ATI Nursing Leadership & Management 2026–2027 | ATI RN
Leadership and Management Proctored Exam & Final Exam
Study Guide | Nursing Leadership, Management Principles,
Delegation, Prioritization, Assignment & Supervision, Staffing,
Scheduling, Teamwork, Communication, Conflict Resolution,
Change Management, Decision-Making, Client & Staff
Advocacy, Quality Improvement, Patient Safety, Risk
Management, Legal & Ethical Responsibilities, Scope of
Practice, HIPAA, Resource Management, Clinical Judgment,
NCLEX-RN & NGN-Style Practice Questions, Case Studies,
Answers & Detailed Rationales
Question 1: A nurse manager is reviewing unit staffing patterns and
notices that overtime costs have increased by 22% over three
months. Which management function is the nurse manager
primarily performing?
A. Planning
B. Organizing
C. Directing
D. Controlling
CORRECT ANSWER: D. Controlling
Rationale: Controlling involves evaluating performance and resource
utilization against established standards and taking corrective action when
deviations occur. Reviewing cost data and identifying budget variances falls
within the controlling function. Planning involves setting goals, organizing
involves structuring resources, and directing involves motivating and
leading staff.
Question 2: A nurse is assigned to float to a unit where the staff are
known to be unwelcoming to float personnel. Which action should
the nurse take first upon arrival?
A. Request to be reassigned to a different unit
B. Introduce oneself to the charge nurse and ask about unit routines
C. Complain to the nursing supervisor about the unit's reputation
D. Refuse to accept the assignment
CORRECT ANSWER: B. Introduce oneself to the charge nurse and
ask about unit routines
,Rationale: Professional behavior requires the nurse to approach the
assignment with a collaborative attitude. Introducing oneself and seeking
information about unit routines demonstrates respect and facilitates
integration into the team. Refusing an assignment or complaining before
experiencing the unit is unprofessional and may constitute patient
abandonment.
Question 3: A nurse manager is using the nominal group technique
to address a unit problem. Which statement describes this decision-
making method?
A. Members vote anonymously on solutions after discussion
B. The manager makes the decision without staff input
C. Members generate ideas independently, then discuss and rank them
D. A single staff member is designated to solve the problem
CORRECT ANSWER: C. Members generate ideas independently,
then discuss and rank them
Rationale: The nominal group technique involves individual idea generation
followed by structured group discussion and ranking of proposed solutions.
This method prevents dominant personalities from monopolizing
discussion and ensures all members contribute. Anonymous voting after
discussion describes a different technique, and unilateral decision-making
describes autocratic leadership.
Question 4: A nurse delegates vital sign measurement to an
assistive personnel (AP). Two hours later, the AP reports that a
client's blood pressure is 88/52 mm Hg. Which action should the
nurse take next?
A. Instruct the AP to recheck the blood pressure in 30 minutes
B. Document the finding and continue with current tasks
C. Assess the client immediately and notify the provider
D. Ask the AP to report the finding at the end of the shift
CORRECT ANSWER: C. Assess the client immediately and notify
the provider
, Rationale: The nurse retains accountability for client assessment and
clinical judgment when delegating tasks. A blood pressure of 88/52 mm Hg
is significantly below normal and may indicate hypoperfusion. The nurse
must personally assess the client and escalate to the provider rather than
delegating the reassessment or delaying action.
Question 5: A nurse manager is preparing to terminate an employee
for repeated policy violations. Which action should the nurse
manager take to minimize legal risk?
A. Terminate the employee immediately without documentation
B. Document all incidents, provide prior warnings, and follow facility policy
C. Discuss the termination with other staff members before acting
D. Allow the employee to resign instead of being terminated
CORRECT ANSWER: B. Document all incidents, provide prior
warnings, and follow facility policy
Rationale: Termination carries significant legal risk if not properly
documented and executed. The manager must demonstrate progressive
discipline, maintain thorough written documentation, and adhere strictly to
organizational policy and employment law. Immediate termination without
documentation or discussing the matter with other staff violates
confidentiality and due process.
Question 6: A nurse is caring for a client who has a do-not-
resuscitate (DNR) order. The client's family member insists that
"everything be done" if the client stops breathing. Which action
should the nurse take?
A. Follow the family's wishes and initiate CPR if needed
B. Explain the DNR order and notify the provider of the family's concerns
C. Ask the family to sign a waiver releasing the nurse from liability
D. Ignore the family's request and continue providing comfort care only
CORRECT ANSWER: B. Explain the DNR order and notify the
provider of the family's concerns
Rationale: The nurse must respect the client's legal DNR order while
addressing family concerns with compassion and accurate information. The
Leadership and Management Proctored Exam & Final Exam
Study Guide | Nursing Leadership, Management Principles,
Delegation, Prioritization, Assignment & Supervision, Staffing,
Scheduling, Teamwork, Communication, Conflict Resolution,
Change Management, Decision-Making, Client & Staff
Advocacy, Quality Improvement, Patient Safety, Risk
Management, Legal & Ethical Responsibilities, Scope of
Practice, HIPAA, Resource Management, Clinical Judgment,
NCLEX-RN & NGN-Style Practice Questions, Case Studies,
Answers & Detailed Rationales
Question 1: A nurse manager is reviewing unit staffing patterns and
notices that overtime costs have increased by 22% over three
months. Which management function is the nurse manager
primarily performing?
A. Planning
B. Organizing
C. Directing
D. Controlling
CORRECT ANSWER: D. Controlling
Rationale: Controlling involves evaluating performance and resource
utilization against established standards and taking corrective action when
deviations occur. Reviewing cost data and identifying budget variances falls
within the controlling function. Planning involves setting goals, organizing
involves structuring resources, and directing involves motivating and
leading staff.
Question 2: A nurse is assigned to float to a unit where the staff are
known to be unwelcoming to float personnel. Which action should
the nurse take first upon arrival?
A. Request to be reassigned to a different unit
B. Introduce oneself to the charge nurse and ask about unit routines
C. Complain to the nursing supervisor about the unit's reputation
D. Refuse to accept the assignment
CORRECT ANSWER: B. Introduce oneself to the charge nurse and
ask about unit routines
,Rationale: Professional behavior requires the nurse to approach the
assignment with a collaborative attitude. Introducing oneself and seeking
information about unit routines demonstrates respect and facilitates
integration into the team. Refusing an assignment or complaining before
experiencing the unit is unprofessional and may constitute patient
abandonment.
Question 3: A nurse manager is using the nominal group technique
to address a unit problem. Which statement describes this decision-
making method?
A. Members vote anonymously on solutions after discussion
B. The manager makes the decision without staff input
C. Members generate ideas independently, then discuss and rank them
D. A single staff member is designated to solve the problem
CORRECT ANSWER: C. Members generate ideas independently,
then discuss and rank them
Rationale: The nominal group technique involves individual idea generation
followed by structured group discussion and ranking of proposed solutions.
This method prevents dominant personalities from monopolizing
discussion and ensures all members contribute. Anonymous voting after
discussion describes a different technique, and unilateral decision-making
describes autocratic leadership.
Question 4: A nurse delegates vital sign measurement to an
assistive personnel (AP). Two hours later, the AP reports that a
client's blood pressure is 88/52 mm Hg. Which action should the
nurse take next?
A. Instruct the AP to recheck the blood pressure in 30 minutes
B. Document the finding and continue with current tasks
C. Assess the client immediately and notify the provider
D. Ask the AP to report the finding at the end of the shift
CORRECT ANSWER: C. Assess the client immediately and notify
the provider
, Rationale: The nurse retains accountability for client assessment and
clinical judgment when delegating tasks. A blood pressure of 88/52 mm Hg
is significantly below normal and may indicate hypoperfusion. The nurse
must personally assess the client and escalate to the provider rather than
delegating the reassessment or delaying action.
Question 5: A nurse manager is preparing to terminate an employee
for repeated policy violations. Which action should the nurse
manager take to minimize legal risk?
A. Terminate the employee immediately without documentation
B. Document all incidents, provide prior warnings, and follow facility policy
C. Discuss the termination with other staff members before acting
D. Allow the employee to resign instead of being terminated
CORRECT ANSWER: B. Document all incidents, provide prior
warnings, and follow facility policy
Rationale: Termination carries significant legal risk if not properly
documented and executed. The manager must demonstrate progressive
discipline, maintain thorough written documentation, and adhere strictly to
organizational policy and employment law. Immediate termination without
documentation or discussing the matter with other staff violates
confidentiality and due process.
Question 6: A nurse is caring for a client who has a do-not-
resuscitate (DNR) order. The client's family member insists that
"everything be done" if the client stops breathing. Which action
should the nurse take?
A. Follow the family's wishes and initiate CPR if needed
B. Explain the DNR order and notify the provider of the family's concerns
C. Ask the family to sign a waiver releasing the nurse from liability
D. Ignore the family's request and continue providing comfort care only
CORRECT ANSWER: B. Explain the DNR order and notify the
provider of the family's concerns
Rationale: The nurse must respect the client's legal DNR order while
addressing family concerns with compassion and accurate information. The
