ATI RN Leadership 2023 (Latest 2025 Version) Proctored Exam
with NGN 70 Questions and Expert-Approved Answers |
Actual Detailed RN ATI Leadership Exam with NGN!
Candidate Full Name: _________________________________
Candidate ID Number: _________________________________
Exam Date: _________________________________
Start Time: _________________________________
EXAM INFORMATION
Total Questions: 70 (including NGN items)
Time Limit: 3 hours (180 minutes)
Passing Score: As determined by ATI
INSTRUCTIONS
• Read each question carefully.
• Some questions require selecting all that apply.
• NGN items include bow‑tie, drag‑drop, matrix, and highlight.
• Once you answer a question, you CANNOT go back.
• Select the BEST answer for each question.
TIMER: 3:00:00
DO NOT TURN THIS PAGE UNTIL
INSTRUCTED TO DO SO.
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
,Case Scenario 1 (Questions 1-3)
Setting: Medical-surgical unit. Nurse manager is observing a new graduate RN.
Question 1 out of 70
⏱️ Time remaining: 2:59:48
The new graduate RN is caring for a patient with a chest tube. Which actions would
cause the manager to intervene? (Select all that apply)
A. Clamping the chest tube during patient transport
B. Placing the drainage system below the level of the patient’s chest
C. Emptying the drainage system without wearing gloves
D. Reporting a sudden increase in bubbling in the water seal chamber
E. Coiling excess tubing on the bed to prevent dependent loops
Correct Answer: A, C, E
Rationale: Clamping during transport (A) can cause tension pneumothorax. Emptying
without gloves (C) is an infection risk. Coiling tubing on the bed (E) creates dependent
loops that impede drainage. Placing system below chest (B) is correct. Increased
bubbling (D) should be reported – that is appropriate.
Question 2 out of 70
⏱️ Time remaining: 2:59:35
The new graduate asks the charge nurse, “When can I delegate taking vital signs to the
AP?” The charge nurse’s best response is:
A. “Any time the AP is not busy with another task.”
B. “Only after you have assessed the patient and determined they are stable.”
C. “Never – vital signs must be done by licensed staff.”
D. “As long as you document that you delegated it.”
Correct Answer: B
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
,Rationale: Delegation requires the RN to assess the patient and the task first. Vital signs
can be delegated to AP if the patient is stable, the AP is competent, and the RN provides
appropriate supervision.
Question 3 out of 70
⏱️ Time remaining: 2:59:20
The nurse manager reviews the new graduate’s documentation and finds an entry:
“Patient refused morning medications.” No further details. What should the manager tell
the new graduate?
A. “That is sufficient as long as you initialed it.”
B. “You must also document the reason for refusal, who you notified, and any
follow-up.”
C. “Refusals do not need to be documented if the patient is alert.”
D. “Only verbal refusals require documentation, not medication refusals.”
Correct Answer: B
Rationale: Documentation of refusal must include the patient’s stated reason, attempts
to educate, notification of the provider, and any alternative actions taken. Incomplete
documentation creates legal and safety risks.
Case Scenario 2 (Questions 4-6)
Setting: Emergency department after a mass casualty incident (bus crash).
Question 4 out of 70
⏱️ Time remaining: 2:59:05
Which client should receive a black tag (expectant)?
A. Client with partial-thickness burns on 30% of TBSA, awake and talking
B. Client with open femur fracture and palpable distal pulse
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
, C. Client with agonal breathing and no palpable carotid pulse
D. Client with sucking chest wound and stridor
Correct Answer: C
Rationale: Black tag is for those unlikely to survive with available resources. Agonal
breathing with no palpable pulse indicates impending death. Others (A, B, D) are
salvageable (red or yellow tags).
Question 5 out of 70 (NGN – Drag and Drop)
⏱️ Time remaining: 2:58:50
You are the triage nurse. Drag the correct triage tag color to each patient description.
• Patient 1: Ambulatory, minor abrasions → Green
• Patient 2: Severe dyspnea, stridor, oxygen saturation 82% → Red
• Patient 3: Open femur fracture, bleeding controlled, pulse present → Yellow
• Patient 4: Unresponsive, no pulse, not breathing → Black
Rationale: Green (minor), Red (immediate life threat), Yellow (delayed but stable), Black
(expectant/deceased).
Question 6 out of 70
⏱️ Time remaining: 2:58:35
After triage, a family member runs toward a patient tagged red. What should the nurse
do first?
A. Allow the family member to stay with the patient
B. Call security to remove the family member
C. Calmly direct the family member to the designated waiting area
D. Ignore the family member and continue working
Correct Answer: C
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
with NGN 70 Questions and Expert-Approved Answers |
Actual Detailed RN ATI Leadership Exam with NGN!
Candidate Full Name: _________________________________
Candidate ID Number: _________________________________
Exam Date: _________________________________
Start Time: _________________________________
EXAM INFORMATION
Total Questions: 70 (including NGN items)
Time Limit: 3 hours (180 minutes)
Passing Score: As determined by ATI
INSTRUCTIONS
• Read each question carefully.
• Some questions require selecting all that apply.
• NGN items include bow‑tie, drag‑drop, matrix, and highlight.
• Once you answer a question, you CANNOT go back.
• Select the BEST answer for each question.
TIMER: 3:00:00
DO NOT TURN THIS PAGE UNTIL
INSTRUCTED TO DO SO.
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
,Case Scenario 1 (Questions 1-3)
Setting: Medical-surgical unit. Nurse manager is observing a new graduate RN.
Question 1 out of 70
⏱️ Time remaining: 2:59:48
The new graduate RN is caring for a patient with a chest tube. Which actions would
cause the manager to intervene? (Select all that apply)
A. Clamping the chest tube during patient transport
B. Placing the drainage system below the level of the patient’s chest
C. Emptying the drainage system without wearing gloves
D. Reporting a sudden increase in bubbling in the water seal chamber
E. Coiling excess tubing on the bed to prevent dependent loops
Correct Answer: A, C, E
Rationale: Clamping during transport (A) can cause tension pneumothorax. Emptying
without gloves (C) is an infection risk. Coiling tubing on the bed (E) creates dependent
loops that impede drainage. Placing system below chest (B) is correct. Increased
bubbling (D) should be reported – that is appropriate.
Question 2 out of 70
⏱️ Time remaining: 2:59:35
The new graduate asks the charge nurse, “When can I delegate taking vital signs to the
AP?” The charge nurse’s best response is:
A. “Any time the AP is not busy with another task.”
B. “Only after you have assessed the patient and determined they are stable.”
C. “Never – vital signs must be done by licensed staff.”
D. “As long as you document that you delegated it.”
Correct Answer: B
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
,Rationale: Delegation requires the RN to assess the patient and the task first. Vital signs
can be delegated to AP if the patient is stable, the AP is competent, and the RN provides
appropriate supervision.
Question 3 out of 70
⏱️ Time remaining: 2:59:20
The nurse manager reviews the new graduate’s documentation and finds an entry:
“Patient refused morning medications.” No further details. What should the manager tell
the new graduate?
A. “That is sufficient as long as you initialed it.”
B. “You must also document the reason for refusal, who you notified, and any
follow-up.”
C. “Refusals do not need to be documented if the patient is alert.”
D. “Only verbal refusals require documentation, not medication refusals.”
Correct Answer: B
Rationale: Documentation of refusal must include the patient’s stated reason, attempts
to educate, notification of the provider, and any alternative actions taken. Incomplete
documentation creates legal and safety risks.
Case Scenario 2 (Questions 4-6)
Setting: Emergency department after a mass casualty incident (bus crash).
Question 4 out of 70
⏱️ Time remaining: 2:59:05
Which client should receive a black tag (expectant)?
A. Client with partial-thickness burns on 30% of TBSA, awake and talking
B. Client with open femur fracture and palpable distal pulse
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
, C. Client with agonal breathing and no palpable carotid pulse
D. Client with sucking chest wound and stridor
Correct Answer: C
Rationale: Black tag is for those unlikely to survive with available resources. Agonal
breathing with no palpable pulse indicates impending death. Others (A, B, D) are
salvageable (red or yellow tags).
Question 5 out of 70 (NGN – Drag and Drop)
⏱️ Time remaining: 2:58:50
You are the triage nurse. Drag the correct triage tag color to each patient description.
• Patient 1: Ambulatory, minor abrasions → Green
• Patient 2: Severe dyspnea, stridor, oxygen saturation 82% → Red
• Patient 3: Open femur fracture, bleeding controlled, pulse present → Yellow
• Patient 4: Unresponsive, no pulse, not breathing → Black
Rationale: Green (minor), Red (immediate life threat), Yellow (delayed but stable), Black
(expectant/deceased).
Question 6 out of 70
⏱️ Time remaining: 2:58:35
After triage, a family member runs toward a patient tagged red. What should the nurse
do first?
A. Allow the family member to stay with the patient
B. Call security to remove the family member
C. Calmly direct the family member to the designated waiting area
D. Ignore the family member and continue working
Correct Answer: C
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an
alert message sent to the proctor and may result in the termination of your assessment
