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ATI Nursing Leadership and Management Actual
Exam 2026/2027 | Questions with Complete
Solutions | Comprehensive Practice Test Aligned
with 2026/2027 ATI Proctored Exam Blueprint |
Pass Guaranteed - A+ Graded
ATI NURSING LEADERSHIP AND MANAGEMENT
SECTION 1: MANAGEMENT OF CARE (35 Questions)
DELEGATION (Questions 1-10)
Q1: A charge nurse is making assignments for the shift. Which task is most appropriate to
delegate to a licensed practical nurse (LPN)?
A. Assessing a newly admitted patient with chest pain
B. Administering oral medications to a stable patient
C. Developing the plan of care for a postoperative patient
D. Teaching a patient with new diabetes diagnosis about insulin
Correct Answer: B [CORRECT]
Rationale: LPNs can administer medications to stable patients with predictable outcomes.
Assessment, care planning, and initial teaching require RN-level education and scope of practice.
Q2: Which task can be delegated to unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of pain medication
B. Obtaining vital signs on a stable patient
C. Assessing a patient's surgical incision
D. Teaching a patient about fall prevention
Correct Answer: B [CORRECT]
Rationale: UAP can perform routine, non-invasive tasks with stable patients, including
obtaining vital signs. Assessment, evaluation, and teaching require licensed nursing judgment.
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Q3: The RN is considering delegating a blood glucose check to a UAP. Which factor is most
important to verify before delegation?
A. The UAP's certification in phlebotomy
B. The stability of the patient and predictability of the task
C. The UAP's personal interest in learning new skills
D. The availability of the charge nurse to observe
Correct Answer: B [CORRECT]
Rationale: The five rights of delegation require assessment of patient stability, task complexity,
and predictable outcomes. Patient condition determines appropriate delegation, not staff interest
or general availability.
Q4: A nurse delegates wound dressing changes to an LPN. What is the RN's ongoing
responsibility?
A. To perform all subsequent dressing changes to verify technique
B. To supervise and evaluate the LPN's performance and patient outcomes
C. To document that the LPN performed the dressing change
D. To assume no further responsibility once delegation occurs
Correct Answer: B [CORRECT]
Rationale: The delegating RN maintains accountability for the overall nursing care and must
provide appropriate supervision, including monitoring performance and evaluating patient
outcomes.
Q5: Which task should the RN perform rather than delegate to an LPN?
A. Administering a scheduled oral antibiotic to a stable patient
B. Monitoring a patient receiving their first dose of chemotherapy
C. Providing routine tracheostomy care to a long-term patient
D. Documenting intake and output for a stable postoperative patient
Correct Answer: B [CORRECT]
Rationale: First-dose chemotherapy requires complex assessment, monitoring for immediate
adverse reactions, and clinical judgment beyond LPN scope. The unpredictable nature and high-
risk profile require RN-level care.
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Q6: A UAP reports that a patient's blood pressure is 180/110 mmHg. What is the appropriate
nursing action?
A. Instruct the UAP to recheck the blood pressure in 2 hours
B. Assess the patient immediately and verify the reading
C. Document the finding and notify the provider later
D. Delegate the UAP to notify the provider directly
Correct Answer: B [CORRECT]
Rationale: Abnormal vital signs require RN assessment and clinical judgment. The RN must
verify the reading, assess the patient, and determine appropriate interventions based on the
complete clinical picture.
Q7: Which statement about delegation is correct?
A. The RN can delegate accountability but not responsibility
B. The RN retains accountability while delegating authority to perform a task
C. Once delegated, the task becomes the sole responsibility of the delegatee
D. Delegation eliminates the need for RN supervision
Correct Answer: B [CORRECT]
Rationale: The RN always retains accountability for the nursing care provided to the patient.
Delegation transfers the authority to perform specific tasks while maintaining appropriate
supervision and ultimate accountability.
Q8: Which factors must the RN consider when delegating tasks to LPNs and UAP? (SELECT
ALL THAT APPLY)
A. Stability of the patient
B. Complexity of the task
C. Predictability of outcomes
D. Educational preparation of the delegate
E. Facility policies and job descriptions
F. Personal preference of the delegate
Correct Answers: A, B, C, D, E [CORRECT]
Rationale: Delegation decisions are based on patient stability, task complexity, outcome
predictability, delegate's education/competence, and facility policies. Personal preference is not a
valid consideration.
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Q9: A nurse manager is reviewing delegation practices on the unit. Which scenario demonstrates
appropriate delegation?
A. An RN delegates the initial assessment of a new admission to an experienced LPN
B. An RN delegates medication administration to a UAP under close supervision
C. An RN delegates feeding a stable patient to a UAP with appropriate instructions
D. An RN delegates developing the nursing care plan to the charge nurse
Correct Answer: C [CORRECT]
Rationale: Feeding a stable patient is within UAP scope when proper direction and
circumstances are provided. Initial assessments, medication administration, and care planning
require RN judgment and cannot be delegated to UAP.
Q10: The charge nurse is delegating tasks for the shift. Which task requires the RN to provide
the most specific direction and supervision?
A. Ambulating a stable patient who has been walking independently
B. Obtaining vital signs on a patient whose condition is deteriorating
C. Assisting with hygiene for a patient on bedrest
D. Transporting a patient to physical therapy
Correct Answer: B [CORRECT]
Rationale: When patient condition is unstable or changing, the RN must provide more specific
direction, closer supervision, and frequent evaluation. Deteriorating condition increases task
complexity and requires enhanced oversight.
PRIORITIZATION (Questions 11-18)
Q11: A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with diabetes requesting pain medication
B. A patient with a new tracheostomy who has noisy, gurgling respirations
C. A patient scheduled for discharge in 1 hour
D. A patient with a fractured arm waiting for a snack tray
Correct Answer: B [CORRECT]
Rationale: Using the ABC prioritization framework, airway always comes first. Noisy, gurgling
respirations indicate potential airway obstruction requiring immediate assessment and
intervention.
ATI Nursing Leadership and Management Actual
Exam 2026/2027 | Questions with Complete
Solutions | Comprehensive Practice Test Aligned
with 2026/2027 ATI Proctored Exam Blueprint |
Pass Guaranteed - A+ Graded
ATI NURSING LEADERSHIP AND MANAGEMENT
SECTION 1: MANAGEMENT OF CARE (35 Questions)
DELEGATION (Questions 1-10)
Q1: A charge nurse is making assignments for the shift. Which task is most appropriate to
delegate to a licensed practical nurse (LPN)?
A. Assessing a newly admitted patient with chest pain
B. Administering oral medications to a stable patient
C. Developing the plan of care for a postoperative patient
D. Teaching a patient with new diabetes diagnosis about insulin
Correct Answer: B [CORRECT]
Rationale: LPNs can administer medications to stable patients with predictable outcomes.
Assessment, care planning, and initial teaching require RN-level education and scope of practice.
Q2: Which task can be delegated to unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of pain medication
B. Obtaining vital signs on a stable patient
C. Assessing a patient's surgical incision
D. Teaching a patient about fall prevention
Correct Answer: B [CORRECT]
Rationale: UAP can perform routine, non-invasive tasks with stable patients, including
obtaining vital signs. Assessment, evaluation, and teaching require licensed nursing judgment.
,2
Q3: The RN is considering delegating a blood glucose check to a UAP. Which factor is most
important to verify before delegation?
A. The UAP's certification in phlebotomy
B. The stability of the patient and predictability of the task
C. The UAP's personal interest in learning new skills
D. The availability of the charge nurse to observe
Correct Answer: B [CORRECT]
Rationale: The five rights of delegation require assessment of patient stability, task complexity,
and predictable outcomes. Patient condition determines appropriate delegation, not staff interest
or general availability.
Q4: A nurse delegates wound dressing changes to an LPN. What is the RN's ongoing
responsibility?
A. To perform all subsequent dressing changes to verify technique
B. To supervise and evaluate the LPN's performance and patient outcomes
C. To document that the LPN performed the dressing change
D. To assume no further responsibility once delegation occurs
Correct Answer: B [CORRECT]
Rationale: The delegating RN maintains accountability for the overall nursing care and must
provide appropriate supervision, including monitoring performance and evaluating patient
outcomes.
Q5: Which task should the RN perform rather than delegate to an LPN?
A. Administering a scheduled oral antibiotic to a stable patient
B. Monitoring a patient receiving their first dose of chemotherapy
C. Providing routine tracheostomy care to a long-term patient
D. Documenting intake and output for a stable postoperative patient
Correct Answer: B [CORRECT]
Rationale: First-dose chemotherapy requires complex assessment, monitoring for immediate
adverse reactions, and clinical judgment beyond LPN scope. The unpredictable nature and high-
risk profile require RN-level care.
,3
Q6: A UAP reports that a patient's blood pressure is 180/110 mmHg. What is the appropriate
nursing action?
A. Instruct the UAP to recheck the blood pressure in 2 hours
B. Assess the patient immediately and verify the reading
C. Document the finding and notify the provider later
D. Delegate the UAP to notify the provider directly
Correct Answer: B [CORRECT]
Rationale: Abnormal vital signs require RN assessment and clinical judgment. The RN must
verify the reading, assess the patient, and determine appropriate interventions based on the
complete clinical picture.
Q7: Which statement about delegation is correct?
A. The RN can delegate accountability but not responsibility
B. The RN retains accountability while delegating authority to perform a task
C. Once delegated, the task becomes the sole responsibility of the delegatee
D. Delegation eliminates the need for RN supervision
Correct Answer: B [CORRECT]
Rationale: The RN always retains accountability for the nursing care provided to the patient.
Delegation transfers the authority to perform specific tasks while maintaining appropriate
supervision and ultimate accountability.
Q8: Which factors must the RN consider when delegating tasks to LPNs and UAP? (SELECT
ALL THAT APPLY)
A. Stability of the patient
B. Complexity of the task
C. Predictability of outcomes
D. Educational preparation of the delegate
E. Facility policies and job descriptions
F. Personal preference of the delegate
Correct Answers: A, B, C, D, E [CORRECT]
Rationale: Delegation decisions are based on patient stability, task complexity, outcome
predictability, delegate's education/competence, and facility policies. Personal preference is not a
valid consideration.
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Q9: A nurse manager is reviewing delegation practices on the unit. Which scenario demonstrates
appropriate delegation?
A. An RN delegates the initial assessment of a new admission to an experienced LPN
B. An RN delegates medication administration to a UAP under close supervision
C. An RN delegates feeding a stable patient to a UAP with appropriate instructions
D. An RN delegates developing the nursing care plan to the charge nurse
Correct Answer: C [CORRECT]
Rationale: Feeding a stable patient is within UAP scope when proper direction and
circumstances are provided. Initial assessments, medication administration, and care planning
require RN judgment and cannot be delegated to UAP.
Q10: The charge nurse is delegating tasks for the shift. Which task requires the RN to provide
the most specific direction and supervision?
A. Ambulating a stable patient who has been walking independently
B. Obtaining vital signs on a patient whose condition is deteriorating
C. Assisting with hygiene for a patient on bedrest
D. Transporting a patient to physical therapy
Correct Answer: B [CORRECT]
Rationale: When patient condition is unstable or changing, the RN must provide more specific
direction, closer supervision, and frequent evaluation. Deteriorating condition increases task
complexity and requires enhanced oversight.
PRIORITIZATION (Questions 11-18)
Q11: A nurse is caring for four patients. Which patient should the nurse assess first?
A. A patient with diabetes requesting pain medication
B. A patient with a new tracheostomy who has noisy, gurgling respirations
C. A patient scheduled for discharge in 1 hour
D. A patient with a fractured arm waiting for a snack tray
Correct Answer: B [CORRECT]
Rationale: Using the ABC prioritization framework, airway always comes first. Noisy, gurgling
respirations indicate potential airway obstruction requiring immediate assessment and
intervention.
