2026 ATI RN Leadership and
Management Practice Exam Questions
with Answers and Detailed Rationales
Question 1
A charge nurse is assigning clients to four registered nurses
(RNs) at the beginning of a shift. Which client should the
charge nurse assign to the RN who is most experienced in
emergency care?
A. A client 2 days postoperative following a total hip
arthroplasty who requires routine neurovascular assessments
B. A client with chronic heart failure who is awaiting
discharge teaching
C. A client with pneumonia who has a stable oxygen
saturation of 95% on 2 L/min oxygen via nasal cannula
D. A client who developed sudden dyspnea, hypotension,
and altered mental status following central venous catheter
insertion
Rationale: The client with acute dyspnea, hypotension, and
altered mental status requires immediate assessment and
intervention for a potentially life-threatening complication
such as a pneumothorax, air embolism, or other acute event.
The most experienced nurse should receive the highest-acuity,
least predictable assignment. Stable postoperative, chronic,
,and routine clients can be assigned to nurses with less
emergency experience.
Question 2
A nurse manager is evaluating whether to delegate a task to
an assistive personnel (AP). Which action is most
appropriate?
A. Delegate a task based solely on the AP's previous
employment history
B. Delegate any task the AP states they are comfortable
performing
C. Verify that the task is within the AP's role, provide clear
instructions, and evaluate the client's response
D. Delegate the task and assume the AP will report any
unexpected findings
Rationale: Safe delegation requires consideration of the five
rights of delegation: right task, circumstance, person,
direction/communication, and supervision/evaluation. The RN
remains accountable for appropriate delegation and
evaluation of outcomes.
Question 3
A nurse is caring for a client who suddenly becomes
unresponsive. The nurse activates the emergency response
system and begins resuscitation. Which action by the charge
nurse demonstrates effective leadership?
,A. Ask the nurse to document the event before continuing
care
B. Assign all available staff to the client's bedside
C. Assign specific roles to team members and coordinate
communication during the emergency
D. Allow each team member to independently determine
which intervention to perform
Rationale: Effective leadership during emergencies requires
rapid role assignment, clear communication, coordination,
and prioritization. Defined responsibilities reduce duplication,
omissions, and confusion during high-stress situations.
Question 4
A nurse manager notices increasing conflict between two
nurses regarding weekend assignments. Which action should
the manager take first?
A. Change the schedule to prevent the nurses from working
together
B. Counsel the nurse who has the most seniority
C. Ask the nurses to submit written complaints
D. Meet with both nurses to identify the underlying issues
and facilitate collaborative problem solving
Rationale: The manager should address conflict at its source.
A collaborative approach allows each nurse to communicate
concerns, clarify expectations, and work toward a mutually
acceptable solution. Avoidance or unilateral decisions may
temporarily suppress but not resolve the conflict.
, Question 5
A nurse is caring for a client who has a newly inserted chest
tube. The nurse notes continuous bubbling in the water-seal
chamber. Which action should the nurse take?
A. Clamp the chest tube immediately
B. Increase the wall suction pressure
C. Assess the system for an air leak and inspect connections
from the client toward the drainage unit
D. Remove the chest tube and apply an occlusive dressing
Rationale: Continuous bubbling in the water-seal chamber
may indicate an air leak. The nurse should systematically
assess the tubing and connections, beginning near the client,
to identify the source. Routine clamping can worsen a
pneumothorax and should not be performed without an
appropriate indication.
Question 6
A nurse manager is implementing a new electronic
medication administration system. Which action best
demonstrates transformational leadership?
A. Require nurses to follow the new process without
discussion
B. Discipline nurses who question the change
C. Inspire staff to participate in the change by explaining its
purpose and involving them in implementation
Management Practice Exam Questions
with Answers and Detailed Rationales
Question 1
A charge nurse is assigning clients to four registered nurses
(RNs) at the beginning of a shift. Which client should the
charge nurse assign to the RN who is most experienced in
emergency care?
A. A client 2 days postoperative following a total hip
arthroplasty who requires routine neurovascular assessments
B. A client with chronic heart failure who is awaiting
discharge teaching
C. A client with pneumonia who has a stable oxygen
saturation of 95% on 2 L/min oxygen via nasal cannula
D. A client who developed sudden dyspnea, hypotension,
and altered mental status following central venous catheter
insertion
Rationale: The client with acute dyspnea, hypotension, and
altered mental status requires immediate assessment and
intervention for a potentially life-threatening complication
such as a pneumothorax, air embolism, or other acute event.
The most experienced nurse should receive the highest-acuity,
least predictable assignment. Stable postoperative, chronic,
,and routine clients can be assigned to nurses with less
emergency experience.
Question 2
A nurse manager is evaluating whether to delegate a task to
an assistive personnel (AP). Which action is most
appropriate?
A. Delegate a task based solely on the AP's previous
employment history
B. Delegate any task the AP states they are comfortable
performing
C. Verify that the task is within the AP's role, provide clear
instructions, and evaluate the client's response
D. Delegate the task and assume the AP will report any
unexpected findings
Rationale: Safe delegation requires consideration of the five
rights of delegation: right task, circumstance, person,
direction/communication, and supervision/evaluation. The RN
remains accountable for appropriate delegation and
evaluation of outcomes.
Question 3
A nurse is caring for a client who suddenly becomes
unresponsive. The nurse activates the emergency response
system and begins resuscitation. Which action by the charge
nurse demonstrates effective leadership?
,A. Ask the nurse to document the event before continuing
care
B. Assign all available staff to the client's bedside
C. Assign specific roles to team members and coordinate
communication during the emergency
D. Allow each team member to independently determine
which intervention to perform
Rationale: Effective leadership during emergencies requires
rapid role assignment, clear communication, coordination,
and prioritization. Defined responsibilities reduce duplication,
omissions, and confusion during high-stress situations.
Question 4
A nurse manager notices increasing conflict between two
nurses regarding weekend assignments. Which action should
the manager take first?
A. Change the schedule to prevent the nurses from working
together
B. Counsel the nurse who has the most seniority
C. Ask the nurses to submit written complaints
D. Meet with both nurses to identify the underlying issues
and facilitate collaborative problem solving
Rationale: The manager should address conflict at its source.
A collaborative approach allows each nurse to communicate
concerns, clarify expectations, and work toward a mutually
acceptable solution. Avoidance or unilateral decisions may
temporarily suppress but not resolve the conflict.
, Question 5
A nurse is caring for a client who has a newly inserted chest
tube. The nurse notes continuous bubbling in the water-seal
chamber. Which action should the nurse take?
A. Clamp the chest tube immediately
B. Increase the wall suction pressure
C. Assess the system for an air leak and inspect connections
from the client toward the drainage unit
D. Remove the chest tube and apply an occlusive dressing
Rationale: Continuous bubbling in the water-seal chamber
may indicate an air leak. The nurse should systematically
assess the tubing and connections, beginning near the client,
to identify the source. Routine clamping can worsen a
pneumothorax and should not be performed without an
appropriate indication.
Question 6
A nurse manager is implementing a new electronic
medication administration system. Which action best
demonstrates transformational leadership?
A. Require nurses to follow the new process without
discussion
B. Discipline nurses who question the change
C. Inspire staff to participate in the change by explaining its
purpose and involving them in implementation
