ATI PN LEADERSHIP PROCTORED EXAM-STYLE PRACTICE
QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT | GRADE A+
CORE DOMAINS
• Management of Care and Prioritization
• Delegation and Assignment
• Ethical and Legal Responsibilities
• Safety and Infection Control
• Communication and Conflict Resolution
• Quality Improvement and Risk Management
• Time Management and Organization
• Supervision and Staff Education
• Advocacy and Client Rights
• NGN Leadership and Clinical Judgment Scenarios
INTRODUCTION
This comprehensive practice examination is designed for practical nursing
students preparing for the ATI PN Leadership Proctored Exam. It contains
original, exam-style questions with verified answers and detailed rationales
covering management of care, prioritization, delegation, legal and ethical
responsibilities, safety, communication, quality improvement, and
supervision. The examination mirrors the ATI proctored exam format and
emphasizes clinical judgment, safe decision-making, and effective
leadership at the practical nurse level. Each question includes a correct
answer and a rationale to reinforce understanding and prepare candidates
for real-world leadership responsibilities.
SECTION ONE: MANAGEMENT OF CARE AND PRIORITIZATION
(QUESTIONS 1–10)
1. A PN receives shift report on four clients. Which client should the
PN assess first?
,A. A client with chronic obstructive pulmonary disease who has an oxygen
saturation of 89% on 2 L/min nasal cannula
B. A client who is 1 day postoperative and reports pain at the surgical site
C. A client with diabetes who has a blood glucose of 180 mg/dL
D. A client who is requesting assistance with ambulation to the bathroom
A. A client with chronic obstructive pulmonary disease who has an
oxygen saturation of 89% on 2 L/min nasal cannula
RATIONALE: Using the ABC priority framework, oxygenation is the
highest priority. An SpO₂ of 89% on oxygen indicates inadequate
oxygenation and requires immediate assessment and intervention. Pain,
elevated glucose, and ambulation requests are important but not
immediately life-threatening.
2. A PN is caring for a client who is newly admitted with heart failure.
Which action should the PN take first?
A. Administer prescribed furosemide
B. Obtain a full set of vital signs and oxygen saturation
C. Assist the client with ambulation
D. Provide discharge teaching about a low-sodium diet
B. Obtain a full set of vital signs and oxygen saturation
RATIONALE: Assessment is the first step of the nursing process.
Before administering medications or teaching, the PN must establish
baseline vital signs and oxygenation status.
3. A PN is prioritizing care for clients on a medical-surgical unit.
Which client should the PN see first?
A. A client who is scheduled for discharge in 2 hours
B. A client who reports new onset of chest pain
C. A client who needs a routine dressing change
D. A client who is requesting a telephone to call family
B. A client who reports new onset of chest pain
RATIONALE: New-onset chest pain may indicate myocardial ischemia
,or infarction. This is a life-threatening emergency requiring immediate
assessment and provider notification.
4. A PN is caring for a client with a new colostomy. Which action
should the PN take to promote client safety?
A. Encourage the client to change the pouch independently
B. Assess the stoma and peristomal skin regularly
C. Restrict fluids to prevent stool output
D. Apply tight abdominal binders
B. Assess the stoma and peristomal skin regularly
RATIONALE: Regular assessment of the stoma and surrounding skin
helps detect complications such as ischemia, infection, or skin breakdown
early. Independence is encouraged gradually, not before teaching.
5. A PN is caring for a client who has just returned from surgery.
Which finding requires immediate intervention?
A. Blood pressure 110/70 mm Hg
B. Heart rate 88 bpm
C. Respiratory rate 8/min and difficult to arouse
D. Temperature 99.0°F
C. Respiratory rate 8/min and difficult to arouse
RATIONALE: Respiratory depression and decreased level of
consciousness after surgery may indicate opioid overdose, anesthesia
complications, or airway compromise. This is an emergency.
6. A PN is assigned to care for a client with a new diagnosis of
seizures. Which action should the PN include in the plan of care?
A. Place the client in a supine position during a seizure
B. Pad the side rails and keep suction equipment at the bedside
C. Restrain the client's arms during a seizure
D. Insert a tongue blade into the mouth during a seizure
B. Pad the side rails and keep suction equipment at the bedside
RATIONALE: Seizure precautions include padding side rails, keeping
, suction and oxygen available, and protecting the client from injury.
Restraints and tongue blades are dangerous.
7. A PN is caring for a client who is receiving a blood transfusion.
Which finding should the PN report immediately?
A. Mild itching at the IV site
B. Temperature increase from 98.6°F to 100.4°F with chills
C. Blood pressure 118/76 mm Hg
D. Heart rate 88 bpm
B. Temperature increase from 98.6°F to 100.4°F with chills
RATIONALE: Fever and chills during transfusion may indicate a febrile
non-hemolytic or hemolytic transfusion reaction. The transfusion should be
stopped and the provider notified immediately.
8. A PN is prioritizing client care. Which client should the PN assess
first?
A. A client with a urinary tract infection who reports burning on urination
B. A client with asthma who is using accessory muscles to breathe
C. A client with arthritis who reports joint stiffness
D. A client with constipation who has not had a bowel movement in 2 days
B. A client with asthma who is using accessory muscles to breathe
RATIONALE: Accessory muscle use indicates increased work of
breathing and possible respiratory distress. This client is at highest risk for
respiratory failure.
9. A PN is caring for a client who has a prescription for oxygen at 2
L/min via nasal cannula. Which action should the PN take first?
A. Increase oxygen to 4 L/min
B. Assess the client's respiratory status and oxygen saturation
C. Administer a bronchodilator
D. Notify the provider immediately
B. Assess the client's respiratory status and oxygen saturation
RATIONALE: Assessment before intervention is essential. The PN must
QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT | GRADE A+
CORE DOMAINS
• Management of Care and Prioritization
• Delegation and Assignment
• Ethical and Legal Responsibilities
• Safety and Infection Control
• Communication and Conflict Resolution
• Quality Improvement and Risk Management
• Time Management and Organization
• Supervision and Staff Education
• Advocacy and Client Rights
• NGN Leadership and Clinical Judgment Scenarios
INTRODUCTION
This comprehensive practice examination is designed for practical nursing
students preparing for the ATI PN Leadership Proctored Exam. It contains
original, exam-style questions with verified answers and detailed rationales
covering management of care, prioritization, delegation, legal and ethical
responsibilities, safety, communication, quality improvement, and
supervision. The examination mirrors the ATI proctored exam format and
emphasizes clinical judgment, safe decision-making, and effective
leadership at the practical nurse level. Each question includes a correct
answer and a rationale to reinforce understanding and prepare candidates
for real-world leadership responsibilities.
SECTION ONE: MANAGEMENT OF CARE AND PRIORITIZATION
(QUESTIONS 1–10)
1. A PN receives shift report on four clients. Which client should the
PN assess first?
,A. A client with chronic obstructive pulmonary disease who has an oxygen
saturation of 89% on 2 L/min nasal cannula
B. A client who is 1 day postoperative and reports pain at the surgical site
C. A client with diabetes who has a blood glucose of 180 mg/dL
D. A client who is requesting assistance with ambulation to the bathroom
A. A client with chronic obstructive pulmonary disease who has an
oxygen saturation of 89% on 2 L/min nasal cannula
RATIONALE: Using the ABC priority framework, oxygenation is the
highest priority. An SpO₂ of 89% on oxygen indicates inadequate
oxygenation and requires immediate assessment and intervention. Pain,
elevated glucose, and ambulation requests are important but not
immediately life-threatening.
2. A PN is caring for a client who is newly admitted with heart failure.
Which action should the PN take first?
A. Administer prescribed furosemide
B. Obtain a full set of vital signs and oxygen saturation
C. Assist the client with ambulation
D. Provide discharge teaching about a low-sodium diet
B. Obtain a full set of vital signs and oxygen saturation
RATIONALE: Assessment is the first step of the nursing process.
Before administering medications or teaching, the PN must establish
baseline vital signs and oxygenation status.
3. A PN is prioritizing care for clients on a medical-surgical unit.
Which client should the PN see first?
A. A client who is scheduled for discharge in 2 hours
B. A client who reports new onset of chest pain
C. A client who needs a routine dressing change
D. A client who is requesting a telephone to call family
B. A client who reports new onset of chest pain
RATIONALE: New-onset chest pain may indicate myocardial ischemia
,or infarction. This is a life-threatening emergency requiring immediate
assessment and provider notification.
4. A PN is caring for a client with a new colostomy. Which action
should the PN take to promote client safety?
A. Encourage the client to change the pouch independently
B. Assess the stoma and peristomal skin regularly
C. Restrict fluids to prevent stool output
D. Apply tight abdominal binders
B. Assess the stoma and peristomal skin regularly
RATIONALE: Regular assessment of the stoma and surrounding skin
helps detect complications such as ischemia, infection, or skin breakdown
early. Independence is encouraged gradually, not before teaching.
5. A PN is caring for a client who has just returned from surgery.
Which finding requires immediate intervention?
A. Blood pressure 110/70 mm Hg
B. Heart rate 88 bpm
C. Respiratory rate 8/min and difficult to arouse
D. Temperature 99.0°F
C. Respiratory rate 8/min and difficult to arouse
RATIONALE: Respiratory depression and decreased level of
consciousness after surgery may indicate opioid overdose, anesthesia
complications, or airway compromise. This is an emergency.
6. A PN is assigned to care for a client with a new diagnosis of
seizures. Which action should the PN include in the plan of care?
A. Place the client in a supine position during a seizure
B. Pad the side rails and keep suction equipment at the bedside
C. Restrain the client's arms during a seizure
D. Insert a tongue blade into the mouth during a seizure
B. Pad the side rails and keep suction equipment at the bedside
RATIONALE: Seizure precautions include padding side rails, keeping
, suction and oxygen available, and protecting the client from injury.
Restraints and tongue blades are dangerous.
7. A PN is caring for a client who is receiving a blood transfusion.
Which finding should the PN report immediately?
A. Mild itching at the IV site
B. Temperature increase from 98.6°F to 100.4°F with chills
C. Blood pressure 118/76 mm Hg
D. Heart rate 88 bpm
B. Temperature increase from 98.6°F to 100.4°F with chills
RATIONALE: Fever and chills during transfusion may indicate a febrile
non-hemolytic or hemolytic transfusion reaction. The transfusion should be
stopped and the provider notified immediately.
8. A PN is prioritizing client care. Which client should the PN assess
first?
A. A client with a urinary tract infection who reports burning on urination
B. A client with asthma who is using accessory muscles to breathe
C. A client with arthritis who reports joint stiffness
D. A client with constipation who has not had a bowel movement in 2 days
B. A client with asthma who is using accessory muscles to breathe
RATIONALE: Accessory muscle use indicates increased work of
breathing and possible respiratory distress. This client is at highest risk for
respiratory failure.
9. A PN is caring for a client who has a prescription for oxygen at 2
L/min via nasal cannula. Which action should the PN take first?
A. Increase oxygen to 4 L/min
B. Assess the client's respiratory status and oxygen saturation
C. Administer a bronchodilator
D. Notify the provider immediately
B. Assess the client's respiratory status and oxygen saturation
RATIONALE: Assessment before intervention is essential. The PN must
