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
,Question 1 out of 70
NGN Style – Highlight (Select all that apply)
A nurse manager is observing a new graduate RN caring for a patient with a chest tube.
Which actions by the new graduate 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:
• A (Clamping during transport) – Can cause tension pneumothorax; never clamp
unless specifically ordered.
• C (Emptying without gloves) – Infection risk; gloves are required.
• E (Coiling tubing on bed) – Creates dependent loops that impede drainage;
tubing should be secured without loops.
• B is correct (below chest level promotes drainage).
• D is correct (increased bubbling indicates possible air leak and should be
reported).
Question 2 out of 70
Standalone – Delegation
A charge nurse on a medical-surgical unit is planning care for a patient with a new
diagnosis of diabetes mellitus. Which task should the charge nurse assign to an
LPN/VN?
A. Teaching the patient how to adjust insulin doses based on carbohydrate intake
B. Administering subcutaneous insulin to a stable patient according to a sliding scale
C. Evaluating the patient’s understanding of hypoglycemia treatment
D. Drawing up both regular and NPH insulin into the same syringe for an unstable
patient
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
,Correct Answer: B
Rationale: LPNs can administer subcutaneous insulin to stable patients with predictable
outcomes. Teaching (A) and evaluating understanding (C) require RN scope. Drawing
mixed insulin for an unstable patient (D) requires RN judgment.
Question 3 out of 70
NGN – Bow-tie
Case: A patient received the wrong medication because two nurses failed to complete
an independent double-check. The center of the bow-tie is “Medication Error.”
Left side (Causes): Select two causes from the list.
A. Barcode scanner malfunction
B. Distraction during double-check
C. Failure to follow policy
D. Patient refused the correct medication earlier
Correct Answer: B and C
Rationale: Distraction and policy violation are direct, modifiable causes. Barcode
malfunction (A) might contribute but is not mentioned. Patient refusal (D) is unrelated.
Right side (Actions to prevent recurrence): Select two actions.
E. Require a silent, independent double-check
F. Punish the nurses involved
G. Implement a barcode scanning system
H. Remove all high-alert medications from the unit
Correct Answer: E and G
Rationale: System changes (independent double-check, barcode scanning) are effective.
Punishment (F) does not fix system flaws. Removing all high-alert meds (H) is not
practical.
Question 4 out of 70
Standalone – Informed Consent
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
, A charge nurse observes a staff nurse administering a blood transfusion without
obtaining written informed consent. The client is conscious and alert. Which action
should the charge nurse take first?
A. Complete an incident report
B. Stop the transfusion immediately
C. Ask the nurse to obtain consent from the client
D. Notify the provider
Correct Answer: B
Rationale: Client safety is the priority. Administering blood without consent violates
patient rights. The transfusion must be stopped first. After stopping, the charge nurse
can notify the provider, complete an incident report, and obtain consent if still indicated.
Question 5 out of 70
NGN – Matrix (Matching)
A nurse manager documents observed behaviors during a conflict between two nurses.
Match each behavior to the appropriate conflict resolution step.
Behavior Step
“I feel frustrated when tasks are not completed.” 1. Express feelings using “I” statements
“Let’s agree to check in every 2 hours.” 2. Negotiate a solution
“What do you think is causing the problem?” 3. Explore underlying interests
“You’re wrong and I’m right.” 4. (Not a constructive step)
Correct Answer: 1→A, 2→B, 3→C, 4→D
Rationale: Using “I” statements, exploring interests, and negotiating solutions are
constructive. Blaming statements escalate conflict and are not a step in resolution.
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
,Question 1 out of 70
NGN Style – Highlight (Select all that apply)
A nurse manager is observing a new graduate RN caring for a patient with a chest tube.
Which actions by the new graduate 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:
• A (Clamping during transport) – Can cause tension pneumothorax; never clamp
unless specifically ordered.
• C (Emptying without gloves) – Infection risk; gloves are required.
• E (Coiling tubing on bed) – Creates dependent loops that impede drainage;
tubing should be secured without loops.
• B is correct (below chest level promotes drainage).
• D is correct (increased bubbling indicates possible air leak and should be
reported).
Question 2 out of 70
Standalone – Delegation
A charge nurse on a medical-surgical unit is planning care for a patient with a new
diagnosis of diabetes mellitus. Which task should the charge nurse assign to an
LPN/VN?
A. Teaching the patient how to adjust insulin doses based on carbohydrate intake
B. Administering subcutaneous insulin to a stable patient according to a sliding scale
C. Evaluating the patient’s understanding of hypoglycemia treatment
D. Drawing up both regular and NPH insulin into the same syringe for an unstable
patient
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
,Correct Answer: B
Rationale: LPNs can administer subcutaneous insulin to stable patients with predictable
outcomes. Teaching (A) and evaluating understanding (C) require RN scope. Drawing
mixed insulin for an unstable patient (D) requires RN judgment.
Question 3 out of 70
NGN – Bow-tie
Case: A patient received the wrong medication because two nurses failed to complete
an independent double-check. The center of the bow-tie is “Medication Error.”
Left side (Causes): Select two causes from the list.
A. Barcode scanner malfunction
B. Distraction during double-check
C. Failure to follow policy
D. Patient refused the correct medication earlier
Correct Answer: B and C
Rationale: Distraction and policy violation are direct, modifiable causes. Barcode
malfunction (A) might contribute but is not mentioned. Patient refusal (D) is unrelated.
Right side (Actions to prevent recurrence): Select two actions.
E. Require a silent, independent double-check
F. Punish the nurses involved
G. Implement a barcode scanning system
H. Remove all high-alert medications from the unit
Correct Answer: E and G
Rationale: System changes (independent double-check, barcode scanning) are effective.
Punishment (F) does not fix system flaws. Removing all high-alert meds (H) is not
practical.
Question 4 out of 70
Standalone – Informed Consent
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
, A charge nurse observes a staff nurse administering a blood transfusion without
obtaining written informed consent. The client is conscious and alert. Which action
should the charge nurse take first?
A. Complete an incident report
B. Stop the transfusion immediately
C. Ask the nurse to obtain consent from the client
D. Notify the provider
Correct Answer: B
Rationale: Client safety is the priority. Administering blood without consent violates
patient rights. The transfusion must be stopped first. After stopping, the charge nurse
can notify the provider, complete an incident report, and obtain consent if still indicated.
Question 5 out of 70
NGN – Matrix (Matching)
A nurse manager documents observed behaviors during a conflict between two nurses.
Match each behavior to the appropriate conflict resolution step.
Behavior Step
“I feel frustrated when tasks are not completed.” 1. Express feelings using “I” statements
“Let’s agree to check in every 2 hours.” 2. Negotiate a solution
“What do you think is causing the problem?” 3. Explore underlying interests
“You’re wrong and I’m right.” 4. (Not a constructive step)
Correct Answer: 1→A, 2→B, 3→C, 4→D
Rationale: Using “I” statements, exploring interests, and negotiating solutions are
constructive. Blaming statements escalate conflict and are not a step in resolution.
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
