ATI Fundamentals: Prioritization & Delegation Practice Pack
2026/2027 |Questions |Answers |Rationales
1. A nurse is assigned to four clients. Which client should the nurse assess first?
A. A client who had a thyroidectomy 6 hours ago and is reporting tingling in the fingers
B. A client who is 2 days postoperative and has not had a bowel movement
C. A client with chronic obstructive pulmonary disease (COPD) and a pulse oximetry of 91%
D. A client who is requesting a PRN medication for moderate back pain
Answer: A
Rationale: Tingling in the fingers after a thyroidectomy can indicate hypocalcemia due to
parathyroid damage, which is a medical emergency that can lead to laryngospasm.
2. Which of the following tasks should a nurse delegate to an assistive personnel
(AP)?
A. Updating the care plan for a client with a pressure injury
B. Measuring and recording a client’s intake and output
C. Feeding a client who has a high risk for aspiration
D. Providing discharge instructions to a client going home
Answer: B
Rationale: Measuring and recording intake and output is within the scope of practice for
an AP. Tasks involving assessment, teaching, or clinical judgment (like feeding a high-risk
patient) must be performed by a nurse.
,3. A nurse is caring for a group of clients. Which client should be the priority for
an immediate assessment?
A. A client with a new onset of confusion and restlessness
B. A client who is receiving a continuous IV infusion and reports pain at the site
C. A client who has a temperature of 37.9 C (100.2 F) 4 hours after surgery
D. A client who needs a dressing change for a stage 2 pressure injury
Answer: A
Rationale: New onset confusion and restlessness are early signs of hypoxia or
physiological distress and require immediate intervention according to the ABC (Airway,
Breathing, Circulation) framework.
4. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate for the LPN?
A. Completing the initial admission assessment for a new client
B. Administering a scheduled oral antibiotic to a stable client
C. Developing a teaching plan for a client with a new colostomy
D. Administering an IV push medication for severe nausea
Answer: B
Rationale: LPNs can administer oral medications to stable clients. Initial assessments,
developing teaching plans, and administering IV push medications are generally reserved
for RNs.
5. Which client should the nurse prioritize during the initial morning rounds?
A. A client with diabetes whose morning blood glucose was 140 mg/dL
B. A client who was admitted overnight with chest pain and is now reporting nausea
C. A client with a history of heart failure who gained 1 lb in 24 hours
D. A client with pneumonia who has a productive cough and thick green sputum
Answer: B
, Rationale: Nausea can be an atypical symptom of myocardial infarction or worsening
cardiac ischemia in a client admitted with chest pain, making this the highest priority.
6. A nurse is planning to delegate tasks to an AP. Which of the following is one
of the ‘five rights’ of delegation?
A. Right Supervision
B. Right Compensation
C. Right Sequence
D. Right Location
Answer: A
Rationale: The five rights of delegation include: Right Task, Right Circumstance, Right
Person, Right Direction/Communication, and Right Supervision/Evaluation.
7. A nurse is triage manager in an emergency department. Which client should
be seen first?
A. A 45-year-old reporting sudden, severe substernal chest pain
B. An 82-year-old with a suspected urinary tract infection and low-grade fever
C. A 10-year-old with a forearm fracture and a pain rating of 7/10
D. A 22-year-old with a 2-cm laceration on the calf from a fall
Answer: A
Rationale: Chest pain is a priority because it suggests a life-threatening cardiac event
(Circulation/ABC priority).
8. The nurse is assigned to a client who is 12 hours postoperative following a
gastrectomy. Which task should be delegated to an LPN?
A. Auscultating bowel sounds for the first time post-surgery
B. Providing wound care and redressing the surgical incision
C. Evaluating the effectiveness of pain medication administered 1 hour ago
D. Educating the client on the importance of early ambulation
Answer: B
2026/2027 |Questions |Answers |Rationales
1. A nurse is assigned to four clients. Which client should the nurse assess first?
A. A client who had a thyroidectomy 6 hours ago and is reporting tingling in the fingers
B. A client who is 2 days postoperative and has not had a bowel movement
C. A client with chronic obstructive pulmonary disease (COPD) and a pulse oximetry of 91%
D. A client who is requesting a PRN medication for moderate back pain
Answer: A
Rationale: Tingling in the fingers after a thyroidectomy can indicate hypocalcemia due to
parathyroid damage, which is a medical emergency that can lead to laryngospasm.
2. Which of the following tasks should a nurse delegate to an assistive personnel
(AP)?
A. Updating the care plan for a client with a pressure injury
B. Measuring and recording a client’s intake and output
C. Feeding a client who has a high risk for aspiration
D. Providing discharge instructions to a client going home
Answer: B
Rationale: Measuring and recording intake and output is within the scope of practice for
an AP. Tasks involving assessment, teaching, or clinical judgment (like feeding a high-risk
patient) must be performed by a nurse.
,3. A nurse is caring for a group of clients. Which client should be the priority for
an immediate assessment?
A. A client with a new onset of confusion and restlessness
B. A client who is receiving a continuous IV infusion and reports pain at the site
C. A client who has a temperature of 37.9 C (100.2 F) 4 hours after surgery
D. A client who needs a dressing change for a stage 2 pressure injury
Answer: A
Rationale: New onset confusion and restlessness are early signs of hypoxia or
physiological distress and require immediate intervention according to the ABC (Airway,
Breathing, Circulation) framework.
4. A nurse is delegating tasks to a licensed practical nurse (LPN). Which task is
appropriate for the LPN?
A. Completing the initial admission assessment for a new client
B. Administering a scheduled oral antibiotic to a stable client
C. Developing a teaching plan for a client with a new colostomy
D. Administering an IV push medication for severe nausea
Answer: B
Rationale: LPNs can administer oral medications to stable clients. Initial assessments,
developing teaching plans, and administering IV push medications are generally reserved
for RNs.
5. Which client should the nurse prioritize during the initial morning rounds?
A. A client with diabetes whose morning blood glucose was 140 mg/dL
B. A client who was admitted overnight with chest pain and is now reporting nausea
C. A client with a history of heart failure who gained 1 lb in 24 hours
D. A client with pneumonia who has a productive cough and thick green sputum
Answer: B
, Rationale: Nausea can be an atypical symptom of myocardial infarction or worsening
cardiac ischemia in a client admitted with chest pain, making this the highest priority.
6. A nurse is planning to delegate tasks to an AP. Which of the following is one
of the ‘five rights’ of delegation?
A. Right Supervision
B. Right Compensation
C. Right Sequence
D. Right Location
Answer: A
Rationale: The five rights of delegation include: Right Task, Right Circumstance, Right
Person, Right Direction/Communication, and Right Supervision/Evaluation.
7. A nurse is triage manager in an emergency department. Which client should
be seen first?
A. A 45-year-old reporting sudden, severe substernal chest pain
B. An 82-year-old with a suspected urinary tract infection and low-grade fever
C. A 10-year-old with a forearm fracture and a pain rating of 7/10
D. A 22-year-old with a 2-cm laceration on the calf from a fall
Answer: A
Rationale: Chest pain is a priority because it suggests a life-threatening cardiac event
(Circulation/ABC priority).
8. The nurse is assigned to a client who is 12 hours postoperative following a
gastrectomy. Which task should be delegated to an LPN?
A. Auscultating bowel sounds for the first time post-surgery
B. Providing wound care and redressing the surgical incision
C. Evaluating the effectiveness of pain medication administered 1 hour ago
D. Educating the client on the importance of early ambulation
Answer: B
