2023 ATI CMS
LEADERSHIP
EXAM QUESTIONS
(3 FULL SET EXAMS)
(NGN-STYLE QUESTIONS & CASE SCENARIOS)
GET A LEVEL 2 OR HIGHER
What You’ll Get:
• 400+ LEADERSHIP nursing questions
• Detailed answer rationales for each question
Not affiliated with ATI, VATI or NCLEX. For study purposes only.
,PREVIEW QUESTIONS BELOW
GET THE COMPLETE PDF
AFTER PURCHASE
“ If you require further clarification
or in need of any study resources,
feel free to Message me.
”
,Table of Contents
ATI LEADERSHIP EXAM - SET 1 .............................................. 2
ATI LEADERSHIP EXAM - SET 2 ............................................ 53
ATI LEADERSHIP EXAM - SET 3 .......................................... 114
ATI CMS LEADERSHIP (200 BONUS QS) .......................... 180
ATI LEADERSHIP EXAM - SET 1
QUESTION 1
A nurse is reviewing the electronic medical record on clients following the
implementation of a quality improvement plan to reduce health care-
associated infections on a medical-surgical unit.
Exhibits:
• Client 1: Cerebrovascular accident
• Client 2: Pneumonia
• Client 3: Wound infection
• Client 4: Urinary tract infection
• Client 5: Fractured hip
Select the 3 clients whose findings indicate the program is EFFECTIVE:
A. Clients 1, 2, and 4
B. Clients 2, 3, and 5
C. Clients 1, 3, and 5
D. Clients 2, 4, and 5
Correct Answer: B. Clients 2, 3, and 5
,Rationale: A quality improvement plan to reduce healthcare-associated
infections (HAIs) would be considered effective if clients have community-
acquired infections rather than hospital-acquired infections.
• Client 2 (Pneumonia): If community-acquired, indicates prevention of
hospital-acquired pneumonia
• Client 3 (Wound infection): If present on admission, not hospital-
acquired
• Client 5 (Fractured hip): Orthopedic injury without infection indicates
successful prevention
Clients 1 (CVA) and 4 (UTI) are more likely to be hospital-acquired
complications, which would indicate the program is NOT effective.
QUESTION 2
A nurse manager is overseeing employees on their unit. Which of the
following actions is the nurse manager's priority?
A. Document the incident for human resources
B. Remove the employee from the work environment
C. Schedule a meeting with the employee to discuss concerns
D. Review the employee's performance record
Correct Answer: B. Remove the employee from the work environment
Rationale: Patient safety is always the priority. If an employee poses an
immediate risk to patient safety, the nurse manager must first remove that
employee from the work environment to prevent harm. Documentation,
meetings, and record reviews can occur after the immediate safety threat is
addressed. This follows the principle of "first, do no harm."
QUESTION 3
A nurse is triaging a group of clients as they arrive simultaneously in the
emergency department following a nearby bus crash. Which of the
,following clients should the nurse transfer to the three available trauma
rooms? (Select 3)
A. Client with a minor laceration on the arm
B. Client with an open fracture of the tibia
C. Client with a suspected spinal cord injury
D. Client with a Glasgow Coma Scale of 15
E. Client with a tension pneumothorax
F. Client with stable vital signs and abdominal pain
Correct Answer: B, C, and E
Rationale: Trauma rooms are reserved for clients requiring immediate, life-
saving interventions (emergent/urgent categories per triage protocols):
• B. Open fracture of tibia: High risk for infection, blood loss, and
compartment syndrome
• C. Suspected spinal cord injury: Risk for permanent neurological
damage; requires immobilization and immediate assessment
• E. Tension pneumothorax: Life-threatening condition requiring
immediate decompression
Minor lacerations (A), fully alert clients (D-GCS 15), and stable clients (F) can
wait in the regular emergency department.
QUESTION 4
A charge nurse on a mental health unit is receiving change-of-shift report
for a group of clients. The charge nurse is working with an RN, PN, and
assistive personnel (AP) from 0700 to 1900 and is reviewing client care
assignments.
Complete the following sentence: The charge nurse should first assess
________ due to ________ and ________.
A. Client 1 due to HALLUCINATIONS and DELUSIONS
B. Client 2 due to DEPRESSION and SUICIDE RISK
,C. Client 3 due to MANIA and HYPERACTIVITY
D. Client 4 due to ANXIETY and PANIC ATTACKS
Correct Answer: A. Client 1 due to HALLUCINATIONS and DELUSIONS
Rationale: Psychotic symptoms (hallucinations and delusions) represent
the highest priority on a mental health unit because these clients:
• Have impaired reality testing and may act on delusional beliefs
• Pose potential safety risks to themselves or others
• Require immediate assessment for command hallucinations or paranoid
delusions
• Need prompt medication administration and close monitoring
While depression/suicide risk (B) is also high priority, psychotic symptoms
require immediate assessment to determine if the client is responding to
internal stimuli that could result in unpredictable behavior.
QUESTION 5
An infectious disease nurse is reviewing electronic medical records on a
group of clients. Select 4 clients whose diagnosis should be reported to the
health department.
Clients:
• Client 1: Lyme disease
• Client 2: Acute Hepatitis C
• Client 3: Clostridium difficile
• Client 4: Salmonellosis
• Client 5: Streptococcal pharyngitis
• Client 6: Pertussis
,A. Clients 1, 2, 4, and 6
B. Clients 2, 3, 4, and 5
C. Clients 1, 3, 5, and 6
D. Clients 2, 4, 5, and 6
Correct Answer: A. Clients 1, 2, 4, and 6
Rationale: These are nationally notifiable diseases that must be reported to
public health authorities:
• Lyme disease (1): Tick-borne illness requiring surveillance
• Acute Hepatitis C (2): Bloodborne pathogen requiring contact tracing
and surveillance
• Salmonellosis (4): Foodborne illness requiring investigation for
outbreaks
• Pertussis (6): Highly contagious vaccine-preventable disease requiring
contact prophylaxis
Not reportable: C. diff (3) is a nosocomial infection tracked internally;
streptococcal pharyngitis (5) is not nationally notifiable unless part of a
foodborne outbreak.
QUESTION 6
A nurse case manager is coordinating care for a client. History and
physical: Client has terminal lung cancer and is not expected to live more
than 6 months. Select the 3 community resources the nurse should refer
the client.
A. Hospice care, Respite care, Social worker
B. Palliative care team, Physical therapy, Home health aide
C. Nutritionist, Occupational therapy, Chaplain services
D. Home health nurse, Wound care specialist, Diabetes educator
Correct Answer: A. Hospice care, Respite care, Social worker
Rationale: For a client with terminal illness (<6 months prognosis):
, • Hospice care: Specialized end-of-life care focusing on comfort and
quality of life
• Respite care: Provides relief for family caregivers to prevent burnout
• Social worker: Assists with advance directives, financial concerns, funeral
planning, and psychosocial support
While palliative care (B) is appropriate, hospice is specifically for terminal
prognoses. The other options include services less critical for immediate end-
of-life planning.
QUESTION 7
A nurse is observing a newly licensed nurse prepare a medication from an
ampule for a client's injection. For which of the following actions by the
newly licensed nurse should the nurse intervene?
A. Taps the ampule to bring medication to the neck
B. Uses a filtered needle to withdraw the medication
C. Withdraws the medication from the ampule using a subcutaneous needle
D. Breaks the ampule neck away from self using an alcohol swab
Correct Answer: C. Withdraws the medication from the ampule using a
subcutaneous needle
Rationale: Intervention is required because:
• Ampules are made of glass; breaking them creates glass shards
• A filtered needle (not subcutaneous needle) must be used to withdraw
medication to prevent glass particles from entering the syringe
• Subcutaneous needles are for administration, not withdrawing from
ampules
• The filter needle should be changed to an appropriate administration
needle after withdrawal
Options A, B, and D describe correct techniques.
,QUESTION 8
A nurse manager observes an assistive personnel (AP) incorrectly
transferring a client to the bedside commode. Which of the following
actions should the nurse take first?
A. Complete an incident report
B. Help the AP assist the client with the transfer
C. Correct the AP's technique after the transfer
D. Take over the transfer and complete it independently
Correct Answer: B. Help the AP assist the client with the transfer
Rationale: The priority is immediate client safety. An incorrect transfer
technique puts the client at risk for falls and injury. The nurse manager should:
1. First: Assist with the transfer to ensure client safety
2. Then: Use this as a teaching moment to demonstrate correct technique
3. Finally: Document and follow up with additional training if needed
Never prioritize documentation (A) or observation over immediate intervention
when client safety is at risk.
QUESTION 9
A nurse is participating in the development of a disaster management plan
for a hospital. The nurse should recognize that which of the following
resources is the highest priority to have available in response to a
bioterrorism event?
A. A sufficient supply of personal protective equipment
B. A stockpile of antibiotics and antidotes
C. A dedicated isolation unit for contaminated patients
D. A communication system for staff notification
Correct Answer: A. A sufficient supply of personal protective equipment
, Rationale: In a bioterrorism event, healthcare workers are at high risk of
exposure to infectious agents or toxins. PPE is the highest priority because:
• Without PPE, staff cannot safely care for victims
• Staff exposure would deplete the workforce and potentially spread the
agent
• PPE is required before any other interventions can be safely implemented
While antibiotics (B), isolation units (C), and communication systems (D) are
important, they are secondary to protecting the healthcare workforce.
QUESTION 10
A charge nurse observes a client fall while ambulating with an assistive
personnel and notes that the client's gait belt was not in place. When
reviewing the incident report, the charge nurse finds that the report does
not mention the gait belt. Which of the following ethical principles should
the charge nurse follow?
A. Beneficence
B. Nonmaleficence
C. Veracity
D. Justice
Correct Answer: C. Veracity
Rationale: Veracity (truthfulness) requires accurate, honest documentation.
The incident report must include all relevant facts, including:
• The absence of the gait belt (a contributing factor to the fall)
• Complete transparency for quality improvement and risk management
• Factual information for legal protection of all parties
Omitting the gait belt information would be dishonest and could compromise
patient safety improvements. Beneficence (A) and nonmaleficence (B) relate to
actions benefiting patients; justice (D) relates to fair distribution of resources.
LEADERSHIP
EXAM QUESTIONS
(3 FULL SET EXAMS)
(NGN-STYLE QUESTIONS & CASE SCENARIOS)
GET A LEVEL 2 OR HIGHER
What You’ll Get:
• 400+ LEADERSHIP nursing questions
• Detailed answer rationales for each question
Not affiliated with ATI, VATI or NCLEX. For study purposes only.
,PREVIEW QUESTIONS BELOW
GET THE COMPLETE PDF
AFTER PURCHASE
“ If you require further clarification
or in need of any study resources,
feel free to Message me.
”
,Table of Contents
ATI LEADERSHIP EXAM - SET 1 .............................................. 2
ATI LEADERSHIP EXAM - SET 2 ............................................ 53
ATI LEADERSHIP EXAM - SET 3 .......................................... 114
ATI CMS LEADERSHIP (200 BONUS QS) .......................... 180
ATI LEADERSHIP EXAM - SET 1
QUESTION 1
A nurse is reviewing the electronic medical record on clients following the
implementation of a quality improvement plan to reduce health care-
associated infections on a medical-surgical unit.
Exhibits:
• Client 1: Cerebrovascular accident
• Client 2: Pneumonia
• Client 3: Wound infection
• Client 4: Urinary tract infection
• Client 5: Fractured hip
Select the 3 clients whose findings indicate the program is EFFECTIVE:
A. Clients 1, 2, and 4
B. Clients 2, 3, and 5
C. Clients 1, 3, and 5
D. Clients 2, 4, and 5
Correct Answer: B. Clients 2, 3, and 5
,Rationale: A quality improvement plan to reduce healthcare-associated
infections (HAIs) would be considered effective if clients have community-
acquired infections rather than hospital-acquired infections.
• Client 2 (Pneumonia): If community-acquired, indicates prevention of
hospital-acquired pneumonia
• Client 3 (Wound infection): If present on admission, not hospital-
acquired
• Client 5 (Fractured hip): Orthopedic injury without infection indicates
successful prevention
Clients 1 (CVA) and 4 (UTI) are more likely to be hospital-acquired
complications, which would indicate the program is NOT effective.
QUESTION 2
A nurse manager is overseeing employees on their unit. Which of the
following actions is the nurse manager's priority?
A. Document the incident for human resources
B. Remove the employee from the work environment
C. Schedule a meeting with the employee to discuss concerns
D. Review the employee's performance record
Correct Answer: B. Remove the employee from the work environment
Rationale: Patient safety is always the priority. If an employee poses an
immediate risk to patient safety, the nurse manager must first remove that
employee from the work environment to prevent harm. Documentation,
meetings, and record reviews can occur after the immediate safety threat is
addressed. This follows the principle of "first, do no harm."
QUESTION 3
A nurse is triaging a group of clients as they arrive simultaneously in the
emergency department following a nearby bus crash. Which of the
,following clients should the nurse transfer to the three available trauma
rooms? (Select 3)
A. Client with a minor laceration on the arm
B. Client with an open fracture of the tibia
C. Client with a suspected spinal cord injury
D. Client with a Glasgow Coma Scale of 15
E. Client with a tension pneumothorax
F. Client with stable vital signs and abdominal pain
Correct Answer: B, C, and E
Rationale: Trauma rooms are reserved for clients requiring immediate, life-
saving interventions (emergent/urgent categories per triage protocols):
• B. Open fracture of tibia: High risk for infection, blood loss, and
compartment syndrome
• C. Suspected spinal cord injury: Risk for permanent neurological
damage; requires immobilization and immediate assessment
• E. Tension pneumothorax: Life-threatening condition requiring
immediate decompression
Minor lacerations (A), fully alert clients (D-GCS 15), and stable clients (F) can
wait in the regular emergency department.
QUESTION 4
A charge nurse on a mental health unit is receiving change-of-shift report
for a group of clients. The charge nurse is working with an RN, PN, and
assistive personnel (AP) from 0700 to 1900 and is reviewing client care
assignments.
Complete the following sentence: The charge nurse should first assess
________ due to ________ and ________.
A. Client 1 due to HALLUCINATIONS and DELUSIONS
B. Client 2 due to DEPRESSION and SUICIDE RISK
,C. Client 3 due to MANIA and HYPERACTIVITY
D. Client 4 due to ANXIETY and PANIC ATTACKS
Correct Answer: A. Client 1 due to HALLUCINATIONS and DELUSIONS
Rationale: Psychotic symptoms (hallucinations and delusions) represent
the highest priority on a mental health unit because these clients:
• Have impaired reality testing and may act on delusional beliefs
• Pose potential safety risks to themselves or others
• Require immediate assessment for command hallucinations or paranoid
delusions
• Need prompt medication administration and close monitoring
While depression/suicide risk (B) is also high priority, psychotic symptoms
require immediate assessment to determine if the client is responding to
internal stimuli that could result in unpredictable behavior.
QUESTION 5
An infectious disease nurse is reviewing electronic medical records on a
group of clients. Select 4 clients whose diagnosis should be reported to the
health department.
Clients:
• Client 1: Lyme disease
• Client 2: Acute Hepatitis C
• Client 3: Clostridium difficile
• Client 4: Salmonellosis
• Client 5: Streptococcal pharyngitis
• Client 6: Pertussis
,A. Clients 1, 2, 4, and 6
B. Clients 2, 3, 4, and 5
C. Clients 1, 3, 5, and 6
D. Clients 2, 4, 5, and 6
Correct Answer: A. Clients 1, 2, 4, and 6
Rationale: These are nationally notifiable diseases that must be reported to
public health authorities:
• Lyme disease (1): Tick-borne illness requiring surveillance
• Acute Hepatitis C (2): Bloodborne pathogen requiring contact tracing
and surveillance
• Salmonellosis (4): Foodborne illness requiring investigation for
outbreaks
• Pertussis (6): Highly contagious vaccine-preventable disease requiring
contact prophylaxis
Not reportable: C. diff (3) is a nosocomial infection tracked internally;
streptococcal pharyngitis (5) is not nationally notifiable unless part of a
foodborne outbreak.
QUESTION 6
A nurse case manager is coordinating care for a client. History and
physical: Client has terminal lung cancer and is not expected to live more
than 6 months. Select the 3 community resources the nurse should refer
the client.
A. Hospice care, Respite care, Social worker
B. Palliative care team, Physical therapy, Home health aide
C. Nutritionist, Occupational therapy, Chaplain services
D. Home health nurse, Wound care specialist, Diabetes educator
Correct Answer: A. Hospice care, Respite care, Social worker
Rationale: For a client with terminal illness (<6 months prognosis):
, • Hospice care: Specialized end-of-life care focusing on comfort and
quality of life
• Respite care: Provides relief for family caregivers to prevent burnout
• Social worker: Assists with advance directives, financial concerns, funeral
planning, and psychosocial support
While palliative care (B) is appropriate, hospice is specifically for terminal
prognoses. The other options include services less critical for immediate end-
of-life planning.
QUESTION 7
A nurse is observing a newly licensed nurse prepare a medication from an
ampule for a client's injection. For which of the following actions by the
newly licensed nurse should the nurse intervene?
A. Taps the ampule to bring medication to the neck
B. Uses a filtered needle to withdraw the medication
C. Withdraws the medication from the ampule using a subcutaneous needle
D. Breaks the ampule neck away from self using an alcohol swab
Correct Answer: C. Withdraws the medication from the ampule using a
subcutaneous needle
Rationale: Intervention is required because:
• Ampules are made of glass; breaking them creates glass shards
• A filtered needle (not subcutaneous needle) must be used to withdraw
medication to prevent glass particles from entering the syringe
• Subcutaneous needles are for administration, not withdrawing from
ampules
• The filter needle should be changed to an appropriate administration
needle after withdrawal
Options A, B, and D describe correct techniques.
,QUESTION 8
A nurse manager observes an assistive personnel (AP) incorrectly
transferring a client to the bedside commode. Which of the following
actions should the nurse take first?
A. Complete an incident report
B. Help the AP assist the client with the transfer
C. Correct the AP's technique after the transfer
D. Take over the transfer and complete it independently
Correct Answer: B. Help the AP assist the client with the transfer
Rationale: The priority is immediate client safety. An incorrect transfer
technique puts the client at risk for falls and injury. The nurse manager should:
1. First: Assist with the transfer to ensure client safety
2. Then: Use this as a teaching moment to demonstrate correct technique
3. Finally: Document and follow up with additional training if needed
Never prioritize documentation (A) or observation over immediate intervention
when client safety is at risk.
QUESTION 9
A nurse is participating in the development of a disaster management plan
for a hospital. The nurse should recognize that which of the following
resources is the highest priority to have available in response to a
bioterrorism event?
A. A sufficient supply of personal protective equipment
B. A stockpile of antibiotics and antidotes
C. A dedicated isolation unit for contaminated patients
D. A communication system for staff notification
Correct Answer: A. A sufficient supply of personal protective equipment
, Rationale: In a bioterrorism event, healthcare workers are at high risk of
exposure to infectious agents or toxins. PPE is the highest priority because:
• Without PPE, staff cannot safely care for victims
• Staff exposure would deplete the workforce and potentially spread the
agent
• PPE is required before any other interventions can be safely implemented
While antibiotics (B), isolation units (C), and communication systems (D) are
important, they are secondary to protecting the healthcare workforce.
QUESTION 10
A charge nurse observes a client fall while ambulating with an assistive
personnel and notes that the client's gait belt was not in place. When
reviewing the incident report, the charge nurse finds that the report does
not mention the gait belt. Which of the following ethical principles should
the charge nurse follow?
A. Beneficence
B. Nonmaleficence
C. Veracity
D. Justice
Correct Answer: C. Veracity
Rationale: Veracity (truthfulness) requires accurate, honest documentation.
The incident report must include all relevant facts, including:
• The absence of the gait belt (a contributing factor to the fall)
• Complete transparency for quality improvement and risk management
• Factual information for legal protection of all parties
Omitting the gait belt information would be dishonest and could compromise
patient safety improvements. Beneficence (A) and nonmaleficence (B) relate to
actions benefiting patients; justice (D) relates to fair distribution of resources.
