ATI260 ATI Leadership Proctored Exam – ATI
Leadership Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Assessment
Preparation, Nursing Leadership & Management
Review, Delegation, Prioritization, Supervision,
Conflict Resolution, Communication, Patient Safety,
Quality Improvement, Ethical & Legal Responsibilities,
Case Management, Staffing, Disaster Triage & NGN-
Style Clinical Judgment
Question 1: A nurse manager is implementing a new electronic health record (EHR)
system on a unit. Which of the following actions best demonstrates the use of
transformational leadership?
A. Mandating that all staff complete the training module by the end of the week.
B. Offering a monetary bonus to the first nurse who documents a complete patient
chart in the new system.
C. Articulating a clear vision of how the new system will improve patient care and
involving staff in the implementation process.
D. Assigning a super-user to troubleshoot all technical issues and report back to
management.
CORRECT ANSWER: C. Articulating a clear vision of how the new system will
improve patient care and involving staff in the implementation process.
Rationale: Transformational leadership focuses on inspiring and motivating followers to
achieve extraordinary outcomes by appealing to their values and sense of purpose.
Option C demonstrates this by creating a shared vision and encouraging staff
involvement, which fosters ownership and commitment. Option A is autocratic, B is
transactional, and D is a managerial task, not a leadership style.
Question 2: A charge nurse is delegating tasks to a licensed practical nurse (LPN)
and a nursing assistant (NA). Which of the following tasks is most appropriate to
delegate to the LPN?
A. Feeding a patient who requires assistance with meals.
B. Obtaining a routine fingerstick blood glucose level.
C. Administering a tube feeding to a patient with a stable gastrostomy tube.
D. Performing a comprehensive admission assessment on a new patient.
CORRECT ANSWER: C. Administering a tube feeding to a patient with a stable
gastrostomy tube.
Rationale: LPNs are trained to perform stable, predictable procedures like
administering tube feedings and monitoring for complications. Feeding and fingersticks
,are appropriate for NAs (A and B), and comprehensive admission assessments are the
responsibility of the RN (D).
Question 3: A nurse on a medical-surgical unit is caring for a patient who is being
discharged. The patient asks about the cost of a newly prescribed medication.
Which of the following is the nurse's best response?
A. "I will have the social worker contact you about that."
B. "You should ask the pharmacist when you pick up the prescription."
C. "I can provide you with information on patient assistance programs and suggest you
speak with the hospital's financial counselor."
D. "Don't worry about the cost; your insurance will cover most of it."
CORRECT ANSWER: C. I can provide you with information on patient assistance
programs and suggest you speak with the hospital's financial counselor.
Rationale: The nurse has an ethical and professional responsibility to advocate for the
patient's access to care and to connect them with appropriate resources. Option C
provides a direct and helpful resource. Option A is a dismissal, B shifts responsibility,
and D offers a false reassurance about coverage.
Question 4: A nurse is preparing for a Joint Commission survey. Which of the
following actions is most critical for the nurse to take to ensure compliance with
National Patient Safety Goals (NPSGs)?
A. Ensure all crash carts are stocked according to the unit's inventory list.
B. Confirm that the patient's armband contains two unique patient identifiers.
C. Check that all fire extinguishers have been recently inspected.
D. Verify that all staff have current Basic Life Support (BLS) certification.
CORRECT ANSWER: B. Confirm that the patient's armband contains two unique
patient identifiers.
Rationale: The NPSGs are specifically focused on improving patient safety, and one of
the most prominent goals is to improve the accuracy of patient identification. Using two
unique identifiers is a core requirement. Options A, C, and D relate to general safety and
regulatory standards but are not the most critical NPSG-specific action.
Question 5: A new graduate nurse is experiencing high levels of stress and burnout.
Which of the following strategies is an example of an effective coping mechanism
for the novice nurse?
A. Working through lunch breaks to catch up on documentation.
B. Taking a 15-minute break to practice deep breathing exercises during a busy shift.
,C. Volunteering to stay late to help the oncoming shift with admissions.
D. Avoiding difficult patient assignments to reduce anxiety.
CORRECT ANSWER: B. Taking a 15-minute break to practice deep breathing
exercises during a busy shift.
Rationale: Stress management techniques such as deep breathing, brief periods of
mindfulness, and taking short breaks are effective, healthy coping mechanisms. Option
A increases stress and burnout, C leads to exhaustion, and D is avoidance, which
hinders professional development.
Question 6: A nurse is acting as a preceptor for a new hire. The new hire makes a
medication error. What is the preceptor's primary responsibility?
A. Document the error in the new hire's personnel file.
B. Report the error to the nursing supervisor immediately.
C. Assess the situation, ensure patient safety, and provide constructive feedback to
facilitate learning.
D. Complete the incident report on behalf of the new hire.
CORRECT ANSWER: C. Assess the situation, ensure patient safety, and provide
constructive feedback to facilitate learning.
Rationale: The preceptor's role is to foster a safe learning environment. The immediate
priority is patient safety, followed by a non-punitive teaching moment to correct the
behavior and prevent future errors. Reporting to personnel files (A) is premature,
reporting to a supervisor (B) should be done if required but is secondary, and
completing the report for them (D) does not teach the new hire the process.
Question 7: A nursing unit is implementing a shared governance model. Which of
the following outcomes is the primary goal of this structure?
A. Increased administrative control over nursing practice.
B. Empowerment of staff nurses to have a voice in decisions affecting their practice.
C. Decreased cost of nursing care by reducing middle management positions.
D. Standardization of nursing procedures across the entire hospital system.
CORRECT ANSWER: B. Empowerment of staff nurses to have a voice in decisions
affecting their practice.
Rationale: Shared governance is a professional practice model that gives nurses control
over their practice and work environment. It empowers them to make decisions about
clinical issues, quality improvement, and professional development. Options A, C, and
D are not primary goals of shared governance.
, Question 8: A nurse is using the SBAR (Situation, Background, Assessment,
Recommendation) communication tool to call a physician about a patient's change
in condition. Which statement represents the "Assessment" component of SBAR?
A. "The patient was admitted with pneumonia two days ago."
B. "I think the patient is developing sepsis due to the elevated heart rate and
tachypnea."
C. "I am calling because the patient's oxygen saturation has dropped to 88%."
D. "I recommend you come to the bedside to assess the patient now."
CORRECT ANSWER: B. I think the patient is developing sepsis due to the elevated
heart rate and tachypnea.
Rationale: The "Assessment" component is the nurse's professional conclusion or
analysis of the situation. Option A is Background, C is Situation, and D is
Recommendation.
Question 9: A nurse manager is reviewing the budget for the upcoming fiscal year.
Which of the following is an example of a fixed cost for the nursing unit?
A. Overtime pay for staff.
B. Supplies such as IV catheters and dressings.
C. Salaries for full-time, benefit-eligible staff nurses.
D. Utility costs for the unit.
CORRECT ANSWER: C. Salaries for full-time, benefit-eligible staff nurses.
Rationale: Fixed costs remain constant regardless of the volume of patients or services
provided within a certain range. Salaries for full-time staff are fixed, whereas overtime
(A), supplies (B), and utilities (D) are variable costs that fluctuate with patient census
and usage.
Question 10: A nurse is caring for a patient who is a Jehovah's Witness and is
refusing a blood transfusion. The patient is unconscious, and the family requests
the transfusion. What is the nurse's best action?
A. Honor the family's request and prepare the transfusion.
B. Contact the hospital's ethics committee for a consult.
C. Document the patient's religious preference and proceed with the family's wishes.
D. Administer the blood transfusion as it is a life-saving measure.
CORRECT ANSWER: B. Contact the hospital's ethics committee for a consult.
Rationale: This scenario involves a conflict between the patient's previously expressed
wishes, if known, and the family's request. The nurse should advocate for the patient's
autonomy. An ethics committee or legal counsel should be consulted to determine if
Leadership Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Assessment
Preparation, Nursing Leadership & Management
Review, Delegation, Prioritization, Supervision,
Conflict Resolution, Communication, Patient Safety,
Quality Improvement, Ethical & Legal Responsibilities,
Case Management, Staffing, Disaster Triage & NGN-
Style Clinical Judgment
Question 1: A nurse manager is implementing a new electronic health record (EHR)
system on a unit. Which of the following actions best demonstrates the use of
transformational leadership?
A. Mandating that all staff complete the training module by the end of the week.
B. Offering a monetary bonus to the first nurse who documents a complete patient
chart in the new system.
C. Articulating a clear vision of how the new system will improve patient care and
involving staff in the implementation process.
D. Assigning a super-user to troubleshoot all technical issues and report back to
management.
CORRECT ANSWER: C. Articulating a clear vision of how the new system will
improve patient care and involving staff in the implementation process.
Rationale: Transformational leadership focuses on inspiring and motivating followers to
achieve extraordinary outcomes by appealing to their values and sense of purpose.
Option C demonstrates this by creating a shared vision and encouraging staff
involvement, which fosters ownership and commitment. Option A is autocratic, B is
transactional, and D is a managerial task, not a leadership style.
Question 2: A charge nurse is delegating tasks to a licensed practical nurse (LPN)
and a nursing assistant (NA). Which of the following tasks is most appropriate to
delegate to the LPN?
A. Feeding a patient who requires assistance with meals.
B. Obtaining a routine fingerstick blood glucose level.
C. Administering a tube feeding to a patient with a stable gastrostomy tube.
D. Performing a comprehensive admission assessment on a new patient.
CORRECT ANSWER: C. Administering a tube feeding to a patient with a stable
gastrostomy tube.
Rationale: LPNs are trained to perform stable, predictable procedures like
administering tube feedings and monitoring for complications. Feeding and fingersticks
,are appropriate for NAs (A and B), and comprehensive admission assessments are the
responsibility of the RN (D).
Question 3: A nurse on a medical-surgical unit is caring for a patient who is being
discharged. The patient asks about the cost of a newly prescribed medication.
Which of the following is the nurse's best response?
A. "I will have the social worker contact you about that."
B. "You should ask the pharmacist when you pick up the prescription."
C. "I can provide you with information on patient assistance programs and suggest you
speak with the hospital's financial counselor."
D. "Don't worry about the cost; your insurance will cover most of it."
CORRECT ANSWER: C. I can provide you with information on patient assistance
programs and suggest you speak with the hospital's financial counselor.
Rationale: The nurse has an ethical and professional responsibility to advocate for the
patient's access to care and to connect them with appropriate resources. Option C
provides a direct and helpful resource. Option A is a dismissal, B shifts responsibility,
and D offers a false reassurance about coverage.
Question 4: A nurse is preparing for a Joint Commission survey. Which of the
following actions is most critical for the nurse to take to ensure compliance with
National Patient Safety Goals (NPSGs)?
A. Ensure all crash carts are stocked according to the unit's inventory list.
B. Confirm that the patient's armband contains two unique patient identifiers.
C. Check that all fire extinguishers have been recently inspected.
D. Verify that all staff have current Basic Life Support (BLS) certification.
CORRECT ANSWER: B. Confirm that the patient's armband contains two unique
patient identifiers.
Rationale: The NPSGs are specifically focused on improving patient safety, and one of
the most prominent goals is to improve the accuracy of patient identification. Using two
unique identifiers is a core requirement. Options A, C, and D relate to general safety and
regulatory standards but are not the most critical NPSG-specific action.
Question 5: A new graduate nurse is experiencing high levels of stress and burnout.
Which of the following strategies is an example of an effective coping mechanism
for the novice nurse?
A. Working through lunch breaks to catch up on documentation.
B. Taking a 15-minute break to practice deep breathing exercises during a busy shift.
,C. Volunteering to stay late to help the oncoming shift with admissions.
D. Avoiding difficult patient assignments to reduce anxiety.
CORRECT ANSWER: B. Taking a 15-minute break to practice deep breathing
exercises during a busy shift.
Rationale: Stress management techniques such as deep breathing, brief periods of
mindfulness, and taking short breaks are effective, healthy coping mechanisms. Option
A increases stress and burnout, C leads to exhaustion, and D is avoidance, which
hinders professional development.
Question 6: A nurse is acting as a preceptor for a new hire. The new hire makes a
medication error. What is the preceptor's primary responsibility?
A. Document the error in the new hire's personnel file.
B. Report the error to the nursing supervisor immediately.
C. Assess the situation, ensure patient safety, and provide constructive feedback to
facilitate learning.
D. Complete the incident report on behalf of the new hire.
CORRECT ANSWER: C. Assess the situation, ensure patient safety, and provide
constructive feedback to facilitate learning.
Rationale: The preceptor's role is to foster a safe learning environment. The immediate
priority is patient safety, followed by a non-punitive teaching moment to correct the
behavior and prevent future errors. Reporting to personnel files (A) is premature,
reporting to a supervisor (B) should be done if required but is secondary, and
completing the report for them (D) does not teach the new hire the process.
Question 7: A nursing unit is implementing a shared governance model. Which of
the following outcomes is the primary goal of this structure?
A. Increased administrative control over nursing practice.
B. Empowerment of staff nurses to have a voice in decisions affecting their practice.
C. Decreased cost of nursing care by reducing middle management positions.
D. Standardization of nursing procedures across the entire hospital system.
CORRECT ANSWER: B. Empowerment of staff nurses to have a voice in decisions
affecting their practice.
Rationale: Shared governance is a professional practice model that gives nurses control
over their practice and work environment. It empowers them to make decisions about
clinical issues, quality improvement, and professional development. Options A, C, and
D are not primary goals of shared governance.
, Question 8: A nurse is using the SBAR (Situation, Background, Assessment,
Recommendation) communication tool to call a physician about a patient's change
in condition. Which statement represents the "Assessment" component of SBAR?
A. "The patient was admitted with pneumonia two days ago."
B. "I think the patient is developing sepsis due to the elevated heart rate and
tachypnea."
C. "I am calling because the patient's oxygen saturation has dropped to 88%."
D. "I recommend you come to the bedside to assess the patient now."
CORRECT ANSWER: B. I think the patient is developing sepsis due to the elevated
heart rate and tachypnea.
Rationale: The "Assessment" component is the nurse's professional conclusion or
analysis of the situation. Option A is Background, C is Situation, and D is
Recommendation.
Question 9: A nurse manager is reviewing the budget for the upcoming fiscal year.
Which of the following is an example of a fixed cost for the nursing unit?
A. Overtime pay for staff.
B. Supplies such as IV catheters and dressings.
C. Salaries for full-time, benefit-eligible staff nurses.
D. Utility costs for the unit.
CORRECT ANSWER: C. Salaries for full-time, benefit-eligible staff nurses.
Rationale: Fixed costs remain constant regardless of the volume of patients or services
provided within a certain range. Salaries for full-time staff are fixed, whereas overtime
(A), supplies (B), and utilities (D) are variable costs that fluctuate with patient census
and usage.
Question 10: A nurse is caring for a patient who is a Jehovah's Witness and is
refusing a blood transfusion. The patient is unconscious, and the family requests
the transfusion. What is the nurse's best action?
A. Honor the family's request and prepare the transfusion.
B. Contact the hospital's ethics committee for a consult.
C. Document the patient's religious preference and proceed with the family's wishes.
D. Administer the blood transfusion as it is a life-saving measure.
CORRECT ANSWER: B. Contact the hospital's ethics committee for a consult.
Rationale: This scenario involves a conflict between the patient's previously expressed
wishes, if known, and the family's request. The nurse should advocate for the patient's
autonomy. An ethics committee or legal counsel should be consulted to determine if
