ATI RN LEADERSHIP EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY
GRADED A+ ASSURED PASS
The ATI RN Leadership exam is a comprehensive, content-driven assessment
designed to evaluate a nurse's ability to manage care, delegate tasks, and lead
interprofessional teams in complex healthcare environments. It integrates critical
concepts such as the Five Rights of Delegation, ethical-legal principles (autonomy,
advocacy, and informed consent), and emergency preparedness. This examination
emphasizes clinical judgment, prioritizing patient safety, and effective
communication using tools like SBAR. Success requires mastery of quality
improvement, conflict resolution, and resource allocation. The exam prepares
nurses to transition from clinical practice to leadership roles, ensuring they can
coordinate care, supervise personnel, and promote optimal patient outcomes within
dynamic healthcare systems and regulatory frameworks.
Section 1: Delegation and Scope of Practice
This section covers the principles of delegating tasks to licensed practical nurses
(LPNs) and assistive personnel (AP), understanding scope of practice, and the
"Five Rights of Delegation."
Question 1: The RN delegates vital signs to an assistive personnel (AP). Which
client requires the RN to reassess the AP's measurement?
A) Post-operative day 2, afebrile, stable
B) Newly admitted with pneumonia, SpO₂ 89% on room air
C) Chronic hypertension, BP 138/88
D) Hip replacement, pain reported as 3 out of 10
Answer: B
,Detailed Rationale: An oxygen saturation of 89% is abnormal and indicates
hypoxia, requiring immediate RN assessment. Options A, C, and D represent stable
findings that do not require the RN to override the AP's measurement .
Question 2: Which task is appropriate for the RN to delegate to a licensed practical
nurse (LPN)?
A) Performing the initial admission assessment
B) Teaching a client about insulin administration
C) Administering a tube feeding to a stable client
D) Evaluating the client's response to pain medication
Answer: C
Detailed Rationale: LPNs can administer enteral feedings to stable clients with
established feeding tubes. Initial assessments, teaching, and evaluation of
responses are within the RN's scope and cannot be delegated .
Question 3: A charge nurse is assigning clients to an LPN and an AP. Which client
should the charge nurse assign to the LPN?
A) A client who requires a wound culture
B) A client who needs a bed bath
C) A client who is requesting discharge instructions
D) A client who needs vital signs checked every 4 hours
Answer: A
Detailed Rationale: Wound culture collection is within the LPN's scope. Bed baths
and vital signs can be delegated to APs; discharge teaching requires an RN .
Question 4: Which of the following tasks is appropriate for an AP to perform?
A) The AP uses a lift device to transfer a client
B) The AP places a client in a prone position after a meal
C) The AP wears gloves when handling body fluids
D) The AP reports a change in a client's mental status to the nurse
Answer: B
Detailed Rationale: This task is appropriate. Prone positioning after a meal
increases aspiration risk, so the AP should place the client in an upright position .
,Question 5: A charge nurse is assigning clients to a nurse who is floating from the
pediatric unit to the adult medical-surgical unit. Which client should the charge
nurse assign to the float nurse?
A) A client with a new diagnosis of heart failure requiring complex medication
teaching
B) A client with stable diabetes mellitus who needs blood glucose monitoring
C) A client with a chest tube who needs frequent assessment
D) A client with a new tracheostomy who needs suctioning
Answer: B
Detailed Rationale: The float nurse may not be familiar with adult complex
procedures. Stable tasks like blood glucose monitoring are appropriate .
Question 6: Which of the following tasks must be performed by the RN rather than
delegated?
A) Obtaining a client's routine urinalysis sample
B) Completing the client's initial admission assessment
C) Assisting a client who requires help ambulating to the bathroom
D) Documenting routine intake and output (I&O) measurements
Answer: B
Detailed Rationale: The initial admission assessment is a comprehensive
evaluation that requires the clinical judgment of an RN. This task cannot be
delegated to LPNs or APs .
Question 7: An RN delegates the task of obtaining the BP of a client who is 2
hours post-op following a cholecystectomy to an LPN. The LPN reports a BP that
is significantly higher than the client's previous reading. Which action should the
RN take first?
A) Recheck the client's BP
B) Notify the provider
C) Document the finding
D) Administer antihypertensive medication
Answer: A
, Detailed Rationale: The RN should first recheck the client's BP to validate the
finding. After confirmation, further actions such as notifying the provider can be
taken .
Question 8: A charge nurse is delegating tasks on a nursing unit that is short-
staffed. A client has a prescription for a wound irrigation twice per day. Which
action should the charge nurse take?
A) Assign the procedure to an LPN
B) Assign the procedure to an AP
C) Perform the procedure personally
D) Defer the procedure until more staff arrive
Answer: A
Detailed Rationale: Wound irrigation is a sterile procedure that falls within the
LPN's scope of practice. APs cannot perform sterile procedures .
Question 9: A nurse is delegating a client care task to an AP. Which direction
should the nurse give the AP?
A) "This client needs to ambulate using a walker three times today."
B) "Please take this client for a walk."
C) "Ambulate the client when you have time."
D) "The client needs to walk sometime today."
Answer: A
Detailed Rationale: This direction includes the type of task, frequency, duration,
and specific instructions about ambulating the client, which is clear and
measurable .
Question 10: According to the five rights of delegation, which determination
should the nurse make prior to assignment of tasks?
A) The degree of supervision that the AP will require to complete the task
B) The AP's personal schedule preferences
C) The AP's opinion on the task
D) The AP's years of service
Answer: A
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY
GRADED A+ ASSURED PASS
The ATI RN Leadership exam is a comprehensive, content-driven assessment
designed to evaluate a nurse's ability to manage care, delegate tasks, and lead
interprofessional teams in complex healthcare environments. It integrates critical
concepts such as the Five Rights of Delegation, ethical-legal principles (autonomy,
advocacy, and informed consent), and emergency preparedness. This examination
emphasizes clinical judgment, prioritizing patient safety, and effective
communication using tools like SBAR. Success requires mastery of quality
improvement, conflict resolution, and resource allocation. The exam prepares
nurses to transition from clinical practice to leadership roles, ensuring they can
coordinate care, supervise personnel, and promote optimal patient outcomes within
dynamic healthcare systems and regulatory frameworks.
Section 1: Delegation and Scope of Practice
This section covers the principles of delegating tasks to licensed practical nurses
(LPNs) and assistive personnel (AP), understanding scope of practice, and the
"Five Rights of Delegation."
Question 1: The RN delegates vital signs to an assistive personnel (AP). Which
client requires the RN to reassess the AP's measurement?
A) Post-operative day 2, afebrile, stable
B) Newly admitted with pneumonia, SpO₂ 89% on room air
C) Chronic hypertension, BP 138/88
D) Hip replacement, pain reported as 3 out of 10
Answer: B
,Detailed Rationale: An oxygen saturation of 89% is abnormal and indicates
hypoxia, requiring immediate RN assessment. Options A, C, and D represent stable
findings that do not require the RN to override the AP's measurement .
Question 2: Which task is appropriate for the RN to delegate to a licensed practical
nurse (LPN)?
A) Performing the initial admission assessment
B) Teaching a client about insulin administration
C) Administering a tube feeding to a stable client
D) Evaluating the client's response to pain medication
Answer: C
Detailed Rationale: LPNs can administer enteral feedings to stable clients with
established feeding tubes. Initial assessments, teaching, and evaluation of
responses are within the RN's scope and cannot be delegated .
Question 3: A charge nurse is assigning clients to an LPN and an AP. Which client
should the charge nurse assign to the LPN?
A) A client who requires a wound culture
B) A client who needs a bed bath
C) A client who is requesting discharge instructions
D) A client who needs vital signs checked every 4 hours
Answer: A
Detailed Rationale: Wound culture collection is within the LPN's scope. Bed baths
and vital signs can be delegated to APs; discharge teaching requires an RN .
Question 4: Which of the following tasks is appropriate for an AP to perform?
A) The AP uses a lift device to transfer a client
B) The AP places a client in a prone position after a meal
C) The AP wears gloves when handling body fluids
D) The AP reports a change in a client's mental status to the nurse
Answer: B
Detailed Rationale: This task is appropriate. Prone positioning after a meal
increases aspiration risk, so the AP should place the client in an upright position .
,Question 5: A charge nurse is assigning clients to a nurse who is floating from the
pediatric unit to the adult medical-surgical unit. Which client should the charge
nurse assign to the float nurse?
A) A client with a new diagnosis of heart failure requiring complex medication
teaching
B) A client with stable diabetes mellitus who needs blood glucose monitoring
C) A client with a chest tube who needs frequent assessment
D) A client with a new tracheostomy who needs suctioning
Answer: B
Detailed Rationale: The float nurse may not be familiar with adult complex
procedures. Stable tasks like blood glucose monitoring are appropriate .
Question 6: Which of the following tasks must be performed by the RN rather than
delegated?
A) Obtaining a client's routine urinalysis sample
B) Completing the client's initial admission assessment
C) Assisting a client who requires help ambulating to the bathroom
D) Documenting routine intake and output (I&O) measurements
Answer: B
Detailed Rationale: The initial admission assessment is a comprehensive
evaluation that requires the clinical judgment of an RN. This task cannot be
delegated to LPNs or APs .
Question 7: An RN delegates the task of obtaining the BP of a client who is 2
hours post-op following a cholecystectomy to an LPN. The LPN reports a BP that
is significantly higher than the client's previous reading. Which action should the
RN take first?
A) Recheck the client's BP
B) Notify the provider
C) Document the finding
D) Administer antihypertensive medication
Answer: A
, Detailed Rationale: The RN should first recheck the client's BP to validate the
finding. After confirmation, further actions such as notifying the provider can be
taken .
Question 8: A charge nurse is delegating tasks on a nursing unit that is short-
staffed. A client has a prescription for a wound irrigation twice per day. Which
action should the charge nurse take?
A) Assign the procedure to an LPN
B) Assign the procedure to an AP
C) Perform the procedure personally
D) Defer the procedure until more staff arrive
Answer: A
Detailed Rationale: Wound irrigation is a sterile procedure that falls within the
LPN's scope of practice. APs cannot perform sterile procedures .
Question 9: A nurse is delegating a client care task to an AP. Which direction
should the nurse give the AP?
A) "This client needs to ambulate using a walker three times today."
B) "Please take this client for a walk."
C) "Ambulate the client when you have time."
D) "The client needs to walk sometime today."
Answer: A
Detailed Rationale: This direction includes the type of task, frequency, duration,
and specific instructions about ambulating the client, which is clear and
measurable .
Question 10: According to the five rights of delegation, which determination
should the nurse make prior to assignment of tasks?
A) The degree of supervision that the AP will require to complete the task
B) The AP's personal schedule preferences
C) The AP's opinion on the task
D) The AP's years of service
Answer: A
