ATI PN LEADERSHIP & MANAGEMENT
PROCTORED EXAM 2026/2027 | 100
VERIFIED QUESTIONS & ANSWERS
WITH RATIONALES | NGN-STYLE
PRACTICAL NURSING PREP | INSTANT
PDF DOWNLOAD
1. A nurse manager is discussing the difference between leadership and
management with a newly licensed nurse. Which statement by the nurse
indicates understanding?
A. "Management involves inspiring others to achieve a desired outcome."
B. "Leadership focuses on planning, organizing, and coordinating work."
C. "Management is the process of planning, organizing, directing, and coordinating
work within an organization."
D. "Leadership and management are the same concepts."
Correct Answer: C
Rationale: Management is the process of planning, organizing, directing, and
coordinating work within an organization. Leadership, in contrast, is the ability to
inspire others to achieve a desired outcome.
2. A PN charge nurse is delegating tasks to assistive personnel (AP). Which task
is most appropriate to delegate to the AP?
A. Performing an initial admission assessment on a newly admitted client
B. Administering oral medications to a stable client
C. Measuring vital signs on a stable postoperative client
D. Developing a care plan for a client with a new diagnosis
Correct Answer: C
Rationale: Delegation to AP must involve routine, stable tasks with predictable
outcomes. Measuring vital signs on a stable client falls within AP scope. Initial
assessments, medication administration, and care plan development require nursing
judgment and are not delegable to AP.
3. A nurse is caring for four clients. Which client should the nurse assess first?
,A. A client who is requesting pain medication for a headache
B. A client who has a blood glucose level of 52 mg/dL and is diaphoretic
C. A client who needs assistance with ambulation to the bathroom
D. A client who is asking for a glass of water
Correct Answer: B
Rationale: Using the ABCDE framework and Maslow's hierarchy, physiological needs
take priority. A blood glucose of 52 mg/dL with diaphoresis indicates hypoglycemia, a
life-threatening emergency requiring immediate intervention. The other clients have
non-urgent needs.
4. A nurse witnesses a coworker diverting narcotics from the medication
dispensing system. What is the nurse's priority action?
A. Confront the coworker privately in the break room
B. Report the observation to the nurse manager or appropriate authority
C. Ignore the situation to avoid workplace conflict
D. Take over the coworker's patient assignment without reporting
Correct Answer: B
Rationale: Drug diversion is illegal and poses serious patient safety risks. Nurses have a
professional and legal obligation to report suspected diversion to a supervisor or the
appropriate authority. Confronting privately or ignoring the situation does not protect
patients or fulfill professional responsibilities.
5. A nurse is participating in a disaster triage following a mass casualty incident.
Which client should the nurse tag as "red" (immediate treatment priority)?
A. A client with a minor laceration on the forearm
B. A client with a tension pneumothorax and tracheal deviation
C. A client with a sprained ankle who is ambulatory
D. A client with a superficial burn on the hand
Correct Answer: B
Rationale: A tension pneumothorax with tracheal deviation is a life-threatening
condition requiring immediate intervention. In disaster triage, "red" tags are assigned
to clients who need immediate treatment to survive. The other clients have minor or
non-urgent injuries.
6. A nurse manager notices increased medication errors on a unit. Which action
demonstrates effective leadership?
A. Punishing nurses involved in errors
B. Reviewing system factors contributing to errors
,C. Ignoring errors unless harm occurs
D. Assigning all medication administration to senior nurses
Correct Answer: B
Rationale: Effective leadership in quality improvement involves a systems-thinking
approach. Reviewing system factors (e.g., staffing, workflow, equipment) helps identify
root causes and implement sustainable solutions, rather than blaming individuals.
7. A PN receives a prescription that appears unsafe. What should the nurse do
first?
A. Ignore the concern
B. Carry out the prescription immediately
C. Clarify the prescription with the provider
D. Ask another nurse to administer it
Correct Answer: C
Rationale: Nurses have a responsibility to question unclear or potentially harmful
prescriptions before implementation. The first step is to clarify the prescription with the
prescribing provider to ensure patient safety.
8. A nurse is assigned the following four clients for the current shift. Which
client should the nurse assess first?
A. A client who has a hip fracture and is in Buck's traction
B. A client who has aspiration pneumonia and a respiratory rate of 28/min
C. A client who has diabetes mellitus and a stage 2 pressure ulcer on his foot
D. A client who has a C. diff infection and needs a stool specimen collected
Correct Answer: B
Rationale: Using the ABC priority-setting framework, the client with tachypnea
(respiratory rate 28/min) indicates potential respiratory distress and should be assessed
first. The other clients have stable conditions or non-urgent needs.
9. Which situation demonstrates appropriate use of the chain of command?
A. Reporting unsafe staffing conditions to nursing leadership
B. Complaining about coworkers on social media
C. Ignoring unresolved safety concerns
D. Discussing confidential information publicly
Correct Answer: A
Rationale: The chain of command is used to address unresolved concerns by
progressing through appropriate levels of authority. Reporting unsafe staffing
conditions to nursing leadership is the correct professional action.
, 10. A nurse manager is reviewing the "Spectrum of Leadership" with nursing
students. The manager explains that this spectrum ranges from which two
extremes?
A. Autocratic to democratic
B. Task-oriented to relationship-oriented
C. Authoritarian to laissez-faire
D. Transactional to transformational
Correct Answer: C
Rationale: The Spectrum of Leadership ranges from authoritarian (leader makes all
decisions) to laissez-faire (leader makes few decisions and provides minimal direction).
This spectrum helps leaders understand different approaches and when each might be
appropriate based on the situation and staff characteristics.
11. A nurse manager is addressing staff burnout on the unit. Which
intervention demonstrates the manager's understanding of the "Job Demands-
Resources" model?
A. Increasing workload expectations to improve efficiency
B. Reducing job resources to streamline operations
C. Providing additional support and resources to buffer high job demands
D. Ignoring burnout as it is a personal issue
Correct Answer: C
Rationale: The Job Demands-Resources model posits that high job demands (e.g.,
workload, emotional strain) can lead to burnout unless balanced by sufficient job
resources (e.g., social support, autonomy, feedback). Providing additional resources
buffers the negative impact of demands.
12. A PN is serving on a unit-based shared governance council. The council is
discussing a proposal to change shift report format. Which action best reflects
the principles of shared governance?
A. The nurse manager makes the final decision without council input
B. The council members vote on the proposal and implement the change
C. The council makes a recommendation to the nurse manager for final approval
D. The council delegates all decision-making to the unit educator
Correct Answer: B
Rationale: Shared governance distributes decision-making authority to staff nurses who
participate in committees influencing nursing practice. The council voting and
implementing change empowers staff and reflects true shared governance.
PROCTORED EXAM 2026/2027 | 100
VERIFIED QUESTIONS & ANSWERS
WITH RATIONALES | NGN-STYLE
PRACTICAL NURSING PREP | INSTANT
PDF DOWNLOAD
1. A nurse manager is discussing the difference between leadership and
management with a newly licensed nurse. Which statement by the nurse
indicates understanding?
A. "Management involves inspiring others to achieve a desired outcome."
B. "Leadership focuses on planning, organizing, and coordinating work."
C. "Management is the process of planning, organizing, directing, and coordinating
work within an organization."
D. "Leadership and management are the same concepts."
Correct Answer: C
Rationale: Management is the process of planning, organizing, directing, and
coordinating work within an organization. Leadership, in contrast, is the ability to
inspire others to achieve a desired outcome.
2. A PN charge nurse is delegating tasks to assistive personnel (AP). Which task
is most appropriate to delegate to the AP?
A. Performing an initial admission assessment on a newly admitted client
B. Administering oral medications to a stable client
C. Measuring vital signs on a stable postoperative client
D. Developing a care plan for a client with a new diagnosis
Correct Answer: C
Rationale: Delegation to AP must involve routine, stable tasks with predictable
outcomes. Measuring vital signs on a stable client falls within AP scope. Initial
assessments, medication administration, and care plan development require nursing
judgment and are not delegable to AP.
3. A nurse is caring for four clients. Which client should the nurse assess first?
,A. A client who is requesting pain medication for a headache
B. A client who has a blood glucose level of 52 mg/dL and is diaphoretic
C. A client who needs assistance with ambulation to the bathroom
D. A client who is asking for a glass of water
Correct Answer: B
Rationale: Using the ABCDE framework and Maslow's hierarchy, physiological needs
take priority. A blood glucose of 52 mg/dL with diaphoresis indicates hypoglycemia, a
life-threatening emergency requiring immediate intervention. The other clients have
non-urgent needs.
4. A nurse witnesses a coworker diverting narcotics from the medication
dispensing system. What is the nurse's priority action?
A. Confront the coworker privately in the break room
B. Report the observation to the nurse manager or appropriate authority
C. Ignore the situation to avoid workplace conflict
D. Take over the coworker's patient assignment without reporting
Correct Answer: B
Rationale: Drug diversion is illegal and poses serious patient safety risks. Nurses have a
professional and legal obligation to report suspected diversion to a supervisor or the
appropriate authority. Confronting privately or ignoring the situation does not protect
patients or fulfill professional responsibilities.
5. A nurse is participating in a disaster triage following a mass casualty incident.
Which client should the nurse tag as "red" (immediate treatment priority)?
A. A client with a minor laceration on the forearm
B. A client with a tension pneumothorax and tracheal deviation
C. A client with a sprained ankle who is ambulatory
D. A client with a superficial burn on the hand
Correct Answer: B
Rationale: A tension pneumothorax with tracheal deviation is a life-threatening
condition requiring immediate intervention. In disaster triage, "red" tags are assigned
to clients who need immediate treatment to survive. The other clients have minor or
non-urgent injuries.
6. A nurse manager notices increased medication errors on a unit. Which action
demonstrates effective leadership?
A. Punishing nurses involved in errors
B. Reviewing system factors contributing to errors
,C. Ignoring errors unless harm occurs
D. Assigning all medication administration to senior nurses
Correct Answer: B
Rationale: Effective leadership in quality improvement involves a systems-thinking
approach. Reviewing system factors (e.g., staffing, workflow, equipment) helps identify
root causes and implement sustainable solutions, rather than blaming individuals.
7. A PN receives a prescription that appears unsafe. What should the nurse do
first?
A. Ignore the concern
B. Carry out the prescription immediately
C. Clarify the prescription with the provider
D. Ask another nurse to administer it
Correct Answer: C
Rationale: Nurses have a responsibility to question unclear or potentially harmful
prescriptions before implementation. The first step is to clarify the prescription with the
prescribing provider to ensure patient safety.
8. A nurse is assigned the following four clients for the current shift. Which
client should the nurse assess first?
A. A client who has a hip fracture and is in Buck's traction
B. A client who has aspiration pneumonia and a respiratory rate of 28/min
C. A client who has diabetes mellitus and a stage 2 pressure ulcer on his foot
D. A client who has a C. diff infection and needs a stool specimen collected
Correct Answer: B
Rationale: Using the ABC priority-setting framework, the client with tachypnea
(respiratory rate 28/min) indicates potential respiratory distress and should be assessed
first. The other clients have stable conditions or non-urgent needs.
9. Which situation demonstrates appropriate use of the chain of command?
A. Reporting unsafe staffing conditions to nursing leadership
B. Complaining about coworkers on social media
C. Ignoring unresolved safety concerns
D. Discussing confidential information publicly
Correct Answer: A
Rationale: The chain of command is used to address unresolved concerns by
progressing through appropriate levels of authority. Reporting unsafe staffing
conditions to nursing leadership is the correct professional action.
, 10. A nurse manager is reviewing the "Spectrum of Leadership" with nursing
students. The manager explains that this spectrum ranges from which two
extremes?
A. Autocratic to democratic
B. Task-oriented to relationship-oriented
C. Authoritarian to laissez-faire
D. Transactional to transformational
Correct Answer: C
Rationale: The Spectrum of Leadership ranges from authoritarian (leader makes all
decisions) to laissez-faire (leader makes few decisions and provides minimal direction).
This spectrum helps leaders understand different approaches and when each might be
appropriate based on the situation and staff characteristics.
11. A nurse manager is addressing staff burnout on the unit. Which
intervention demonstrates the manager's understanding of the "Job Demands-
Resources" model?
A. Increasing workload expectations to improve efficiency
B. Reducing job resources to streamline operations
C. Providing additional support and resources to buffer high job demands
D. Ignoring burnout as it is a personal issue
Correct Answer: C
Rationale: The Job Demands-Resources model posits that high job demands (e.g.,
workload, emotional strain) can lead to burnout unless balanced by sufficient job
resources (e.g., social support, autonomy, feedback). Providing additional resources
buffers the negative impact of demands.
12. A PN is serving on a unit-based shared governance council. The council is
discussing a proposal to change shift report format. Which action best reflects
the principles of shared governance?
A. The nurse manager makes the final decision without council input
B. The council members vote on the proposal and implement the change
C. The council makes a recommendation to the nurse manager for final approval
D. The council delegates all decision-making to the unit educator
Correct Answer: B
Rationale: Shared governance distributes decision-making authority to staff nurses who
participate in committees influencing nursing practice. The council voting and
implementing change empowers staff and reflects true shared governance.
