ATI Leadership 2026/2027 Study Guide | ACTUAL-
Style ATI Nursing Leadership & Management Practice
Questions & Answers, RN Leadership Exam Prep,
Verified Answers, Detailed Rationales, Prioritization,
Delegation & Assignment, Charge Nurse
Responsibilities, Leadership Styles, Management,
Client & Staff Advocacy, Communication, Conflict
Resolution, Collaboration, Quality Improvement,
Patient Safety, Staffing & Comprehensive Nursing
Review
Question 1: A nurse manager is assigning clients to the nursing staff.
Which client is most appropriate to assign to a licensed practical nurse
(LPN)?
A. A client with new-onset chest pain and diaphoresis
B. A client who is 12 hours postoperative from a hip arthroplasty with stable
vital signs
C. A client admitted with diabetic ketoacidosis requiring hourly glucose
monitoring
D. A client receiving a new dobutamine infusion for heart failure
CORRECT ANSWER: B. A client who is 12 hours postoperative from a hip
arthroplasty with stable vital signs
Rationale: LPNs can provide care for stable clients with predictable
outcomes, such as monitoring vital signs for a postoperative client. Clients
with new-onset chest pain (A), unstable metabolic conditions requiring
frequent monitoring (C), or receiving IV vasoactive drips (D) require RN-
level assessment and intervention.
Question 2: A charge nurse is delegating tasks to assistive personnel
(AP). Which task is appropriate for the AP?
A. Assessing a client who reports new shortness of breath
B. Obtaining routine vital signs for a stable postoperative client
C. Teaching a client how to use an incentive spirometer
D. Evaluating a client's response to pain medication
CORRECT ANSWER: B. Obtaining routine vital signs for a stable
postoperative client
,Rationale: Obtaining routine vital signs for a stable client is within the AP's
scope of practice. Assessment (A), teaching (C), and evaluation (D) require
RN-level clinical judgment and cannot be delegated to AP.
Question 3: A nurse is prioritizing care for four clients. Which client
should the nurse assess first?
A. A client requesting pain medication for a headache
B. A client with COPD whose oxygen saturation dropped from 94% to 84%
C. A client awaiting discharge instructions
D. A client requesting assistance with ambulation
CORRECT ANSWER: B. A client with COPD whose oxygen saturation
dropped from 94% to 84%
Rationale: An acute decrease in oxygen saturation indicates a potential
airway or breathing problem, which takes priority according to the ABC
framework. Pain management (A), discharge planning (C), and ambulation
assistance (D) are important but not immediately life-threatening.
Question 4: A nurse manager is implementing a new evidence-based
protocol. Which action best demonstrates transformational
leadership?
A. Providing a detailed written instruction manual for staff to follow
B. Articulating a vision of patient safety and empowering staff to take
ownership of the change
C. Rewarding staff with a bonus for each month they have zero falls
D. Closely monitoring staff compliance and providing corrective feedback
CORRECT ANSWER: B. Articulating a vision of patient safety and
empowering staff to take ownership of the change
Rationale: Transformational leadership involves inspiring followers to
assume responsibility for a shared vision and empowering them to achieve
goals. Providing instruction manuals (A) is transactional, bonuses (C) are
extrinsic rewards, and close monitoring (D) is autocratic.
Question 5: A nurse witnesses another nurse diverting narcotics. What
is the appropriate action?
A. Confront the nurse privately in the break room
B. Report to the nurse manager or state board of nursing
,C. Ignore the situation to avoid conflict
D. Take over the nurse's patients and let them rest
CORRECT ANSWER: B. Report to the nurse manager or state board of
nursing
Rationale: Drug diversion is illegal and unsafe. Nurses have a legal and
ethical duty to report this to a supervisor or the Board of Nursing.
Confronting the nurse privately (A) is not appropriate, ignoring (C) is
negligent, and taking over patients without reporting (D) does not address
the safety issue.
Question 6: During a disaster triage, which client should be
recommended for treatment first?
A. A client with a minor laceration on the arm
B. A client with two open chest wounds and a left tracheal deviation
C. A client with a sprained ankle
D. A client with a headache and nausea
CORRECT ANSWER: B. A client with two open chest wounds and a left
tracheal deviation
Rationale: This client exhibits signs of tension pneumothorax, a life-
threatening condition requiring immediate intervention. This client receives
a "red tag" in disaster triage. Minor injuries (A, C, D) would receive lower
priority tags.
Question 7: According to Lewin's change theory, which action should a
manager take during the unfreezing stage?
A. Implement the new protocol on all units simultaneously
B. Educate staff about the reasons for the change and limitations of current
practices
C. Reinforce staff adherence through recognition
D. Evaluate patient outcomes after implementation
CORRECT ANSWER: B. Educate staff about the reasons for the change
and limitations of current practices
Rationale: Unfreezing involves creating awareness and readiness for
change by explaining why current practices are inadequate.
, Implementation occurs during the moving stage, and reinforcement (C) and
evaluation (D) occur during refreezing.
Question 8: A nurse manager encourages staff members to participate
in decisions and openly share ideas. Which leadership style is being
demonstrated?
A. Autocratic
B. Laissez-faire
C. Democratic
D. Bureaucratic
CORRECT ANSWER: C. Democratic
Rationale: Democratic leadership emphasizes participation, collaboration,
and shared decision-making. Autocratic leadership (A) involves unilateral
decisions, laissez-faire (B) provides minimal guidance, and bureaucratic
(D) relies on strict adherence to rules.
Question 9: A client has limited English proficiency and is preparing for
surgery. What should the nurse do?
A. Ask a family member to translate
B. Use a qualified medical interpreter
C. Ask another client to interpret
D. Proceed because the procedure is routine
CORRECT ANSWER: B. Use a qualified medical interpreter
Rationale: A qualified interpreter promotes accurate communication and
protects the client's right to informed decision-making. Using family
members (A) or other clients (C) may lead to misinterpretation and
confidentiality breaches. Proceeding without interpretation (D) violates the
client's rights.
Question 10: Two nurses disagree about an assignment and refuse to
communicate. Which approach is most appropriate when the issue
requires a lasting solution?
A. Avoiding the conflict
B. Competing
C. Collaborating
D. Accommodating
Style ATI Nursing Leadership & Management Practice
Questions & Answers, RN Leadership Exam Prep,
Verified Answers, Detailed Rationales, Prioritization,
Delegation & Assignment, Charge Nurse
Responsibilities, Leadership Styles, Management,
Client & Staff Advocacy, Communication, Conflict
Resolution, Collaboration, Quality Improvement,
Patient Safety, Staffing & Comprehensive Nursing
Review
Question 1: A nurse manager is assigning clients to the nursing staff.
Which client is most appropriate to assign to a licensed practical nurse
(LPN)?
A. A client with new-onset chest pain and diaphoresis
B. A client who is 12 hours postoperative from a hip arthroplasty with stable
vital signs
C. A client admitted with diabetic ketoacidosis requiring hourly glucose
monitoring
D. A client receiving a new dobutamine infusion for heart failure
CORRECT ANSWER: B. A client who is 12 hours postoperative from a hip
arthroplasty with stable vital signs
Rationale: LPNs can provide care for stable clients with predictable
outcomes, such as monitoring vital signs for a postoperative client. Clients
with new-onset chest pain (A), unstable metabolic conditions requiring
frequent monitoring (C), or receiving IV vasoactive drips (D) require RN-
level assessment and intervention.
Question 2: A charge nurse is delegating tasks to assistive personnel
(AP). Which task is appropriate for the AP?
A. Assessing a client who reports new shortness of breath
B. Obtaining routine vital signs for a stable postoperative client
C. Teaching a client how to use an incentive spirometer
D. Evaluating a client's response to pain medication
CORRECT ANSWER: B. Obtaining routine vital signs for a stable
postoperative client
,Rationale: Obtaining routine vital signs for a stable client is within the AP's
scope of practice. Assessment (A), teaching (C), and evaluation (D) require
RN-level clinical judgment and cannot be delegated to AP.
Question 3: A nurse is prioritizing care for four clients. Which client
should the nurse assess first?
A. A client requesting pain medication for a headache
B. A client with COPD whose oxygen saturation dropped from 94% to 84%
C. A client awaiting discharge instructions
D. A client requesting assistance with ambulation
CORRECT ANSWER: B. A client with COPD whose oxygen saturation
dropped from 94% to 84%
Rationale: An acute decrease in oxygen saturation indicates a potential
airway or breathing problem, which takes priority according to the ABC
framework. Pain management (A), discharge planning (C), and ambulation
assistance (D) are important but not immediately life-threatening.
Question 4: A nurse manager is implementing a new evidence-based
protocol. Which action best demonstrates transformational
leadership?
A. Providing a detailed written instruction manual for staff to follow
B. Articulating a vision of patient safety and empowering staff to take
ownership of the change
C. Rewarding staff with a bonus for each month they have zero falls
D. Closely monitoring staff compliance and providing corrective feedback
CORRECT ANSWER: B. Articulating a vision of patient safety and
empowering staff to take ownership of the change
Rationale: Transformational leadership involves inspiring followers to
assume responsibility for a shared vision and empowering them to achieve
goals. Providing instruction manuals (A) is transactional, bonuses (C) are
extrinsic rewards, and close monitoring (D) is autocratic.
Question 5: A nurse witnesses another nurse diverting narcotics. What
is the appropriate action?
A. Confront the nurse privately in the break room
B. Report to the nurse manager or state board of nursing
,C. Ignore the situation to avoid conflict
D. Take over the nurse's patients and let them rest
CORRECT ANSWER: B. Report to the nurse manager or state board of
nursing
Rationale: Drug diversion is illegal and unsafe. Nurses have a legal and
ethical duty to report this to a supervisor or the Board of Nursing.
Confronting the nurse privately (A) is not appropriate, ignoring (C) is
negligent, and taking over patients without reporting (D) does not address
the safety issue.
Question 6: During a disaster triage, which client should be
recommended for treatment first?
A. A client with a minor laceration on the arm
B. A client with two open chest wounds and a left tracheal deviation
C. A client with a sprained ankle
D. A client with a headache and nausea
CORRECT ANSWER: B. A client with two open chest wounds and a left
tracheal deviation
Rationale: This client exhibits signs of tension pneumothorax, a life-
threatening condition requiring immediate intervention. This client receives
a "red tag" in disaster triage. Minor injuries (A, C, D) would receive lower
priority tags.
Question 7: According to Lewin's change theory, which action should a
manager take during the unfreezing stage?
A. Implement the new protocol on all units simultaneously
B. Educate staff about the reasons for the change and limitations of current
practices
C. Reinforce staff adherence through recognition
D. Evaluate patient outcomes after implementation
CORRECT ANSWER: B. Educate staff about the reasons for the change
and limitations of current practices
Rationale: Unfreezing involves creating awareness and readiness for
change by explaining why current practices are inadequate.
, Implementation occurs during the moving stage, and reinforcement (C) and
evaluation (D) occur during refreezing.
Question 8: A nurse manager encourages staff members to participate
in decisions and openly share ideas. Which leadership style is being
demonstrated?
A. Autocratic
B. Laissez-faire
C. Democratic
D. Bureaucratic
CORRECT ANSWER: C. Democratic
Rationale: Democratic leadership emphasizes participation, collaboration,
and shared decision-making. Autocratic leadership (A) involves unilateral
decisions, laissez-faire (B) provides minimal guidance, and bureaucratic
(D) relies on strict adherence to rules.
Question 9: A client has limited English proficiency and is preparing for
surgery. What should the nurse do?
A. Ask a family member to translate
B. Use a qualified medical interpreter
C. Ask another client to interpret
D. Proceed because the procedure is routine
CORRECT ANSWER: B. Use a qualified medical interpreter
Rationale: A qualified interpreter promotes accurate communication and
protects the client's right to informed decision-making. Using family
members (A) or other clients (C) may lead to misinterpretation and
confidentiality breaches. Proceeding without interpretation (D) violates the
client's rights.
Question 10: Two nurses disagree about an assignment and refuse to
communicate. Which approach is most appropriate when the issue
requires a lasting solution?
A. Avoiding the conflict
B. Competing
C. Collaborating
D. Accommodating
