ATI RN Leadership 2026
Proctored Exam with NGN
Questions and 100%
Correct Answers to Score
98% and Above in the New
2026 RN ATI Leadership
Proctored Assessment,
Updated Exam Review
Materials, Comprehensive
Study Guide and Practice
Questions
ATI RN Leadership 2026 Proctored Exam Practice
(NGN-Aligned)
,Verified Exam Structure: 70 questions | 3-hour time limit | NGN format including case
studies, bowtie, matrix, and select-all-that-apply items
Section 1: Delegation & Supervision
1. A nurse is delegating tasks to an assistive personnel (AP). Which task is
appropriate to delegate?
A. Assessing a client's post-operative pain level
B. Teaching a client about insulin administration
C. Obtaining vital signs from a stable client
D. Developing a care plan for a newly admitted client
Rationale: Delegation to APs must follow the Five Rights of Delegation. Obtaining vital
signs for a stable client is within the AP's scope of practice. Assessing, teaching, and
developing care plans require RN-level clinical judgment and cannot be delegated. The
RN retains accountability for the delegation decision .
2. A nurse is teaching an AP about caring for a client who has a DNR order. Which
statement by the AP indicates understanding?
A. "If I cannot detect the client's pulse, I will have another AP verify it."
B. "If the client does not have a pulse, I will call for the rapid response team
immediately."
C. "I will initiate CPR until the nurse arrives if I cannot detect the client's pulse."
D. "I will call for the client's nurse to come to the room if I cannot detect the
client's pulse."
Rationale: A DNR order means resuscitation should not be attempted. The AP should
notify the nurse for further assessment. CPR is not indicated for clients with a DNR
order, and the nurse is responsible for clinical decision-making .
3. A charge nurse is making assignments for one practical nurse and three
registered nurses. Which client is best to assign to the LPN?
,A. A client with heart failure receiving a new IV dobutamine infusion
B. A client 12 hours post-op from hip arthroplasty with stable vital signs
C. A client admitted with diabetic ketoacidosis requiring hourly glucose checks
D. A client with a new pulmonary embolism on heparin infusion
Rationale: The post-op hip arthroplasty client is stable with predictable outcomes,
making this assignment appropriate for an LPN under RN supervision. Clients on
vasoactive drips, anticoagulants, or with unstable metabolic conditions require RN-level
assessment and intervention .
4. An RN delegates the task of obtaining the BP of a client who is 2 hours post-op
following a cholecystectomy to an LPN. The LPN reports a BP significantly higher
than the client's previous reading. Which action should the RN take FIRST?
A. Notify the provider
B. Recheck the client's BP
C. Document the finding in the chart
D. Ask the LPN to recheck the BP
Rationale: When a delegated task results in an abnormal finding, the RN is responsible
for reassessing the client. The RN should recheck the BP to confirm the reading before
taking further action. After confirming, the RN can assess further and notify the provider
if needed .
5. Which task can the nurse safely assign to an assistive personnel (AP)?
A. Perform chest compressions on a client in cardiac arrest
B. Change a sterile dressing on a client's leg wound
C. Check the residual volume of a client's gastrostomy tube
D. Instruct the client on the use of a blood glucose machine
Rationale: Basic CPR, including chest compressions, is within the scope of practice for
APs. This is a standard skill that APs are trained to perform. More complex assessments,
sterile procedures, and client teaching must be performed by licensed nurses .
, 6. A nurse is preparing to delegate a sterile dressing change to an LPN. Which
condition must be met for this to be appropriate?
A. The wound is complex with tunneling
B. The LPN has demonstrated competency in the procedure
C. The RN will not supervise the procedure
D. The client is unstable with changing vital signs
Rationale: LPNs can perform sterile dressing changes on stable, non-complex wounds if
their competency is verified. The LPN must have demonstrated competence, the wound
must be stable, and the RN remains responsible for supervision .
7. Which statement by a nurse indicates correct understanding of the Five Rights
of Delegation?
A. "I must ensure the right task is delegated to the right person at the right time."
B. "I must ensure the right task, right circumstance, right person, right
direction/communication, and right supervision."
C. "The Five Rights apply only to delegating to assistive personnel."
D. "Delegation transfers accountability to the delegatee."
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right
Person, Right Direction/Communication, and Right Supervision/Evaluation. These
principles apply to all delegation decisions. The RN retains accountability; accountability
cannot be transferred .
Section 2: Prioritization & Clinical Judgment
8. A nurse receives change-of-shift report on four clients. Which client should the
nurse assess FIRST?
A. A client who is postoperative day 1 following a total knee replacement and reports
pain of 4/10
Proctored Exam with NGN
Questions and 100%
Correct Answers to Score
98% and Above in the New
2026 RN ATI Leadership
Proctored Assessment,
Updated Exam Review
Materials, Comprehensive
Study Guide and Practice
Questions
ATI RN Leadership 2026 Proctored Exam Practice
(NGN-Aligned)
,Verified Exam Structure: 70 questions | 3-hour time limit | NGN format including case
studies, bowtie, matrix, and select-all-that-apply items
Section 1: Delegation & Supervision
1. A nurse is delegating tasks to an assistive personnel (AP). Which task is
appropriate to delegate?
A. Assessing a client's post-operative pain level
B. Teaching a client about insulin administration
C. Obtaining vital signs from a stable client
D. Developing a care plan for a newly admitted client
Rationale: Delegation to APs must follow the Five Rights of Delegation. Obtaining vital
signs for a stable client is within the AP's scope of practice. Assessing, teaching, and
developing care plans require RN-level clinical judgment and cannot be delegated. The
RN retains accountability for the delegation decision .
2. A nurse is teaching an AP about caring for a client who has a DNR order. Which
statement by the AP indicates understanding?
A. "If I cannot detect the client's pulse, I will have another AP verify it."
B. "If the client does not have a pulse, I will call for the rapid response team
immediately."
C. "I will initiate CPR until the nurse arrives if I cannot detect the client's pulse."
D. "I will call for the client's nurse to come to the room if I cannot detect the
client's pulse."
Rationale: A DNR order means resuscitation should not be attempted. The AP should
notify the nurse for further assessment. CPR is not indicated for clients with a DNR
order, and the nurse is responsible for clinical decision-making .
3. A charge nurse is making assignments for one practical nurse and three
registered nurses. Which client is best to assign to the LPN?
,A. A client with heart failure receiving a new IV dobutamine infusion
B. A client 12 hours post-op from hip arthroplasty with stable vital signs
C. A client admitted with diabetic ketoacidosis requiring hourly glucose checks
D. A client with a new pulmonary embolism on heparin infusion
Rationale: The post-op hip arthroplasty client is stable with predictable outcomes,
making this assignment appropriate for an LPN under RN supervision. Clients on
vasoactive drips, anticoagulants, or with unstable metabolic conditions require RN-level
assessment and intervention .
4. An RN delegates the task of obtaining the BP of a client who is 2 hours post-op
following a cholecystectomy to an LPN. The LPN reports a BP significantly higher
than the client's previous reading. Which action should the RN take FIRST?
A. Notify the provider
B. Recheck the client's BP
C. Document the finding in the chart
D. Ask the LPN to recheck the BP
Rationale: When a delegated task results in an abnormal finding, the RN is responsible
for reassessing the client. The RN should recheck the BP to confirm the reading before
taking further action. After confirming, the RN can assess further and notify the provider
if needed .
5. Which task can the nurse safely assign to an assistive personnel (AP)?
A. Perform chest compressions on a client in cardiac arrest
B. Change a sterile dressing on a client's leg wound
C. Check the residual volume of a client's gastrostomy tube
D. Instruct the client on the use of a blood glucose machine
Rationale: Basic CPR, including chest compressions, is within the scope of practice for
APs. This is a standard skill that APs are trained to perform. More complex assessments,
sterile procedures, and client teaching must be performed by licensed nurses .
, 6. A nurse is preparing to delegate a sterile dressing change to an LPN. Which
condition must be met for this to be appropriate?
A. The wound is complex with tunneling
B. The LPN has demonstrated competency in the procedure
C. The RN will not supervise the procedure
D. The client is unstable with changing vital signs
Rationale: LPNs can perform sterile dressing changes on stable, non-complex wounds if
their competency is verified. The LPN must have demonstrated competence, the wound
must be stable, and the RN remains responsible for supervision .
7. Which statement by a nurse indicates correct understanding of the Five Rights
of Delegation?
A. "I must ensure the right task is delegated to the right person at the right time."
B. "I must ensure the right task, right circumstance, right person, right
direction/communication, and right supervision."
C. "The Five Rights apply only to delegating to assistive personnel."
D. "Delegation transfers accountability to the delegatee."
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right
Person, Right Direction/Communication, and Right Supervision/Evaluation. These
principles apply to all delegation decisions. The RN retains accountability; accountability
cannot be transferred .
Section 2: Prioritization & Clinical Judgment
8. A nurse receives change-of-shift report on four clients. Which client should the
nurse assess FIRST?
A. A client who is postoperative day 1 following a total knee replacement and reports
pain of 4/10
