ATI LEADERSHIP PROCTORED EXAM 2026/2027 – EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A nurse is coordinating care for four clients. Which client should the nurse assess first?
A. A client who needs discharge teaching before leaving later today
B. A client requesting assistance with a meal tray
C. A client who developed sudden shortness of breath and oxygen saturation of 86%
D. A client awaiting routine medication administration
Rationale: The client with acute respiratory compromise has the highest priority because
impaired oxygenation can rapidly become life-threatening. The other needs are important but
can safely be addressed after the unstable client is assessed.
2. A charge nurse is assigning responsibilities to members of the nursing team. Which
principle should guide the assignment?
A. Assign the most complex client to the least experienced staff member to build confidence.
B. Match the client's needs with the team member's education, competence, and scope of
practice.
C. Give all high-acuity clients to the same nurse to simplify communication.
D. Assign tasks based primarily on which staff member volunteers first.
Rationale: Safe assignment requires consideration of client needs, staff competence, education,
and scope of practice. Convenience or willingness alone does not establish that an assignment is
appropriate.
3. A nurse is caring for a client who has an advance directive refusing certain life-sustaining
treatments. The client's family requests that the nurse ignore the directive. What is the
nurse's appropriate action?
A. Follow the family's wishes because they are the client's closest relatives.
B. Ask another nurse to make the decision.
C. Delay all treatment until the family reaches an agreement.
,D. Advocate for the client's documented wishes and notify the appropriate healthcare team
members.
Rationale: An advance directive communicates the client's preferences regarding future care.
The nurse should advocate for those wishes and involve the appropriate healthcare professionals
when disagreement occurs.
4. A newly licensed nurse asks the charge nurse about the difference between delegation and
assignment. Which response is accurate?
A. Delegation transfers responsibility for performing a task while the nurse retains
accountability for appropriate delegation and supervision.
B. Delegation transfers all accountability for client outcomes to the delegatee.
C. Assignment can only be made to licensed nurses.
D. Delegation eliminates the need for follow-up assessment.
Rationale: The nurse remains accountable for determining whether delegation is appropriate,
providing necessary direction, and evaluating outcomes. Delegation does not transfer the nurse's
overall accountability for nursing care.
5. A nurse manager is reviewing the concept of informed consent with a group of nurses.
Which responsibility belongs primarily to the provider obtaining consent?
A. Witnessing the client's signature only
B. Determining whether the client has received enough information to make an informed
decision
C. Explaining the procedure, expected benefits, significant risks, and alternatives
D. Persuading the client to accept the recommended procedure
Rationale: The provider performing or prescribing the procedure is responsible for explaining
its nature, risks, benefits, and alternatives. The nurse may witness the signature and reinforce
information but should not substitute for the provider's informed-consent discussion.
6. A nurse receives a telephone prescription from a provider. Which action best promotes
medication safety?
A. Enter the prescription after the provider leaves the unit.
B. Ask another nurse to interpret the prescription.
,C. Document only the medication name and dose.
D. Read the prescription back to the provider to verify the medication, dose, route, and
frequency.
Rationale: Read-back verification helps reduce errors caused by miscommunication, particularly
with verbal or telephone prescriptions. Key prescription elements should be confirmed before
implementation.
7. A nurse discovers that a medication was administered to the wrong client. The client
currently has no symptoms. What should the nurse do first?
A. Complete the incident report.
B. Assess the client for adverse effects and notify the appropriate healthcare provider.
C. Document that no harm occurred.
D. Wait until the end of the shift to notify the nurse manager.
Rationale: The client's immediate safety is the priority. The nurse should assess the client and
promptly notify the appropriate provider. Incident reporting and additional documentation
follow the immediate clinical response.
8. Which statement by a nurse demonstrates an understanding of an incident report?
A. "The report becomes part of the client's permanent medical record."
B. "I should document in the client's record that an incident report was completed."
C. "The report is used to communicate details of an unusual event for quality and risk-
management purposes."
D. "I should complete the report only if the client experiences harm."
Rationale: Incident reports support organizational risk management, quality improvement, and
evaluation of unusual events. They are not substitutes for appropriate clinical documentation,
and reporting is generally appropriate even when no injury occurs.
9. A nurse is preparing to delegate routine vital-sign measurement to assistive personnel
(AP). Which client is most appropriate for this task?
A. A client whose blood pressure has suddenly fallen and who reports dizziness
B. A client receiving a titrated vasoactive infusion
, C. A client experiencing new-onset chest pain
D. A stable postoperative client whose vital signs have been consistent
Rationale: Routine vital-sign measurement can be delegated for a stable client when the AP is
competent to perform the task. Clients with unstable or rapidly changing conditions require
nursing assessment and judgment.
10. A nurse delegates ambulation of a stable client to an AP. Which action by the nurse is
most appropriate?
A. Assume the task was completed because the AP accepted it.
B. Ask the AP to determine whether the client is safe to ambulate.
C. Provide clear instructions and follow up to determine whether the client tolerated
ambulation.
D. Document the task before the AP performs it.
Rationale: Appropriate delegation includes clear instructions, supervision, and evaluation of the
outcome. The nurse retains responsibility for clinical judgment and should determine whether
the expected outcome occurred.
11. A nurse is considering delegating a task to an AP. Which factor is most important before
making the decision?
A. Whether the task is within the AP's permitted role and the AP has demonstrated
competence
B. Whether the task will save the nurse time
C. Whether the AP has previously worked on the same unit
D. Whether another nurse is available to perform the task
Rationale: Delegation must be based on the client's condition, the nature of the task, applicable
scope-of-practice requirements, and the delegatee's competence. Saving time is not sufficient
justification.
12. A nurse manager notices that two nurses frequently disagree about patient assignments.
Which initial action is most appropriate?
A. Transfer one nurse to another unit.
B. Ask the staff to vote on who is responsible.
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A nurse is coordinating care for four clients. Which client should the nurse assess first?
A. A client who needs discharge teaching before leaving later today
B. A client requesting assistance with a meal tray
C. A client who developed sudden shortness of breath and oxygen saturation of 86%
D. A client awaiting routine medication administration
Rationale: The client with acute respiratory compromise has the highest priority because
impaired oxygenation can rapidly become life-threatening. The other needs are important but
can safely be addressed after the unstable client is assessed.
2. A charge nurse is assigning responsibilities to members of the nursing team. Which
principle should guide the assignment?
A. Assign the most complex client to the least experienced staff member to build confidence.
B. Match the client's needs with the team member's education, competence, and scope of
practice.
C. Give all high-acuity clients to the same nurse to simplify communication.
D. Assign tasks based primarily on which staff member volunteers first.
Rationale: Safe assignment requires consideration of client needs, staff competence, education,
and scope of practice. Convenience or willingness alone does not establish that an assignment is
appropriate.
3. A nurse is caring for a client who has an advance directive refusing certain life-sustaining
treatments. The client's family requests that the nurse ignore the directive. What is the
nurse's appropriate action?
A. Follow the family's wishes because they are the client's closest relatives.
B. Ask another nurse to make the decision.
C. Delay all treatment until the family reaches an agreement.
,D. Advocate for the client's documented wishes and notify the appropriate healthcare team
members.
Rationale: An advance directive communicates the client's preferences regarding future care.
The nurse should advocate for those wishes and involve the appropriate healthcare professionals
when disagreement occurs.
4. A newly licensed nurse asks the charge nurse about the difference between delegation and
assignment. Which response is accurate?
A. Delegation transfers responsibility for performing a task while the nurse retains
accountability for appropriate delegation and supervision.
B. Delegation transfers all accountability for client outcomes to the delegatee.
C. Assignment can only be made to licensed nurses.
D. Delegation eliminates the need for follow-up assessment.
Rationale: The nurse remains accountable for determining whether delegation is appropriate,
providing necessary direction, and evaluating outcomes. Delegation does not transfer the nurse's
overall accountability for nursing care.
5. A nurse manager is reviewing the concept of informed consent with a group of nurses.
Which responsibility belongs primarily to the provider obtaining consent?
A. Witnessing the client's signature only
B. Determining whether the client has received enough information to make an informed
decision
C. Explaining the procedure, expected benefits, significant risks, and alternatives
D. Persuading the client to accept the recommended procedure
Rationale: The provider performing or prescribing the procedure is responsible for explaining
its nature, risks, benefits, and alternatives. The nurse may witness the signature and reinforce
information but should not substitute for the provider's informed-consent discussion.
6. A nurse receives a telephone prescription from a provider. Which action best promotes
medication safety?
A. Enter the prescription after the provider leaves the unit.
B. Ask another nurse to interpret the prescription.
,C. Document only the medication name and dose.
D. Read the prescription back to the provider to verify the medication, dose, route, and
frequency.
Rationale: Read-back verification helps reduce errors caused by miscommunication, particularly
with verbal or telephone prescriptions. Key prescription elements should be confirmed before
implementation.
7. A nurse discovers that a medication was administered to the wrong client. The client
currently has no symptoms. What should the nurse do first?
A. Complete the incident report.
B. Assess the client for adverse effects and notify the appropriate healthcare provider.
C. Document that no harm occurred.
D. Wait until the end of the shift to notify the nurse manager.
Rationale: The client's immediate safety is the priority. The nurse should assess the client and
promptly notify the appropriate provider. Incident reporting and additional documentation
follow the immediate clinical response.
8. Which statement by a nurse demonstrates an understanding of an incident report?
A. "The report becomes part of the client's permanent medical record."
B. "I should document in the client's record that an incident report was completed."
C. "The report is used to communicate details of an unusual event for quality and risk-
management purposes."
D. "I should complete the report only if the client experiences harm."
Rationale: Incident reports support organizational risk management, quality improvement, and
evaluation of unusual events. They are not substitutes for appropriate clinical documentation,
and reporting is generally appropriate even when no injury occurs.
9. A nurse is preparing to delegate routine vital-sign measurement to assistive personnel
(AP). Which client is most appropriate for this task?
A. A client whose blood pressure has suddenly fallen and who reports dizziness
B. A client receiving a titrated vasoactive infusion
, C. A client experiencing new-onset chest pain
D. A stable postoperative client whose vital signs have been consistent
Rationale: Routine vital-sign measurement can be delegated for a stable client when the AP is
competent to perform the task. Clients with unstable or rapidly changing conditions require
nursing assessment and judgment.
10. A nurse delegates ambulation of a stable client to an AP. Which action by the nurse is
most appropriate?
A. Assume the task was completed because the AP accepted it.
B. Ask the AP to determine whether the client is safe to ambulate.
C. Provide clear instructions and follow up to determine whether the client tolerated
ambulation.
D. Document the task before the AP performs it.
Rationale: Appropriate delegation includes clear instructions, supervision, and evaluation of the
outcome. The nurse retains responsibility for clinical judgment and should determine whether
the expected outcome occurred.
11. A nurse is considering delegating a task to an AP. Which factor is most important before
making the decision?
A. Whether the task is within the AP's permitted role and the AP has demonstrated
competence
B. Whether the task will save the nurse time
C. Whether the AP has previously worked on the same unit
D. Whether another nurse is available to perform the task
Rationale: Delegation must be based on the client's condition, the nature of the task, applicable
scope-of-practice requirements, and the delegatee's competence. Saving time is not sufficient
justification.
12. A nurse manager notices that two nurses frequently disagree about patient assignments.
Which initial action is most appropriate?
A. Transfer one nurse to another unit.
B. Ask the staff to vote on who is responsible.
