ATI LEADERSHIP PRACTICE
ASSESSMENT A: VERSION 3.1
2025/2026 UPDATED GRADED A+
COMPREHENSIVE 150-QUESTION
ADVANCED EXAMINATION
COVERING COMPLEX NURSING
LEADERSHIP, EXECUTIVE-LEVEL
MANAGEMENT, ADVANCED
DELEGATION FRAMEWORK
QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
• Advanced Delegation and Supervision
• Prioritization and Clinical Decision-Making
• Legal and Ethical Responsibilities in Leadership
, • Quality Improvement and Patient Safety
• Staffing, Scheduling, and Resource Management
• Conflict Resolution and Team Dynamics
• Change Management and Innovation
• Performance Improvement and Evidence-Based Practice
• Executive-Level Management and Organizational Behavior
• Crisis Management and Disaster Preparedness
Introduction
This comprehensive examination assesses the registered nurse's mastery of
advanced leadership and management concepts essential for executive-level
practice. The exam evaluates foundational theory, applied professional
knowledge, regulatory and legal compliance, and ethical standards through
multiple-choice and scenario-based questions. Emphasis is placed on real-
world application and critical decision-making, requiring the candidate to
synthesize complex leadership principles across diverse healthcare settings.
The assessment mirrors the rigor and blueprint of the ATI Leadership Practice
Assessment A, Version 3.1.
SECTION ONE: QUESTIONS 1–150
Question 1
A charge nurse is making client assignments for the oncoming shift. Which
client should be assigned to the most experienced RN?
A. A client who is 1 day postoperative with stable vital signs
B. A client with new-onset atrial fibrillation and a heart rate of 140
C. A client requesting discharge teaching after a total knee replacement
D. A client with a chronic wound requiring a dressing change
B
, RATIONALE: Unstable clients with new-onset dysrhythmias require the
most experienced RN. Stable postoperative clients and routine dressing
changes can be assigned to less experienced staff.
Question 2
A nurse manager is reviewing incident reports and notices a pattern of
medication errors occurring during shift change. Which action should the
nurse manager take first?
A. Discipline the nurses involved in the errors
B. Conduct a root cause analysis to identify system factors
C. Implement a new medication administration policy
D. Require all nurses to attend a medication safety in-service
B
RATIONALE: Root cause analysis identifies underlying system failures
rather than blaming individuals. This is the first step in understanding and
preventing future errors.
Question 3
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A. Assessing a client's response to pain medication
B. Teaching a client how to use an incentive spirometer
C. Measuring and recording a client's intake and output
D. Evaluating a client's wound for signs of infection
C
, RATIONALE: Measuring intake and output is a routine task within the
UAP's scope of practice. Assessment, teaching, and evaluation require nursing
judgment.
Question 4
A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. The client's family insists the transfusion be given. What is the nurse's
priority action?
A. Administer the transfusion as the family requests
B. Notify the healthcare provider of the client's refusal
C. Contact the ethics committee for a consultation
D. Ask the client to reconsider the family's wishes
B
RATIONALE: A competent adult has the right to refuse treatment. The
nurse must respect autonomy, document the refusal, and notify the provider.
Question 5
A nurse manager is developing a budget for the upcoming fiscal year. Which
cost is considered an indirect cost?
A. Medications administered to clients
B. Salaries of nursing staff providing direct care
C. Electricity and utilities for the unit
D. Intravenous fluids and supplies
C
RATIONALE: Indirect costs are expenses not directly related to patient
care, such as utilities, maintenance, and administrative salaries. Direct costs
include medications, supplies, and direct care staff salaries.
ASSESSMENT A: VERSION 3.1
2025/2026 UPDATED GRADED A+
COMPREHENSIVE 150-QUESTION
ADVANCED EXAMINATION
COVERING COMPLEX NURSING
LEADERSHIP, EXECUTIVE-LEVEL
MANAGEMENT, ADVANCED
DELEGATION FRAMEWORK
QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
• Advanced Delegation and Supervision
• Prioritization and Clinical Decision-Making
• Legal and Ethical Responsibilities in Leadership
, • Quality Improvement and Patient Safety
• Staffing, Scheduling, and Resource Management
• Conflict Resolution and Team Dynamics
• Change Management and Innovation
• Performance Improvement and Evidence-Based Practice
• Executive-Level Management and Organizational Behavior
• Crisis Management and Disaster Preparedness
Introduction
This comprehensive examination assesses the registered nurse's mastery of
advanced leadership and management concepts essential for executive-level
practice. The exam evaluates foundational theory, applied professional
knowledge, regulatory and legal compliance, and ethical standards through
multiple-choice and scenario-based questions. Emphasis is placed on real-
world application and critical decision-making, requiring the candidate to
synthesize complex leadership principles across diverse healthcare settings.
The assessment mirrors the rigor and blueprint of the ATI Leadership Practice
Assessment A, Version 3.1.
SECTION ONE: QUESTIONS 1–150
Question 1
A charge nurse is making client assignments for the oncoming shift. Which
client should be assigned to the most experienced RN?
A. A client who is 1 day postoperative with stable vital signs
B. A client with new-onset atrial fibrillation and a heart rate of 140
C. A client requesting discharge teaching after a total knee replacement
D. A client with a chronic wound requiring a dressing change
B
, RATIONALE: Unstable clients with new-onset dysrhythmias require the
most experienced RN. Stable postoperative clients and routine dressing
changes can be assigned to less experienced staff.
Question 2
A nurse manager is reviewing incident reports and notices a pattern of
medication errors occurring during shift change. Which action should the
nurse manager take first?
A. Discipline the nurses involved in the errors
B. Conduct a root cause analysis to identify system factors
C. Implement a new medication administration policy
D. Require all nurses to attend a medication safety in-service
B
RATIONALE: Root cause analysis identifies underlying system failures
rather than blaming individuals. This is the first step in understanding and
preventing future errors.
Question 3
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A. Assessing a client's response to pain medication
B. Teaching a client how to use an incentive spirometer
C. Measuring and recording a client's intake and output
D. Evaluating a client's wound for signs of infection
C
, RATIONALE: Measuring intake and output is a routine task within the
UAP's scope of practice. Assessment, teaching, and evaluation require nursing
judgment.
Question 4
A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. The client's family insists the transfusion be given. What is the nurse's
priority action?
A. Administer the transfusion as the family requests
B. Notify the healthcare provider of the client's refusal
C. Contact the ethics committee for a consultation
D. Ask the client to reconsider the family's wishes
B
RATIONALE: A competent adult has the right to refuse treatment. The
nurse must respect autonomy, document the refusal, and notify the provider.
Question 5
A nurse manager is developing a budget for the upcoming fiscal year. Which
cost is considered an indirect cost?
A. Medications administered to clients
B. Salaries of nursing staff providing direct care
C. Electricity and utilities for the unit
D. Intravenous fluids and supplies
C
RATIONALE: Indirect costs are expenses not directly related to patient
care, such as utilities, maintenance, and administrative salaries. Direct costs
include medications, supplies, and direct care staff salaries.
