ATI RN Leadership Level 3 Proctored
Exam 2023 with NGN All 100 Questions
With Answers
EXAM
1. A charge nurse is assigning client care for a medical-surgical unit. Which client
should be assigned to a licensed practical nurse (LPN)?
A. A client with a new tracheostomy requiring frequent suctioning
B. A client with diabetes mellitus requiring insulin before meals
C. A client with acute chest pain and an elevated troponin level
D. A client with a new diagnosis of stroke requiring neurological checks every hour
Correct Answer: B. Insulin administration is within the scope of an LPN. The other
options involve unstable or complex clients requiring RN assessment and intervention.
2. A nurse is delegating tasks to an assistive personnel (AP). Which of the
following tasks is appropriate to delegate?
A. Administering a tap water enema
B. Ambulating a client with a walker
C. Assessing a client’s post-operative incision
D. Reinforcing teaching about a low-sodium diet
Correct Answer: B. Ambulating a stable client with a walker is within the AP’s scope.
The other tasks require nursing judgment, assessment, or licensed scope.
3. A nurse manager is evaluating delegation practices. Which of the following
indicates appropriate delegation?
A. The RN delegates medication administration to an AP.
B. The RN delegates vital signs on a stable postoperative client to an LPN.
,C. The RN delegates the initial admission assessment to an LPN.
D. The RN delegates client education to an AP.
Correct Answer: B. LPNs can obtain vital signs on stable clients. Delegation of
medication, initial assessment, and teaching requires an RN.
4. A charge nurse is making assignments for the shift. Which client should be
assigned to the most experienced RN?
A. A client with a fractured femur in Buck’s traction
B. A client with pneumonia requiring IV antibiotics
C. A client with a chest tube and continuous bubbling in the water seal chamber
D. A client with a urinary tract infection and confusion
Correct Answer: C. Continuous bubbling indicates an air leak, requiring advanced
assessment and intervention. This is the most unstable client.
5. An RN observes an LPN inserting a urinary catheter without sterile gloves. What
is the priority action?
A. Report the LPN to the nurse manager after the shift.
B. Interrupt the procedure immediately to prevent infection.
C. Document the observation in the LPN’s personnel file.
D. Discuss the error with the LPN after the procedure is completed.
Correct Answer: B. Patient safety is the priority. The RN must intervene immediately to
prevent harm.
6. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with pneumonia who has an oxygen saturation of 91% on 2 L/min
B. A client with a hip fracture who reports pain of 7 on a 0–10 scale
C. A client with diabetes mellitus who has a blood glucose of 58 mg/dL
D. A client with a history of seizures who is requesting a glass of water
,Correct Answer: C. A blood glucose of 58 mg/dL indicates hypoglycemia, which can
lead to altered mental status or seizures. This is the most urgent.
7. A nurse receives report on four clients. Which client requires immediate
intervention?
A. A client with a new colostomy who has not had output in 24 hours
B. A client with heart failure who has 2+ pitting edema in the lower extremities
C. A client with a nasogastric tube who has green drainage
D. A client with a urinary catheter who has cloudy urine
Correct Answer: A. No colostomy output in 24 hours suggests possible obstruction or
ileus, requiring prompt evaluation.
8. A nurse is prioritizing morning care. Which client should be seen first?
A. A client scheduled for surgery at 0900
B. A client requesting pain medication for a headache
C. A client with a new-onset rash and difficulty breathing
D. A client ready for discharge teaching
Correct Answer: C. Difficulty breathing with a rash indicates possible anaphylaxis—this
is a life-threatening emergency.
9. A nurse has multiple tasks. Which task should be delegated to an AP?
A. Administering an oral antibiotic
B. Performing a sterile dressing change
C. Assisting a client with a meal
D. Assessing a client’s lung sounds
Correct Answer: C. Assisting with meals is within the AP’s scope. The others require
licensed nursing skills.
10. A nurse is managing time effectively. Which action demonstrates appropriate
time management?
, A. Completing all non-urgent tasks before addressing client concerns
B. Clustering care to minimize client interruptions
C. Delegating all client assessments to the LPN
D. Waiting until the end of the shift to document
Correct Answer: B. Clustering care improves efficiency and allows for uninterrupted rest
periods for clients.
11. Two staff nurses are arguing about the assignment of overtime. The nurse
manager should take which action first?
A. Send both nurses to human resources.
B. Listen to each nurse’s perspective individually.
C. Assign the overtime to the nurse with less seniority.
D. Hold a unit meeting to discuss the conflict.
Correct Answer: B. The first step in conflict resolution is to gather information by
listening to each party privately.
12. A nurse manager is addressing lateral violence on the unit. Which intervention
is most effective?
A. Implementing a zero-tolerance policy
B. Encouraging staff to ignore minor incidents
C. Providing education on professional communication
D. Transferring the instigator to another unit
Correct Answer: C. Education on communication and setting clear expectations helps
change unit culture long-term.
13. A staff nurse reports feeling bullied by a charge nurse. What is the nurse
manager’s priority?
A. Reassign the staff nurse to a different shift.
B. Investigate the allegations promptly.
Exam 2023 with NGN All 100 Questions
With Answers
EXAM
1. A charge nurse is assigning client care for a medical-surgical unit. Which client
should be assigned to a licensed practical nurse (LPN)?
A. A client with a new tracheostomy requiring frequent suctioning
B. A client with diabetes mellitus requiring insulin before meals
C. A client with acute chest pain and an elevated troponin level
D. A client with a new diagnosis of stroke requiring neurological checks every hour
Correct Answer: B. Insulin administration is within the scope of an LPN. The other
options involve unstable or complex clients requiring RN assessment and intervention.
2. A nurse is delegating tasks to an assistive personnel (AP). Which of the
following tasks is appropriate to delegate?
A. Administering a tap water enema
B. Ambulating a client with a walker
C. Assessing a client’s post-operative incision
D. Reinforcing teaching about a low-sodium diet
Correct Answer: B. Ambulating a stable client with a walker is within the AP’s scope.
The other tasks require nursing judgment, assessment, or licensed scope.
3. A nurse manager is evaluating delegation practices. Which of the following
indicates appropriate delegation?
A. The RN delegates medication administration to an AP.
B. The RN delegates vital signs on a stable postoperative client to an LPN.
,C. The RN delegates the initial admission assessment to an LPN.
D. The RN delegates client education to an AP.
Correct Answer: B. LPNs can obtain vital signs on stable clients. Delegation of
medication, initial assessment, and teaching requires an RN.
4. A charge nurse is making assignments for the shift. Which client should be
assigned to the most experienced RN?
A. A client with a fractured femur in Buck’s traction
B. A client with pneumonia requiring IV antibiotics
C. A client with a chest tube and continuous bubbling in the water seal chamber
D. A client with a urinary tract infection and confusion
Correct Answer: C. Continuous bubbling indicates an air leak, requiring advanced
assessment and intervention. This is the most unstable client.
5. An RN observes an LPN inserting a urinary catheter without sterile gloves. What
is the priority action?
A. Report the LPN to the nurse manager after the shift.
B. Interrupt the procedure immediately to prevent infection.
C. Document the observation in the LPN’s personnel file.
D. Discuss the error with the LPN after the procedure is completed.
Correct Answer: B. Patient safety is the priority. The RN must intervene immediately to
prevent harm.
6. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with pneumonia who has an oxygen saturation of 91% on 2 L/min
B. A client with a hip fracture who reports pain of 7 on a 0–10 scale
C. A client with diabetes mellitus who has a blood glucose of 58 mg/dL
D. A client with a history of seizures who is requesting a glass of water
,Correct Answer: C. A blood glucose of 58 mg/dL indicates hypoglycemia, which can
lead to altered mental status or seizures. This is the most urgent.
7. A nurse receives report on four clients. Which client requires immediate
intervention?
A. A client with a new colostomy who has not had output in 24 hours
B. A client with heart failure who has 2+ pitting edema in the lower extremities
C. A client with a nasogastric tube who has green drainage
D. A client with a urinary catheter who has cloudy urine
Correct Answer: A. No colostomy output in 24 hours suggests possible obstruction or
ileus, requiring prompt evaluation.
8. A nurse is prioritizing morning care. Which client should be seen first?
A. A client scheduled for surgery at 0900
B. A client requesting pain medication for a headache
C. A client with a new-onset rash and difficulty breathing
D. A client ready for discharge teaching
Correct Answer: C. Difficulty breathing with a rash indicates possible anaphylaxis—this
is a life-threatening emergency.
9. A nurse has multiple tasks. Which task should be delegated to an AP?
A. Administering an oral antibiotic
B. Performing a sterile dressing change
C. Assisting a client with a meal
D. Assessing a client’s lung sounds
Correct Answer: C. Assisting with meals is within the AP’s scope. The others require
licensed nursing skills.
10. A nurse is managing time effectively. Which action demonstrates appropriate
time management?
, A. Completing all non-urgent tasks before addressing client concerns
B. Clustering care to minimize client interruptions
C. Delegating all client assessments to the LPN
D. Waiting until the end of the shift to document
Correct Answer: B. Clustering care improves efficiency and allows for uninterrupted rest
periods for clients.
11. Two staff nurses are arguing about the assignment of overtime. The nurse
manager should take which action first?
A. Send both nurses to human resources.
B. Listen to each nurse’s perspective individually.
C. Assign the overtime to the nurse with less seniority.
D. Hold a unit meeting to discuss the conflict.
Correct Answer: B. The first step in conflict resolution is to gather information by
listening to each party privately.
12. A nurse manager is addressing lateral violence on the unit. Which intervention
is most effective?
A. Implementing a zero-tolerance policy
B. Encouraging staff to ignore minor incidents
C. Providing education on professional communication
D. Transferring the instigator to another unit
Correct Answer: C. Education on communication and setting clear expectations helps
change unit culture long-term.
13. A staff nurse reports feeling bullied by a charge nurse. What is the nurse
manager’s priority?
A. Reassign the staff nurse to a different shift.
B. Investigate the allegations promptly.
