with cardiac history poses an immediate life-threatening risk.
6. A nurse is caring for a client who is 1 day post-operative and reports sudden chest pain and
shortness of breath. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Assess vital signs and oxygen saturation
C) Notify the provider
D) Encourage deep breathing exercises
Correct Answer: B
Rationale: Sudden chest pain and shortness of breath in a postoperative client may indicate a
pulmonary embolism. The nurse must first assess vital signs and oxygen saturation to gather data
before notifying the provider or implementing interventions.
7. A nurse is prioritizing care for multiple clients. Which client should be seen first?
A) A client who is 3 days post-operative and has a temperature of 37.8°C (100°F)
B) A client who is requesting a PRN pain medication for a headache
C) A client who has a new-onset seizure
D) A client who needs assistance with ambulation
Correct Answer: C
Rationale: A new-onset seizure is an acute, potentially life-threatening event requiring immediate
assessment and intervention. This takes priority over stable vital signs, pain management, or
ambulation assistance.
Practice
Assessment B well
written one year
2025 /2026
updated graded
A+ Comprehensive 150-Question Practice
Examination
,EXAM OVERVIEW
Title: ATI Leadership Practice Assessment B: Comprehensive 150-Question Examination Covering
Delegation, Prioritization, Conflict Resolution, Ethical and Legal Responsibilities, Quality Improvement,
Resource Management, Staff Development, Disaster Preparedness, and Professional Nursing
Leadership Principles for Advanced Nursing Practice
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Nursing Students, Professional Nurses, and Healthcare Leaders preparing for ATI RN
Leadership Proctored Examination – Form B
Exam Structure: 150 multiple-choice questions organized across 10 core content domains, featuring
conceptual, application-based, and scenario-based questions with detailed rationales for each correct
answer.
SECTION 1: PRIORITIZATION AND CLINICAL JUDGMENT (Questions 1-
15)
1. A nurse on a medical-surgical unit receives change-of-shift report for four clients. Which
client should the nurse assess first?
A) A client who had abdominal surgery 6 hours ago and has had a heart rate of 120/min for the last
2hours
B) A client with COPD and an oxygen saturation of 88% on room air
C) A client with diabetes who has a blood glucose of 180 mg/dL
D) A client with a fractured hip who reports pain of 6 on a 0–10 scale
Correct Answer: A
Rationale: A heart rate of 120/min in a postoperative patient may indicate hypovolemia, hemorrhage,
or infection. Tachycardia with no clear cause in a postoperative patient is a warning sign requiring
,immediate assessment. While oxygen saturation of 88% is concerning, it is stable; pain and glucose
elevation are not emergent priorities.
2. A nurse is assigned to four patients. Which patient should the nurse see first?
A) A patient with COPD who has a respiratory rate of 24/min and uses accessory muscles
B) A patient with a fractured femur who received morphine 30 minutes ago and reports itching
C) A patient with diabetes who has a blood glucose of 60 mg/dL and is alert
D) A patient with a wound vac who has a low continuous alarm sounding
Correct Answer: A
Rationale: Increased work of breathing (accessory muscle use) indicates respiratory distress, a high
priority. Using the ABCs (airway, breathing, circulation), a patient demonstrating respiratory
compromise should be assessed first. The blood glucose of 60 mg/dL requires intervention but the
patient is alert.
3. A client reports shortness of breath. According to the ABC framework, when should this client
be assessed?
A) After the client with a pressure ulcer
B) After the client requesting pain medication
C) Before all other clients
D) After completing medication passes
Correct Answer: C
Rationale: The ABC framework prioritizes airway, breathing, and circulation. A client with shortness of
breath has a breathing problem that requires immediate assessment before addressing other concerns
such as pain, skin integrity, or scheduled medications.
4. A charge nurse is making assignments for the shift. Which client should be assigned to the
most experienced RN?
A) A client who is 2 days post-operative hip replacement and is ambulating with assistance
B) A client with diabetes who requires insulin administration
C) A client with a new tracheostomy who is unstable and requires frequent suctioning
D) A client with a urinary tract infection who is receiving oral antibiotics
Correct Answer: C
Rationale: The most unstable client with complex care needs (new tracheostomy with instability)
should be assigned to the most experienced RN. Stable, predictable clients can be assigned to less
experienced staff or LPNs with appropriate supervision.
, 5. A nurse receives report on four clients. Which client should the nurse assess first?
A) A client with a fever of 38.3°C (101°F) who is requesting antipyretics
B) A client with chest pain rated 7/10 who has a history of myocardial infarction
C) A client with a new onset of confusion and lethargy
D) A client with a wound infection requiring dressing change
Correct Answer: B
Rationale: Chest pain in a client with a history of MI is a priority concern that may indicate acute
coronary syndrome. This requires immediate assessment and intervention. While new onset confusion
is concerning, chest pain with cardiac history poses an immediate life-threatening risk.
6. A nurse is caring for a client who is 1 day post-operative and reports sudden chest pain and
shortness of breath. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Assess vital signs and oxygen saturation
C) Notify the provider
D) Encourage deep breathing exercises
Correct Answer: B
Rationale: Sudden chest pain and shortness of breath in a postoperative client may indicate a
pulmonary embolism. The nurse must first assess vital signs and oxygen saturation to gather data
before notifying the provider or implementing interventions.
7. A nurse is prioritizing care for multiple clients. Which client should be seen first?
A) A client who is 3 days post-operative and has a temperature of 37.8°C (100°F)
B) A client who is requesting a PRN pain medication for a headache
C) A client who has a new-onset seizure
D) A client who needs assistance with ambulation
Correct Answer: C
Rationale: A new-onset seizure is an acute, potentially life-threatening event requiring immediate
assessment and intervention. This takes priority over stable vital signs, pain management, or
ambulation assistance.
