ATI Leadership Management Proctored Exam
2026/2027 | Complete Question Bank with
Verified Answers & Rationales | Latest Version |
Guaranteed Pass
Instructions to Student
● Time allowed: 2 hours (120 minutes)
● 70 multiple-choice questions; select the ONE best answer
● Apply the ATI Clinical Judgment Model: Recognize Cues → Analyze Cues →
Prioritize Hypotheses → Generate Solutions → Take Action → Evaluate
Outcomes
● Use current ANA Scope & Standards of Practice (2026 ed.) and 2026/2027 CMS,
TJC, and state regulations
● Non-programmable calculator, dry-erase board, and pencil permitted; personal
electronics prohibited
1. The charge nurse on a 28-bed medical-remote-hybrid unit is making shift
assignments. Which client is most appropriate to assign to the LPN/VN who is
trained in the 2026 expanded scope for remote-monitoring medication
administration?
A. A client with new-onset AFib on continuous AI-telemetry with PRN IV diltiazem
push via tele-pump
B. *A stable client with chronic heart failure whose AI-powered pill dispenser
alerts are reviewed virtually every 4 hours
C. A client 2 hours post-thrombolysis with tPA for acute ischemic stroke on
hourly NIHSS
D. A client with septic shock on norepinephrine 0.15 mcg/kg/min titrated every
15 minutes
Rationale: The 2026 LPN/VN expanded scope allows virtual supervision of
, AI-dispensing oral medication for stable clients. Continuous titration of
vasoactive drips (A, D) and acute stroke monitoring (C) require RN assessment
and decision-making.
2. A physician enters an AI-generated order set for a client with CHF that includes
daily weight and strict I&O. The nurse notes the client has an AI-integrated urinary
sensor but the order still reads “void in hat.” Which action demonstrates the RN’s
role in AI governance?
A. Follow the order as written to avoid conflict
B. *Submit a QI ticket to the AI-order-set team to align device output with
documentation fields
C. Delete the sensor data and document manually
D. Ask the LPN/VN to edit the order
Rationale: ANA 2026 AI standards direct nurses to validate and refine AI tools.
Option B uses the QI structure to improve system accuracy while maintaining
safety.
3. The unit’s predictive-analytics dashboard flags a 78 % probability of a fall for
Client X within 6 hours. Which leadership action is priority?
A. Place the prediction in the EHR comments only
B. *Activate the fall-prevention protocol and assign the client a sitter before the
next hourly round
C. Wait for the next scheduled huddle to discuss trends
D. Inform the client’s family that a fall is likely
Rationale: Predictive analytics are actionable intelligence. The RN leader must
intervene immediately (Generate Solutions → Take Action) per TJC 2026 Sentinel
Alert on predictive tools.
4. A multigenerational team (Gen Z, Millennial, Gen X, Boomer) complains about
group-chat tone. Which initial strategy applies transformational leadership?
A. Mandate emojis for all messages
B. *Facilitate a 15-minute micro-learning session on generational digital-etiquette
preferences and co-create chat norms
C. Disable the group chat and return to pagers
D. Assign a single generation to manage all chats
Rationale: Transformational leaders inspire and individualize consideration.
Co-creating norms (B) addresses unique generational values while fostering
buy-in.
5. A union nurse in a state with newly ratified 2026 safe-staffing ratios (4:1 medical)
is assigned five clients due to call-outs. Which action balances legal obligation
and client safety?
A. Accept assignment and document protest later
, B. *File an instant safe-staffing variance report via the state portal and notify
supervisor; accept only after interim relief plan is documented
C. Refuse the fifth client and leave the unit
D. Ask the oldest nurse to take five instead
Rationale: 2026 ratios are law in 14 states; variance reports trigger immediate
administrative action and protect the nurse from abandonment claims.
6. An AI voice-assistant charting device misunderstands “15 mcg” as “50 mcg” of
fentanyl. Which action is priority?
A. Laugh it off and correct later
B. *Manually override the error immediately and complete a safety report
C. Restart the device and hope it learns
D. Ask the LPN/VN to verify the entry next shift
Rationale: High-alert medication errors require instant correction and
system-level reporting to prevent recurrence (Take Action → Evaluate
Outcomes).
7. A client on continuous remote cardiac AI monitoring suddenly goes offline for 10
minutes. Which hypothesis should the nurse prioritize first?
A. Device battery depleted
B. *Client may have removed leads due to skin irritation or clinical deterioration
C. Hospital Wi-Fi is down system-wide
D. Monitor tech is on break
Rationale: Ten-minute gap triggers immediate client assessment (Recognize
Cues → Analyze Cues). Physiologic or behavioral causes take precedence over
technical assumptions.
8. During a virtual family conference, two adult children argue about code status.
Which intervention applies principled negotiation?
A. “I will mute the louder person.”
B. *“Let’s identify shared goals for your father’s comfort and then explore options
that meet those goals.”
C. “The physician will decide for you.”
D. “Vote by show of hands.”
Rationale: Principled negotiation separates people from the problem and focuses
on interests, not positions (Fisher & Ury, adapted ANA 2026).
9. A nurse leader is evaluating the effectiveness of AI-assisted scheduling. Which
metric best reflects staff well-being?
A. Overtime dollars saved
B. *Nurse-reported burnout score on the 2026 ANA Healthy Nurse Survey
C. Number of shift swaps
D. Predictive accuracy percentage of the algorithm
2026/2027 | Complete Question Bank with
Verified Answers & Rationales | Latest Version |
Guaranteed Pass
Instructions to Student
● Time allowed: 2 hours (120 minutes)
● 70 multiple-choice questions; select the ONE best answer
● Apply the ATI Clinical Judgment Model: Recognize Cues → Analyze Cues →
Prioritize Hypotheses → Generate Solutions → Take Action → Evaluate
Outcomes
● Use current ANA Scope & Standards of Practice (2026 ed.) and 2026/2027 CMS,
TJC, and state regulations
● Non-programmable calculator, dry-erase board, and pencil permitted; personal
electronics prohibited
1. The charge nurse on a 28-bed medical-remote-hybrid unit is making shift
assignments. Which client is most appropriate to assign to the LPN/VN who is
trained in the 2026 expanded scope for remote-monitoring medication
administration?
A. A client with new-onset AFib on continuous AI-telemetry with PRN IV diltiazem
push via tele-pump
B. *A stable client with chronic heart failure whose AI-powered pill dispenser
alerts are reviewed virtually every 4 hours
C. A client 2 hours post-thrombolysis with tPA for acute ischemic stroke on
hourly NIHSS
D. A client with septic shock on norepinephrine 0.15 mcg/kg/min titrated every
15 minutes
Rationale: The 2026 LPN/VN expanded scope allows virtual supervision of
, AI-dispensing oral medication for stable clients. Continuous titration of
vasoactive drips (A, D) and acute stroke monitoring (C) require RN assessment
and decision-making.
2. A physician enters an AI-generated order set for a client with CHF that includes
daily weight and strict I&O. The nurse notes the client has an AI-integrated urinary
sensor but the order still reads “void in hat.” Which action demonstrates the RN’s
role in AI governance?
A. Follow the order as written to avoid conflict
B. *Submit a QI ticket to the AI-order-set team to align device output with
documentation fields
C. Delete the sensor data and document manually
D. Ask the LPN/VN to edit the order
Rationale: ANA 2026 AI standards direct nurses to validate and refine AI tools.
Option B uses the QI structure to improve system accuracy while maintaining
safety.
3. The unit’s predictive-analytics dashboard flags a 78 % probability of a fall for
Client X within 6 hours. Which leadership action is priority?
A. Place the prediction in the EHR comments only
B. *Activate the fall-prevention protocol and assign the client a sitter before the
next hourly round
C. Wait for the next scheduled huddle to discuss trends
D. Inform the client’s family that a fall is likely
Rationale: Predictive analytics are actionable intelligence. The RN leader must
intervene immediately (Generate Solutions → Take Action) per TJC 2026 Sentinel
Alert on predictive tools.
4. A multigenerational team (Gen Z, Millennial, Gen X, Boomer) complains about
group-chat tone. Which initial strategy applies transformational leadership?
A. Mandate emojis for all messages
B. *Facilitate a 15-minute micro-learning session on generational digital-etiquette
preferences and co-create chat norms
C. Disable the group chat and return to pagers
D. Assign a single generation to manage all chats
Rationale: Transformational leaders inspire and individualize consideration.
Co-creating norms (B) addresses unique generational values while fostering
buy-in.
5. A union nurse in a state with newly ratified 2026 safe-staffing ratios (4:1 medical)
is assigned five clients due to call-outs. Which action balances legal obligation
and client safety?
A. Accept assignment and document protest later
, B. *File an instant safe-staffing variance report via the state portal and notify
supervisor; accept only after interim relief plan is documented
C. Refuse the fifth client and leave the unit
D. Ask the oldest nurse to take five instead
Rationale: 2026 ratios are law in 14 states; variance reports trigger immediate
administrative action and protect the nurse from abandonment claims.
6. An AI voice-assistant charting device misunderstands “15 mcg” as “50 mcg” of
fentanyl. Which action is priority?
A. Laugh it off and correct later
B. *Manually override the error immediately and complete a safety report
C. Restart the device and hope it learns
D. Ask the LPN/VN to verify the entry next shift
Rationale: High-alert medication errors require instant correction and
system-level reporting to prevent recurrence (Take Action → Evaluate
Outcomes).
7. A client on continuous remote cardiac AI monitoring suddenly goes offline for 10
minutes. Which hypothesis should the nurse prioritize first?
A. Device battery depleted
B. *Client may have removed leads due to skin irritation or clinical deterioration
C. Hospital Wi-Fi is down system-wide
D. Monitor tech is on break
Rationale: Ten-minute gap triggers immediate client assessment (Recognize
Cues → Analyze Cues). Physiologic or behavioral causes take precedence over
technical assumptions.
8. During a virtual family conference, two adult children argue about code status.
Which intervention applies principled negotiation?
A. “I will mute the louder person.”
B. *“Let’s identify shared goals for your father’s comfort and then explore options
that meet those goals.”
C. “The physician will decide for you.”
D. “Vote by show of hands.”
Rationale: Principled negotiation separates people from the problem and focuses
on interests, not positions (Fisher & Ury, adapted ANA 2026).
9. A nurse leader is evaluating the effectiveness of AI-assisted scheduling. Which
metric best reflects staff well-being?
A. Overtime dollars saved
B. *Nurse-reported burnout score on the 2026 ANA Healthy Nurse Survey
C. Number of shift swaps
D. Predictive accuracy percentage of the algorithm
