ActualATIRN Leadership 2023(Latest 2026 Version) n n n n n n n
Proctored Exam with NGN 70 Questions and A+
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VerifiedAnswerKey |Actual Detailed RNATI Leadership n n n n n n n n
Exam with NGN!
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1 of 70 n
Question: A nurse manager is reviewing the principles of delegation with a new charge nurse. Which of the
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following statements by the new charge nurse indicates an understanding of the five rights of delegation?
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Correct Answer: “I must ensure the right task, right circumstance, right person, right
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direction/communication, and right supervision.”
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Rationale: The five rights of delegation are foundational to safe and effective delegation. They ensure the
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task is appropriate, the patient is stable, the delegatee is competent, instructions are clear, and the
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delegator supervises appropriately.
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2 of 70 n
Question: A charge nurse on a medical-surgical unit is planning care for a patient with a new diagnosis of
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diabetes mellitus. Which task should the charge nurse assign to an LPN/VN?
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Correct Answer: Administering subcutaneous insulin to a stable patient according to a sliding scale
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Rationale: LPNs can administer subcutaneous insulin to stable patients with predictable outcomes.
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Teaching about insulin administration (A) requires RN scope. Adjusting insulin based on complex trends
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(C) is an RN responsibility. Drawing up two types of insulin (D) may be done by LPN but administration to an
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unstable patient is not appropriate.
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3 of 70 (NGN – Highlight)
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Question: A nurse manager is observing a new graduate RN caring for a patient with a chest tube. Which
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actions by the new graduate would cause the manager to intervene? (Select all that apply)
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Correct Answer: Clamping the chest tube during patient transport and Emptying the drainage system
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without wearing gloves
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Rationale: Chest tubes should never be clamped during transport unless specifically ordered, as this can lead
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to tension pneumothorax. Emptying the drainage system requires sterile technique or at minimum clean
n n n n n n n n n n n n n n
gloves to prevent infection. Placing the drainage system below the chest level and reporting increased
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bubbling are correct actions.
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4 of 70 n
Question: A charge nurse observes a staff nurse administering a blood transfusion without obtaining
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written informed consent. The client is conscious and alert. Which action should the charge nurse take first?
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Correct Answer: B. Stop the transfusion immediately
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Rationale: Client safety is the priority. Administering blood without informed consent is a violation of
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, patient rights and could lead to legal consequences. The transfusion must be stopped first to prevent
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further risk. After stopping, the charge nurse can notify the provider, complete an incident report, and
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ensure consent is obtained if the transfusion is still indicated.
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5 of 70 n
Question: A nurse manager is reviewing disaster triage tags after a mass casualty event. Which client
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should receive a black tag (expectant)?
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Correct Answer: C. A client with agonal breathing and no palpable carotid pulse
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Rationale: Black tag is for expectant/deceased – those who are unlikely to survive given available
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resources. Agonal breathing with no palpable pulse indicates impending or actual death. The other
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options (partial thickness burn, open femur fracture with pulse, sucking chest wound with stridor) are
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potentially salvageable (red or yellow tags).
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6 of 70 (NGN – Drag and Drop)
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Question: A nurse manager reviews fall data: 80% of falls on night shift in rooms 210–215 (far from nurses’
n n n n n n n n n n n n n n n n n n
station). Hourly rounding implemented; falls decreased 50% in 3 weeks. Drag and drop the two most
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appropriate actions.
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Correct Answer: B. Present the data at the next unit council meeting and E. Evaluate the fall rate again in
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one month
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Rationale: Sharing success with the unit council promotes transparency and staff engagement.
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Re-evaluating in one month ensures the improvement is sustained. Discontinuing rounding (A) is n n n n n n n n n n n n
premature. Requesting more staff (C) may not be necessary if hourly rounding works. Motion sensor mats
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(D) are costly and not yet indicated given current improvement.
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7 of 70 n
Question: A nurse is delegating tasks to an LPN/VN and an AP. Which of the following tasks should the nurse
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delegate to the LPN/VN? (Select all that apply)
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Correct Answer: A, C, E (A. Reinforcing teaching about a low-sodium diet, C. Suctioning a stable
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tracheostomy, E. Changing a sterile wound dressing on a stage 3 pressure injury)
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Rationale: LPNs can reinforce teaching, suction stable tracheostomies, and perform sterile dressing
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changes for chronic stable wounds. Clean catch urine (B) can be delegated to AP. IV push morphine (D) is
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beyond LPN scope in most states.
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8 of 70 n
Question: A charge nurse is leading a team of four RNs, one LPN, and two APs. The unit census is 28 patients.
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Which patient should be assigned to the LPN?
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Correct Answer: A stable patient with a Foley catheter requiring routine care and I&O monitoring
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Rationale: LPNs can care for stable patients with predictable outcomes, perform catheter care, monitor
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I&O, and administer some medications. Unstable, newly post-op, or complex assessment patients should
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be assigned to RNs.
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9 of 70 n
Question: A nurse manager notices increased conflict between two staff nurses. The manager meets
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with them together. One nurse says, “She always criticizes my charting in front of others.” The other
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says, “He never completes his assigned tasks.” Which conflict resolution strategy should the manager
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use first?
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Correct Answer: Facilitate collaborative problem-solving (interest-based negotiation)
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Rationale: The manager should first bring them together to identify underlying issues, use active listening,
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and guide them to a mutually acceptable solution. Avoidance or forcing would not resolve the root cause.
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10 of 70 n
Question: An RN on a medical floor is floating to the ICU for the first time. The ICU charge nurse notes the
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RN is hesitant to care for a patient on a ventilator. What is the charge nurse’s best action?
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Correct Answer: Assign the RN to a stable patient who is ready for transfer to a step-down unit
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Rationale: Floating to a higher acuity area requires appropriate assignment. The charge nurse should
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Proctored Exam with NGN 70 Questions and A+
n n n n n n n n
VerifiedAnswerKey |Actual Detailed RNATI Leadership n n n n n n n n
Exam with NGN!
n n n
1 of 70 n
Question: A nurse manager is reviewing the principles of delegation with a new charge nurse. Which of the
n n n n n n n n n n n n n n n n n
following statements by the new charge nurse indicates an understanding of the five rights of delegation?
n n n n n n n n n n n n n n n n
Correct Answer: “I must ensure the right task, right circumstance, right person, right
n n n n n n n n n n n n
direction/communication, and right supervision.”
n n n n
Rationale: The five rights of delegation are foundational to safe and effective delegation. They ensure the
n n n n n n n n n n n n n n n
task is appropriate, the patient is stable, the delegatee is competent, instructions are clear, and the
n n n n n n n n n n n n n n n n
delegator supervises appropriately.
n n n
2 of 70 n
Question: A charge nurse on a medical-surgical unit is planning care for a patient with a new diagnosis of
n n n n n n n n n n n n n n n n n n
diabetes mellitus. Which task should the charge nurse assign to an LPN/VN?
n n n n n n n n n n n n
Correct Answer: Administering subcutaneous insulin to a stable patient according to a sliding scale
n n n n n n n n n n n n n
Rationale: LPNs can administer subcutaneous insulin to stable patients with predictable outcomes.
n n n n n n n n n n n n
Teaching about insulin administration (A) requires RN scope. Adjusting insulin based on complex trends
n n n n n n n n n n n n n n
(C) is an RN responsibility. Drawing up two types of insulin (D) may be done by LPN but administration to an
n n n n n n n n n n n n n n n n n n n n
unstable patient is not appropriate.
n n n n n
3 of 70 (NGN – Highlight)
n n n n
Question: A nurse manager is observing a new graduate RN caring for a patient with a chest tube. Which
n n n n n n n n n n n n n n n n n n
actions by the new graduate would cause the manager to intervene? (Select all that apply)
n n n n n n n n n n n n n n n
Correct Answer: Clamping the chest tube during patient transport and Emptying the drainage system
n n n n n n n n n n n n n
without wearing gloves
n n n
Rationale: Chest tubes should never be clamped during transport unless specifically ordered, as this can lead
n n n n n n n n n n n n n n n
to tension pneumothorax. Emptying the drainage system requires sterile technique or at minimum clean
n n n n n n n n n n n n n n
gloves to prevent infection. Placing the drainage system below the chest level and reporting increased
n n n n n n n n n n n n n n n
bubbling are correct actions.
n n n n
4 of 70 n
Question: A charge nurse observes a staff nurse administering a blood transfusion without obtaining
n n n n n n n n n n n n n
written informed consent. The client is conscious and alert. Which action should the charge nurse take first?
n n n n n n n n n n n n n n n n n
Correct Answer: B. Stop the transfusion immediately
n n n n n n
Rationale: Client safety is the priority. Administering blood without informed consent is a violation of
n n n n n n n n n n n n n n
, patient rights and could lead to legal consequences. The transfusion must be stopped first to prevent
n n n n n n n n n n n n n n n
further risk. After stopping, the charge nurse can notify the provider, complete an incident report, and
n n n n n n n n n n n n n n n n
ensure consent is obtained if the transfusion is still indicated.
n n n n n n n n n n
5 of 70 n
Question: A nurse manager is reviewing disaster triage tags after a mass casualty event. Which client
n n n n n n n n n n n n n n n
should receive a black tag (expectant)?
n n n n n n
Correct Answer: C. A client with agonal breathing and no palpable carotid pulse
n n n n n n n n n n n n
Rationale: Black tag is for expectant/deceased – those who are unlikely to survive given available
n n n n n n n n n n n n n n
resources. Agonal breathing with no palpable pulse indicates impending or actual death. The other
n n n n n n n n n n n n n n
options (partial thickness burn, open femur fracture with pulse, sucking chest wound with stridor) are
n n n n n n n n n n n n n n n
potentially salvageable (red or yellow tags).
n n n n n n
6 of 70 (NGN – Drag and Drop)
n n n n n n
Question: A nurse manager reviews fall data: 80% of falls on night shift in rooms 210–215 (far from nurses’
n n n n n n n n n n n n n n n n n n
station). Hourly rounding implemented; falls decreased 50% in 3 weeks. Drag and drop the two most
n n n n n n n n n n n n n n n n
appropriate actions.
n n
Correct Answer: B. Present the data at the next unit council meeting and E. Evaluate the fall rate again in
n n n n n n n n n n n n n n n n n n n
one month
n n
Rationale: Sharing success with the unit council promotes transparency and staff engagement.
n n n n n n n n n n n
Re-evaluating in one month ensures the improvement is sustained. Discontinuing rounding (A) is n n n n n n n n n n n n
premature. Requesting more staff (C) may not be necessary if hourly rounding works. Motion sensor mats
n n n n n n n n n n n n n n n n
(D) are costly and not yet indicated given current improvement.
n n n n n n n n n n
7 of 70 n
Question: A nurse is delegating tasks to an LPN/VN and an AP. Which of the following tasks should the nurse
n n n n n n n n n n n n n n n n n n n
delegate to the LPN/VN? (Select all that apply)
n n n n n n n n
Correct Answer: A, C, E (A. Reinforcing teaching about a low-sodium diet, C. Suctioning a stable
n n n n n n n n n n n n n n n
tracheostomy, E. Changing a sterile wound dressing on a stage 3 pressure injury)
n n n n n n n n n n n n n
Rationale: LPNs can reinforce teaching, suction stable tracheostomies, and perform sterile dressing
n n n n n n n n n n n
changes for chronic stable wounds. Clean catch urine (B) can be delegated to AP. IV push morphine (D) is
n n n n n n n n n n n n n n n n n n n
beyond LPN scope in most states.
n n n n n n
8 of 70 n
Question: A charge nurse is leading a team of four RNs, one LPN, and two APs. The unit census is 28 patients.
n n n n n n n n n n n n n n n n n n n n n
Which patient should be assigned to the LPN?
n n n n n n n n
Correct Answer: A stable patient with a Foley catheter requiring routine care and I&O monitoring
n n n n n n n n n n n n n n
Rationale: LPNs can care for stable patients with predictable outcomes, perform catheter care, monitor
n n n n n n n n n n n n n n
I&O, and administer some medications. Unstable, newly post-op, or complex assessment patients should
n n n n n n n n n n n n n
be assigned to RNs.
n n n n
9 of 70 n
Question: A nurse manager notices increased conflict between two staff nurses. The manager meets
n n n n n n n n n n n n n
with them together. One nurse says, “She always criticizes my charting in front of others.” The other
n n n n n n n n n n n n n n n n n
says, “He never completes his assigned tasks.” Which conflict resolution strategy should the manager
n n n n n n n n n n n n n n
use first?
n n
Correct Answer: Facilitate collaborative problem-solving (interest-based negotiation)
n n n n n n
Rationale: The manager should first bring them together to identify underlying issues, use active listening,
n n n n n n n n n n n n n n
and guide them to a mutually acceptable solution. Avoidance or forcing would not resolve the root cause.
n n n n n n n n n n n n n n n n n
10 of 70 n
Question: An RN on a medical floor is floating to the ICU for the first time. The ICU charge nurse notes the
n n n n n n n n n n n n n n n n n n n n n
RN is hesitant to care for a patient on a ventilator. What is the charge nurse’s best action?
n n n n n n n n n n n n n n n n n n
Correct Answer: Assign the RN to a stable patient who is ready for transfer to a step-down unit
n n n n n n n n n n n n n n n n n
Rationale: Floating to a higher acuity area requires appropriate assignment. The charge nurse should
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