NCLEX ATI PRACTICE: LEADERSHIP
ASSESSMENT: 2024 Exam Questions
and Answers
A charge nurse is observing a nurse insert an indwelling urinary catheter into a female client. For which
of the following actions should the charge nurse intervene?
A) The nurse separates the client's labia with her dominant hand
B) The nurse coats the indwelling urinary catheter with lubricant
C) The nurse provides perineal care prior to inserting the urinary catheter
D) The nurse applies the sterile drape prior to inserting the urinary catheter - Correct answer A) The
nurse separates the client's labia with her dominant hand
- The nurse should use her non-dominant hand to separate the labia, or to hold the penis in male clients.
- The dominant hand is the hand that should handle the catheter during insertion and when filling the
balloon.
- If the nurse separated the labia with her dominant hand, it would be more difficult to insert the
catheter in a sterile environment and could result in introduction of bacteria into the urinary tract.
Nurse manager received a client request not to have a specific staff nurse care for her while at the acute
care facility. Which is an appropriate action by the nurse manager?
A) Ask other staff nurses about the level of care the specific staff nurse provides
B) Address the concern with the specific staff nurse
C) Recommend the specific staff nurse to be transferred to another unit
D) Notify the human resources department about the request - Correct answer B) Address the concern
with the specific staff nurse
- The nurse manager should use the conflict management skill collaborating to resolve the conflict.
- The nurse manager should be assertive and ask the specific staff nurse about the problem.
While caring for a client, the nurse experiences a needle stick injury. Which action should the nurse take
first?
,A) Complete an incident report
B) Request the risk manager obtain consent for HIV testing from the client
C) Wash the site of injury with soap and water
D) Consent to post-exposure treatment with antiretroviral meds. - Correct answer C) Wash the site of
injury with soap and water
- The greatest risk to the nurse is infection transmission; therefore, the nurse should first wash the area
with soap and water to reduce the risk of transmission.
Nurse is caring for 4 clients on a med-surg unit. Which clients should the nurse assess first?
A) A client who has NG tube for decompression and the gastric aspirate is green with a pH of 5.3
B) A client who had an indwelling urinary catheter removed 5 hr. ago and has not voided
C) A client who has COPD and the capillary refill time on both hands is 4 seconds
D) A client who has late-stage cirrhosis and whose breath has a fruity odor - Correct answer B) A client
who had an indwelling urinary catheter removed 5 hr. ago and has not voided
- After removal of an indwelling urinary catheter, the client should void within 4 hr.
- If the client has not voided in 4 hr, the nurse may need to reinsert the catheter; therefore, when using
the priority-setting framework of urgent vs. nonurgent, this client should be assessed first because he
has not voided for 5 hr.
Nurse tells another nurse that she thinks he did not provide adequate care for a client who underwent
hip arthroplasty. Which responses by the nurse demonstrates assertiveness?
A) "I feel as though I met the standard of care. Would you tell me more about your concerns?"
B) "You shouldn't make accusations. Your nursing care doesn't always set a good example"
C) "I am at a loss for words. I always do my best to give good care to my clients"
D) "What do you have against me? It must be something or you wouldn't be criticizing my care" - Correct
answer A) "I feel as though I met the standard of care. Would you tell me more about your concerns?"
- Communicating assertively is expressing thoughts in an open, honest, and direct manner that
demonstrates respect for self and others.
,- The use of "I" statements, maintaining eye contact, and congruent verbal and facial expressions are all
components of assertiveness skills.
- The nurse demonstrates respect for the opinion of the other nurse by asking for feedback and the
reason for the concerns.
Nurse has several tasks to delegate to an AP. Which tasks should the AP perform first?
A) Take ABG specimen to lab
B) Transport a client to the radiology department for an x-ray
C) Pass fresh water to clients on the unit
D) Obtain a routine urine sample from a newly-admitted client - Correct answer A) Take ABG specimen
to lab
- When using the urgent vs. nonurgent approach to client care, the nurse should determine the priority
action is to take the ABG blood sample to the laboratory.
- ABG samples are placed on ice and must be transported to the laboratory immediately or the specimen
will deteriorate, making any results inaccurate.
Nurse is triaging clients in an urgent care clinic. Which clients should the nurse have the provider care
for immediately?
A) An adolescent female client who is belligerent and has slurred speech
B) A toddler who has a laceration on his forehead and is screaming
C) A middle adult male who is diaphoretic and reports epigastric pain
D) A young adult with a painful sunburn on his face and arms - Correct answer C) A middle adult male
who is diaphoretic and reports epigastric pain
- When using the urgent vs. nonurgent approach to client care, the nurse should determine that caring
for this client is the highest priority because diaphoresis and epigastric pain are manifestations of an
acute myocardial infarction.
An RN is making nursing staff assignments for his team consisting of himself, 2 LPNs, and an AP. Which
clients should he assume responsibility for?
A) The client who requires frequent ambulation
, B) The client who is in protective isolation
C) The client who is actively dying and requires IV pain meds
D) The client who is 3 days post-op and requires a dressing change - Correct answer C) The client who is
actively dying and requires IV pain meds
- The nurse should assume responsibility of this client because IV pain medications should be
administered by RNs.
- Although this client may require less physical care, he may require more emotional care.
- The nurse should plan to spend extensive time with both the client and his family.
Charge nurse has assigned a group of clients to a LPN. The charge nurse receives report from her
assigned clients about the LPN's lack of care. Which action should the charge nurse take?
A) Review the LPN's personnel file
B) Discuss the LPN's behavior with other nurses on the unit
C) Talk with the clients who have reported the LPN's lack of care
D) Reassign some of the LPN's client care to AP - Correct answer C) Talk with the clients who have
reported the LPN's lack of care
- The charge nurse should investigate the allegations of misconduct to determine if disciplinary action is
warranted.
Nurse is providing care for a surgeon on a med-surg unit. A nurse from another unit asks the nurse
about the surgeon's medical diagnosis. The nurse responds that he is unable to provide that info.
requested. The nurse is displaying which of the following ethical principles?
A) Utility
B) Paternalism
C) Justice
D) Nonmaleficence - Correct answer D) Nonmaleficence
- The nurse is obligated to protect the client's confidential information.
- A breach of confidentiality can place the client at risk of harm.
ASSESSMENT: 2024 Exam Questions
and Answers
A charge nurse is observing a nurse insert an indwelling urinary catheter into a female client. For which
of the following actions should the charge nurse intervene?
A) The nurse separates the client's labia with her dominant hand
B) The nurse coats the indwelling urinary catheter with lubricant
C) The nurse provides perineal care prior to inserting the urinary catheter
D) The nurse applies the sterile drape prior to inserting the urinary catheter - Correct answer A) The
nurse separates the client's labia with her dominant hand
- The nurse should use her non-dominant hand to separate the labia, or to hold the penis in male clients.
- The dominant hand is the hand that should handle the catheter during insertion and when filling the
balloon.
- If the nurse separated the labia with her dominant hand, it would be more difficult to insert the
catheter in a sterile environment and could result in introduction of bacteria into the urinary tract.
Nurse manager received a client request not to have a specific staff nurse care for her while at the acute
care facility. Which is an appropriate action by the nurse manager?
A) Ask other staff nurses about the level of care the specific staff nurse provides
B) Address the concern with the specific staff nurse
C) Recommend the specific staff nurse to be transferred to another unit
D) Notify the human resources department about the request - Correct answer B) Address the concern
with the specific staff nurse
- The nurse manager should use the conflict management skill collaborating to resolve the conflict.
- The nurse manager should be assertive and ask the specific staff nurse about the problem.
While caring for a client, the nurse experiences a needle stick injury. Which action should the nurse take
first?
,A) Complete an incident report
B) Request the risk manager obtain consent for HIV testing from the client
C) Wash the site of injury with soap and water
D) Consent to post-exposure treatment with antiretroviral meds. - Correct answer C) Wash the site of
injury with soap and water
- The greatest risk to the nurse is infection transmission; therefore, the nurse should first wash the area
with soap and water to reduce the risk of transmission.
Nurse is caring for 4 clients on a med-surg unit. Which clients should the nurse assess first?
A) A client who has NG tube for decompression and the gastric aspirate is green with a pH of 5.3
B) A client who had an indwelling urinary catheter removed 5 hr. ago and has not voided
C) A client who has COPD and the capillary refill time on both hands is 4 seconds
D) A client who has late-stage cirrhosis and whose breath has a fruity odor - Correct answer B) A client
who had an indwelling urinary catheter removed 5 hr. ago and has not voided
- After removal of an indwelling urinary catheter, the client should void within 4 hr.
- If the client has not voided in 4 hr, the nurse may need to reinsert the catheter; therefore, when using
the priority-setting framework of urgent vs. nonurgent, this client should be assessed first because he
has not voided for 5 hr.
Nurse tells another nurse that she thinks he did not provide adequate care for a client who underwent
hip arthroplasty. Which responses by the nurse demonstrates assertiveness?
A) "I feel as though I met the standard of care. Would you tell me more about your concerns?"
B) "You shouldn't make accusations. Your nursing care doesn't always set a good example"
C) "I am at a loss for words. I always do my best to give good care to my clients"
D) "What do you have against me? It must be something or you wouldn't be criticizing my care" - Correct
answer A) "I feel as though I met the standard of care. Would you tell me more about your concerns?"
- Communicating assertively is expressing thoughts in an open, honest, and direct manner that
demonstrates respect for self and others.
,- The use of "I" statements, maintaining eye contact, and congruent verbal and facial expressions are all
components of assertiveness skills.
- The nurse demonstrates respect for the opinion of the other nurse by asking for feedback and the
reason for the concerns.
Nurse has several tasks to delegate to an AP. Which tasks should the AP perform first?
A) Take ABG specimen to lab
B) Transport a client to the radiology department for an x-ray
C) Pass fresh water to clients on the unit
D) Obtain a routine urine sample from a newly-admitted client - Correct answer A) Take ABG specimen
to lab
- When using the urgent vs. nonurgent approach to client care, the nurse should determine the priority
action is to take the ABG blood sample to the laboratory.
- ABG samples are placed on ice and must be transported to the laboratory immediately or the specimen
will deteriorate, making any results inaccurate.
Nurse is triaging clients in an urgent care clinic. Which clients should the nurse have the provider care
for immediately?
A) An adolescent female client who is belligerent and has slurred speech
B) A toddler who has a laceration on his forehead and is screaming
C) A middle adult male who is diaphoretic and reports epigastric pain
D) A young adult with a painful sunburn on his face and arms - Correct answer C) A middle adult male
who is diaphoretic and reports epigastric pain
- When using the urgent vs. nonurgent approach to client care, the nurse should determine that caring
for this client is the highest priority because diaphoresis and epigastric pain are manifestations of an
acute myocardial infarction.
An RN is making nursing staff assignments for his team consisting of himself, 2 LPNs, and an AP. Which
clients should he assume responsibility for?
A) The client who requires frequent ambulation
, B) The client who is in protective isolation
C) The client who is actively dying and requires IV pain meds
D) The client who is 3 days post-op and requires a dressing change - Correct answer C) The client who is
actively dying and requires IV pain meds
- The nurse should assume responsibility of this client because IV pain medications should be
administered by RNs.
- Although this client may require less physical care, he may require more emotional care.
- The nurse should plan to spend extensive time with both the client and his family.
Charge nurse has assigned a group of clients to a LPN. The charge nurse receives report from her
assigned clients about the LPN's lack of care. Which action should the charge nurse take?
A) Review the LPN's personnel file
B) Discuss the LPN's behavior with other nurses on the unit
C) Talk with the clients who have reported the LPN's lack of care
D) Reassign some of the LPN's client care to AP - Correct answer C) Talk with the clients who have
reported the LPN's lack of care
- The charge nurse should investigate the allegations of misconduct to determine if disciplinary action is
warranted.
Nurse is providing care for a surgeon on a med-surg unit. A nurse from another unit asks the nurse
about the surgeon's medical diagnosis. The nurse responds that he is unable to provide that info.
requested. The nurse is displaying which of the following ethical principles?
A) Utility
B) Paternalism
C) Justice
D) Nonmaleficence - Correct answer D) Nonmaleficence
- The nurse is obligated to protect the client's confidential information.
- A breach of confidentiality can place the client at risk of harm.
