ATI RN LEADERSHIP & MANAGEMENT
PROCTORED EXAM 2026–2027 | STUDY
GUIDE & TEST PREP | DELEGATION,
PRIORITIZATION, SUPERVISION, SAFETY &
LEGAL/ETHICAL NURSING
ATI RN LEADERSHIP & MANAGEMENT PROCTORED EXAM 2026–2027 | STUDY
GUIDE & TEST PREP
• This study guide contains 200 comprehensive multiple-choice questions designed
to build mastery across all tested domains: delegation, prioritization, supervision,
safety, and legal/ethical nursing practice.
• Study by working through each question methodically, reviewing rationales
carefully to understand the clinical reasoning behind correct answers—this
approach builds both knowledge and confidence for exam success.
DELEGATION QUESTIONS
1. A nurse manager is assigning patient care tasks to team members. Which of
the following is the primary consideration when delegating patient care to a
licensed practical nurse (LPN)?
A) The complexity of the task and the LPN's education and experience
B) The nurse manager's current workload and time constraints
C) The patient's preference for who provides care
D) The hospital's staffing schedule for the day
E) The cost savings associated with using an LPN
CORRECT ANSWER: A) The complexity of the task and the LPN's education and
experience
Rationale: When delegating tasks, the registered nurse must consider the scope of
practice, education level, and competency of the delegate. Delegation decisions
must be based on the task's complexity and the individual's qualifications to
,perform it safely and effectively. The nurse manager's workload, patient
preference, staffing schedule, and cost considerations are secondary to patient
safety and appropriate delegation.
2. A registered nurse is caring for a group of 8 patients and needs to delegate
blood pressure monitoring to an unlicensed assistive personnel (UAP). Which
characteristic of the task makes it appropriate for delegation to a UAP?
A) The task requires immediate intervention if abnormal findings are noted
B) The task is routine, non-invasive, and has a predictable outcome
C) The task requires nursing judgment to determine if findings are abnormal
D) The task involves teaching the patient about self-monitoring
E) The task requires assessment of the patient's skin integrity
CORRECT ANSWER: B) The task is routine, non-invasive, and has a predictable
outcome
Rationale: UAPs can perform routine, non-invasive tasks with predictable outcomes
under supervision. Blood pressure monitoring meets these criteria when the
patient is stable and the findings are expected to be within normal range. Tasks
requiring nursing judgment, immediate intervention capabilities, patient teaching,
or complex assessment should not be delegated to UAPs.
3. When delegating medication administration to licensed vocational nurses
(LVNs) in a state where this is within their scope of practice, what is the RN's
responsibility?
A) Provide the medication order and allow the LVN to administer independently
without further involvement
B) Remain accountable for the delegation, verify competency, and ensure
appropriate supervision
C) Document that the task was delegated but not monitor the outcome
,D) Only verify that the LVN has a current license
E) Allow the LVN to decide which medications they feel comfortable administering
CORRECT ANSWER: B) Remain accountable for the delegation, verify
competency, and ensure appropriate supervision
Rationale: The RN who delegates retains accountability for the delegation decision
and the patient outcome. The RN must verify that the LVN is competent, provide
appropriate supervision, and ensure that delegated tasks are performed safely.
Delegating does not eliminate the RN's responsibility; it merely shifts task
performance while maintaining accountability.
4. A nurse manager observes an RN delegating patient hygiene care to a
certified nursing assistant (CNA) whose competency has not been validated.
What should the manager do?
A) Allow the delegation to continue since hygiene care is a basic task
B) Wait until the end of the shift and discuss the issue with the RN
C) Immediately intervene and halt the delegation until competency is verified
D) Document the incident but take no immediate action
E) Inform human resources without speaking to the RN first
CORRECT ANSWER: C) Immediately intervene and halt the delegation until
competency is verified
Rationale: Delegating to an unvalidated or incompetent individual puts patient
safety at risk. The manager must immediately stop the delegation and ensure that
the CNA's competency is verified before task assignment. This is a patient safety
issue that requires immediate intervention, not delayed discussion or
documentation alone.
5. Which of the following tasks would be INAPPROPRIATE to delegate to an
UAP?
, A) Assisting an independent patient with activities of daily living
B) Obtaining vital signs on a stable patient without recent changes
C) Assessing a post-operative patient's wound for signs of infection
D) Helping a patient ambulate in the hallway with a walker
E) Bathing and grooming a bedridden patient
CORRECT ANSWER: C) Assessing a post-operative patient's wound for signs of
infection
Rationale: Wound assessment is a nursing function that requires knowledge of
normal and abnormal healing, recognition of complications, and clinical judgment.
This assessment cannot be delegated because it requires RN expertise and
decision-making. The other options are routine, non-invasive tasks with predictable
outcomes that are appropriate for UAP delegation.
6. A nurse manager is planning staffing for a surgical unit. An experienced RN
calls in sick, and the manager must reassign patient care. Which action
demonstrates appropriate delegation principles?
A) Assign the most complex patient to the newest nurse to promote learning
B) Assign patients based on acuity, experience level, and individual competencies
C) Distribute patients equally among all staff regardless of experience
D) Give the nursing assistant all the simple tasks to manage time
E) Have the most experienced nurse take all critical patients
CORRECT ANSWER: B) Assign patients based on acuity, experience level, and
individual competencies
Rationale: Appropriate delegation matches patient acuity and complexity to the
caregiver's education, experience, and competency. This ensures patient safety
while optimizing the skill mix. Giving the newest nurse complex patients without
support, distributing equally regardless of ability, or concentrating all critical
patients with one nurse does not follow delegation principles.
PROCTORED EXAM 2026–2027 | STUDY
GUIDE & TEST PREP | DELEGATION,
PRIORITIZATION, SUPERVISION, SAFETY &
LEGAL/ETHICAL NURSING
ATI RN LEADERSHIP & MANAGEMENT PROCTORED EXAM 2026–2027 | STUDY
GUIDE & TEST PREP
• This study guide contains 200 comprehensive multiple-choice questions designed
to build mastery across all tested domains: delegation, prioritization, supervision,
safety, and legal/ethical nursing practice.
• Study by working through each question methodically, reviewing rationales
carefully to understand the clinical reasoning behind correct answers—this
approach builds both knowledge and confidence for exam success.
DELEGATION QUESTIONS
1. A nurse manager is assigning patient care tasks to team members. Which of
the following is the primary consideration when delegating patient care to a
licensed practical nurse (LPN)?
A) The complexity of the task and the LPN's education and experience
B) The nurse manager's current workload and time constraints
C) The patient's preference for who provides care
D) The hospital's staffing schedule for the day
E) The cost savings associated with using an LPN
CORRECT ANSWER: A) The complexity of the task and the LPN's education and
experience
Rationale: When delegating tasks, the registered nurse must consider the scope of
practice, education level, and competency of the delegate. Delegation decisions
must be based on the task's complexity and the individual's qualifications to
,perform it safely and effectively. The nurse manager's workload, patient
preference, staffing schedule, and cost considerations are secondary to patient
safety and appropriate delegation.
2. A registered nurse is caring for a group of 8 patients and needs to delegate
blood pressure monitoring to an unlicensed assistive personnel (UAP). Which
characteristic of the task makes it appropriate for delegation to a UAP?
A) The task requires immediate intervention if abnormal findings are noted
B) The task is routine, non-invasive, and has a predictable outcome
C) The task requires nursing judgment to determine if findings are abnormal
D) The task involves teaching the patient about self-monitoring
E) The task requires assessment of the patient's skin integrity
CORRECT ANSWER: B) The task is routine, non-invasive, and has a predictable
outcome
Rationale: UAPs can perform routine, non-invasive tasks with predictable outcomes
under supervision. Blood pressure monitoring meets these criteria when the
patient is stable and the findings are expected to be within normal range. Tasks
requiring nursing judgment, immediate intervention capabilities, patient teaching,
or complex assessment should not be delegated to UAPs.
3. When delegating medication administration to licensed vocational nurses
(LVNs) in a state where this is within their scope of practice, what is the RN's
responsibility?
A) Provide the medication order and allow the LVN to administer independently
without further involvement
B) Remain accountable for the delegation, verify competency, and ensure
appropriate supervision
C) Document that the task was delegated but not monitor the outcome
,D) Only verify that the LVN has a current license
E) Allow the LVN to decide which medications they feel comfortable administering
CORRECT ANSWER: B) Remain accountable for the delegation, verify
competency, and ensure appropriate supervision
Rationale: The RN who delegates retains accountability for the delegation decision
and the patient outcome. The RN must verify that the LVN is competent, provide
appropriate supervision, and ensure that delegated tasks are performed safely.
Delegating does not eliminate the RN's responsibility; it merely shifts task
performance while maintaining accountability.
4. A nurse manager observes an RN delegating patient hygiene care to a
certified nursing assistant (CNA) whose competency has not been validated.
What should the manager do?
A) Allow the delegation to continue since hygiene care is a basic task
B) Wait until the end of the shift and discuss the issue with the RN
C) Immediately intervene and halt the delegation until competency is verified
D) Document the incident but take no immediate action
E) Inform human resources without speaking to the RN first
CORRECT ANSWER: C) Immediately intervene and halt the delegation until
competency is verified
Rationale: Delegating to an unvalidated or incompetent individual puts patient
safety at risk. The manager must immediately stop the delegation and ensure that
the CNA's competency is verified before task assignment. This is a patient safety
issue that requires immediate intervention, not delayed discussion or
documentation alone.
5. Which of the following tasks would be INAPPROPRIATE to delegate to an
UAP?
, A) Assisting an independent patient with activities of daily living
B) Obtaining vital signs on a stable patient without recent changes
C) Assessing a post-operative patient's wound for signs of infection
D) Helping a patient ambulate in the hallway with a walker
E) Bathing and grooming a bedridden patient
CORRECT ANSWER: C) Assessing a post-operative patient's wound for signs of
infection
Rationale: Wound assessment is a nursing function that requires knowledge of
normal and abnormal healing, recognition of complications, and clinical judgment.
This assessment cannot be delegated because it requires RN expertise and
decision-making. The other options are routine, non-invasive tasks with predictable
outcomes that are appropriate for UAP delegation.
6. A nurse manager is planning staffing for a surgical unit. An experienced RN
calls in sick, and the manager must reassign patient care. Which action
demonstrates appropriate delegation principles?
A) Assign the most complex patient to the newest nurse to promote learning
B) Assign patients based on acuity, experience level, and individual competencies
C) Distribute patients equally among all staff regardless of experience
D) Give the nursing assistant all the simple tasks to manage time
E) Have the most experienced nurse take all critical patients
CORRECT ANSWER: B) Assign patients based on acuity, experience level, and
individual competencies
Rationale: Appropriate delegation matches patient acuity and complexity to the
caregiver's education, experience, and competency. This ensures patient safety
while optimizing the skill mix. Giving the newest nurse complex patients without
support, distributing equally regardless of ability, or concentrating all critical
patients with one nurse does not follow delegation principles.
