ATI LEADERSHIP PROCTORED FINAL
EXAM Questions And Well Graded
Solutions With Rationales Updated 2026-
2027
1. The charge nurse is assigning patients to the team. Which patient should be
assigned to the RN rather than the LPN?
A. Patient with a new colostomy needing stoma care teaching
B. Patient with stable CHF requiring daily weights
C. Patient with a urinary tract infection on oral antibiotics
D. Patient with a pressure injury needing wound dressing change
Answer: A
Rationale: Teaching and discharge planning require RN-level assessment and
education. LPNs can perform stable wound care, administer oral meds, and
obtain daily weights under RN supervision.
2. A nurse manager notices a staff nurse frequently documenting vital signs without
actually assessing the patient. What is the manager’s priority action?
A. Ignore it unless a patient is harmed
B. Speak privately with the nurse to address the falsification
C. Report the nurse to the state board of nursing immediately
D. Reassign the nurse to non-patient-care duties
Answer: B
Rationale: Falsification of records is a serious breach of ethics and patient
safety. The manager should first address the issue privately, investigate, and
take corrective action—escalating only if warranted.
,3. Which client should the charge nurse assign to the most experienced RN on a
medical-surgical unit?
A. 45-year-old with pneumonia and stable vitals
B. 60-year-old with COPD exacerbation on bi-level positive airway pressure (BiPAP)
C. 30-year-old with cellulitis receiving IV antibiotics
D. 70-year-old with constipation and abdominal cramping
Answer: B
Rationale: A patient on BiPAP is unstable and requires close respiratory
monitoring. The most experienced RN should manage the highest-acuity
patient.
4. A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. What is the nurse’s best action?
A. Administer the transfusion because it is medically necessary
B. Notify the provider and respect the client’s decision
C. Ask the family to convince the client
D. Document the refusal but administer the transfusion anyway
Answer: B
Rationale: The client has the right to refuse treatment under informed consent
and autonomy. The nurse must respect the decision, notify the provider, and
explore alternatives.
5. A charge nurse observes an assistive personnel (AP) applying a restraint without a
provider’s order. What is the first action?
A. Remove the restraint immediately
B. Document the incident in the AP’s file
C. Ask the AP to get an order within 1 hour
D. Report the AP to the nursing supervisor
,Answer: A
Rationale: Restraints without an order are illegal and constitute false
imprisonment. The nurse must remove the restraint immediately and address
the AP’s practice.
6. A nurse is delegating tasks to an LPN. Which task is appropriate to delegate?
A. Initial admission assessment of a new patient
B. Administration of a tube feeding to a stable patient
C. Discharge teaching for a diabetic patient
D. Evaluation of a patient’s response to pain medication
Answer: B
Rationale: LPNs can administer tube feedings to stable patients. Initial
assessments, teaching, and evaluation are RN responsibilities.
7. A nurse manager is implementing a new evidence-based fall prevention protocol.
Which leadership style is most effective for gaining staff buy-in?
A. Authoritarian
B. Laissez-faire
C. Democratic
D. Autocratic
Answer: C
Rationale: A democratic style involves staff in decision-making, increases
engagement, and improves adherence to new protocols.
8. A patient with a do-not-resuscitate (DNR) order begins to have difficulty
breathing. What is the nurse’s priority?
, A. Initiate CPR immediately
B. Call a code blue
C. Provide comfort measures and notify the provider
D. Intubate the patient
Answer: C
Rationale: A DNR order means no CPR or intubation. The nurse should provide
supportive comfort care, position the patient, administer oxygen, and notify the
provider.
9. A nurse witnesses another nurse diverting opioid medications. What is the
appropriate action?
A. Ignore it to avoid conflict
B. Confront the nurse privately
C. Report the diversion to the nursing supervisor and risk management
D. Wait until the nurse makes a medication error
Answer: C
Rationale: Diversion is illegal and unsafe. The nurse has a duty to report to the
supervisor and risk management to protect patients and the impaired nurse.
10. A newly graduated RN is struggling with time management. Which strategy
should the preceptor recommend first?
A. Delegate all hygiene tasks to AP
B. Cluster care and prioritize high-acuity patients first
C. Take longer breaks to reduce stress
D. Document at the end of the shift
Answer: B
Rationale: Clustering care (e.g., vitals, meds, baths together) and prioritizing
unstable patients improves efficiency and time management.
EXAM Questions And Well Graded
Solutions With Rationales Updated 2026-
2027
1. The charge nurse is assigning patients to the team. Which patient should be
assigned to the RN rather than the LPN?
A. Patient with a new colostomy needing stoma care teaching
B. Patient with stable CHF requiring daily weights
C. Patient with a urinary tract infection on oral antibiotics
D. Patient with a pressure injury needing wound dressing change
Answer: A
Rationale: Teaching and discharge planning require RN-level assessment and
education. LPNs can perform stable wound care, administer oral meds, and
obtain daily weights under RN supervision.
2. A nurse manager notices a staff nurse frequently documenting vital signs without
actually assessing the patient. What is the manager’s priority action?
A. Ignore it unless a patient is harmed
B. Speak privately with the nurse to address the falsification
C. Report the nurse to the state board of nursing immediately
D. Reassign the nurse to non-patient-care duties
Answer: B
Rationale: Falsification of records is a serious breach of ethics and patient
safety. The manager should first address the issue privately, investigate, and
take corrective action—escalating only if warranted.
,3. Which client should the charge nurse assign to the most experienced RN on a
medical-surgical unit?
A. 45-year-old with pneumonia and stable vitals
B. 60-year-old with COPD exacerbation on bi-level positive airway pressure (BiPAP)
C. 30-year-old with cellulitis receiving IV antibiotics
D. 70-year-old with constipation and abdominal cramping
Answer: B
Rationale: A patient on BiPAP is unstable and requires close respiratory
monitoring. The most experienced RN should manage the highest-acuity
patient.
4. A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. What is the nurse’s best action?
A. Administer the transfusion because it is medically necessary
B. Notify the provider and respect the client’s decision
C. Ask the family to convince the client
D. Document the refusal but administer the transfusion anyway
Answer: B
Rationale: The client has the right to refuse treatment under informed consent
and autonomy. The nurse must respect the decision, notify the provider, and
explore alternatives.
5. A charge nurse observes an assistive personnel (AP) applying a restraint without a
provider’s order. What is the first action?
A. Remove the restraint immediately
B. Document the incident in the AP’s file
C. Ask the AP to get an order within 1 hour
D. Report the AP to the nursing supervisor
,Answer: A
Rationale: Restraints without an order are illegal and constitute false
imprisonment. The nurse must remove the restraint immediately and address
the AP’s practice.
6. A nurse is delegating tasks to an LPN. Which task is appropriate to delegate?
A. Initial admission assessment of a new patient
B. Administration of a tube feeding to a stable patient
C. Discharge teaching for a diabetic patient
D. Evaluation of a patient’s response to pain medication
Answer: B
Rationale: LPNs can administer tube feedings to stable patients. Initial
assessments, teaching, and evaluation are RN responsibilities.
7. A nurse manager is implementing a new evidence-based fall prevention protocol.
Which leadership style is most effective for gaining staff buy-in?
A. Authoritarian
B. Laissez-faire
C. Democratic
D. Autocratic
Answer: C
Rationale: A democratic style involves staff in decision-making, increases
engagement, and improves adherence to new protocols.
8. A patient with a do-not-resuscitate (DNR) order begins to have difficulty
breathing. What is the nurse’s priority?
, A. Initiate CPR immediately
B. Call a code blue
C. Provide comfort measures and notify the provider
D. Intubate the patient
Answer: C
Rationale: A DNR order means no CPR or intubation. The nurse should provide
supportive comfort care, position the patient, administer oxygen, and notify the
provider.
9. A nurse witnesses another nurse diverting opioid medications. What is the
appropriate action?
A. Ignore it to avoid conflict
B. Confront the nurse privately
C. Report the diversion to the nursing supervisor and risk management
D. Wait until the nurse makes a medication error
Answer: C
Rationale: Diversion is illegal and unsafe. The nurse has a duty to report to the
supervisor and risk management to protect patients and the impaired nurse.
10. A newly graduated RN is struggling with time management. Which strategy
should the preceptor recommend first?
A. Delegate all hygiene tasks to AP
B. Cluster care and prioritize high-acuity patients first
C. Take longer breaks to reduce stress
D. Document at the end of the shift
Answer: B
Rationale: Clustering care (e.g., vitals, meds, baths together) and prioritizing
unstable patients improves efficiency and time management.
