RN Leadership 2026: Comprehensive
Study & Practice Examination
;Questions with Answers and
Rationales for the Proctored
Leadership Exam
SECTION 1: DELEGATION AND SUPERVISION
Question 1
A charge nurse is making client assignments for the upcoming shift. Which
task is most appropriate to delegate to an LPN/VN?
A) Admitting a new client with chest pain and completing the initial
assessment
B) Performing a focused wound assessment and documenting findings for a
stable post-op client
C) Developing the nursing care plan for a client newly diagnosed with
diabetes
D) Teaching a client self-administration of insulin using a prefilled pen
Correct Answer: B
Rationale: LPN/VNs can perform focused assessments and document
stable client findings within their scope of practice. The RN retains
responsibility for initial comprehensive assessments (A), care planning (C),
and patient education involving new skills (D). Delegation follows the Five
,Rights: right task, right person, right circumstance, right communication,
right supervision .
Question 2
A nurse delegates vital signs and blood glucose monitoring for four clients
to a nursing assistant. Which statement by the nurse reflects the correct
principle of supervision?
A) "I will check on you at the end of the shift."
B) "Report back to me immediately if any blood glucose is below 70 mg/dL
or above 300 mg/dL."
C) "You do not need to tell me the results unless something looks wrong."
D) "Just document the results in the chart and I will review them later."
Correct Answer: B
Rationale: Proper delegation requires clear parameters for reporting back,
including specific abnormal values requiring immediate RN attention. The
RN remains accountable for delegated tasks and must provide adequate
supervision and feedback. Delayed or absent communication (A, C, D)
creates patient safety risks and violates the RN's supervisory responsibility .
Question 3
Which client should the charge nurse assign to a new graduate RN who is
on orientation?
A) A client receiving a continuous heparin drip with a PTT due in 2 hours
B) A client with stable COPD who requires assistance with ADLs and
discharge teaching
C) A client admitted with a GI bleed who has dropping hemoglobin levels
D) A client in the immediate postoperative period following cardiac surgery
Correct Answer: B
,Rationale: New graduates should be assigned stable, predictable patients
to build competence and confidence. Clients with unstable conditions,
continuous infusions requiring frequent titration, or complex postoperative
needs require experienced nursing assessment and critical thinking. The
stable COPD client offers learning opportunities (ADLs, teaching) without
high-risk complexity .
Question 4
A charge nurse is mentoring a new RN who is hesitant to delegate tasks to
assistive personnel. Which statement by the charge nurse best addresses
this concern?
A) "You need to delegate tasks because you cannot do everything yourself"
B) "Delegation is a leadership skill that requires understanding scope of
practice and competency"
C) "Just assign routine tasks and check on them periodically"
D) "If you don't delegate, you will burn out quickly"
Correct Answer: B
Rationale: Effective delegation requires understanding each team
member's scope of practice, competency, and the right circumstances for
delegation. Mentorship builds confidence and ensures safe delegation.
Option A focuses on workload rather than skill development. Option C lacks
necessary guidance about appropriate delegation. Option D uses fear as
motivation .
Question 5
A nurse on a medical-surgical unit is providing care for a group of clients.
The nurse should delegate collection of which of the following specimens
to the assistive personnel (AP)?
, A) Random stool specimen
B) Sterile urine specimen from an indwelling catheter
C) Sputum specimen for culture and sensitivity
D) Blood specimen for therapeutic drug monitoring
Correct Answer: A
Rationale: Collection of a random stool specimen is a routine task that can
be delegated to AP. Sterile specimen collection, blood draws, and sputum
cultures require nursing judgment and sterile technique that fall within the
RN or LPN scope of practice .
Question 6
A volunteer assigned to the pediatric unit reports to the charge nurse for an
assignment. Which of the following assignments is unsafe for the
volunteer?
A) Transporting a school-age client who is in traction to another
department
B) Delivering meal trays to client rooms
C) Restocking supplies in client rooms
D) Answering call lights and reporting client requests to the nurse
Correct Answer: A
Rationale: Transporting a client in traction requires clinical assessment
skills and knowledge of proper positioning and equipment management.
Volunteers should not be assigned tasks that require clinical judgment or
direct client care involving complex equipment. Meal delivery, restocking
supplies, and answering call lights are appropriate non-clinical tasks .
Question 7
A nurse manager hears a staff nurse on the unit speak openly about her
Study & Practice Examination
;Questions with Answers and
Rationales for the Proctored
Leadership Exam
SECTION 1: DELEGATION AND SUPERVISION
Question 1
A charge nurse is making client assignments for the upcoming shift. Which
task is most appropriate to delegate to an LPN/VN?
A) Admitting a new client with chest pain and completing the initial
assessment
B) Performing a focused wound assessment and documenting findings for a
stable post-op client
C) Developing the nursing care plan for a client newly diagnosed with
diabetes
D) Teaching a client self-administration of insulin using a prefilled pen
Correct Answer: B
Rationale: LPN/VNs can perform focused assessments and document
stable client findings within their scope of practice. The RN retains
responsibility for initial comprehensive assessments (A), care planning (C),
and patient education involving new skills (D). Delegation follows the Five
,Rights: right task, right person, right circumstance, right communication,
right supervision .
Question 2
A nurse delegates vital signs and blood glucose monitoring for four clients
to a nursing assistant. Which statement by the nurse reflects the correct
principle of supervision?
A) "I will check on you at the end of the shift."
B) "Report back to me immediately if any blood glucose is below 70 mg/dL
or above 300 mg/dL."
C) "You do not need to tell me the results unless something looks wrong."
D) "Just document the results in the chart and I will review them later."
Correct Answer: B
Rationale: Proper delegation requires clear parameters for reporting back,
including specific abnormal values requiring immediate RN attention. The
RN remains accountable for delegated tasks and must provide adequate
supervision and feedback. Delayed or absent communication (A, C, D)
creates patient safety risks and violates the RN's supervisory responsibility .
Question 3
Which client should the charge nurse assign to a new graduate RN who is
on orientation?
A) A client receiving a continuous heparin drip with a PTT due in 2 hours
B) A client with stable COPD who requires assistance with ADLs and
discharge teaching
C) A client admitted with a GI bleed who has dropping hemoglobin levels
D) A client in the immediate postoperative period following cardiac surgery
Correct Answer: B
,Rationale: New graduates should be assigned stable, predictable patients
to build competence and confidence. Clients with unstable conditions,
continuous infusions requiring frequent titration, or complex postoperative
needs require experienced nursing assessment and critical thinking. The
stable COPD client offers learning opportunities (ADLs, teaching) without
high-risk complexity .
Question 4
A charge nurse is mentoring a new RN who is hesitant to delegate tasks to
assistive personnel. Which statement by the charge nurse best addresses
this concern?
A) "You need to delegate tasks because you cannot do everything yourself"
B) "Delegation is a leadership skill that requires understanding scope of
practice and competency"
C) "Just assign routine tasks and check on them periodically"
D) "If you don't delegate, you will burn out quickly"
Correct Answer: B
Rationale: Effective delegation requires understanding each team
member's scope of practice, competency, and the right circumstances for
delegation. Mentorship builds confidence and ensures safe delegation.
Option A focuses on workload rather than skill development. Option C lacks
necessary guidance about appropriate delegation. Option D uses fear as
motivation .
Question 5
A nurse on a medical-surgical unit is providing care for a group of clients.
The nurse should delegate collection of which of the following specimens
to the assistive personnel (AP)?
, A) Random stool specimen
B) Sterile urine specimen from an indwelling catheter
C) Sputum specimen for culture and sensitivity
D) Blood specimen for therapeutic drug monitoring
Correct Answer: A
Rationale: Collection of a random stool specimen is a routine task that can
be delegated to AP. Sterile specimen collection, blood draws, and sputum
cultures require nursing judgment and sterile technique that fall within the
RN or LPN scope of practice .
Question 6
A volunteer assigned to the pediatric unit reports to the charge nurse for an
assignment. Which of the following assignments is unsafe for the
volunteer?
A) Transporting a school-age client who is in traction to another
department
B) Delivering meal trays to client rooms
C) Restocking supplies in client rooms
D) Answering call lights and reporting client requests to the nurse
Correct Answer: A
Rationale: Transporting a client in traction requires clinical assessment
skills and knowledge of proper positioning and equipment management.
Volunteers should not be assigned tasks that require clinical judgment or
direct client care involving complex equipment. Meal delivery, restocking
supplies, and answering call lights are appropriate non-clinical tasks .
Question 7
A nurse manager hears a staff nurse on the unit speak openly about her
