ATI RN Leadership Proctored Retake Exam 2026 | Nursing Management
ATI NURSING
RN LEADERSHIP PROCTORED RETAKE EXAM
Nursing Leadership & Management | Latest 2026 Edition
60 Questions with Correct Answers and Detailed Rationales
Total Questions: 60 | Total Sections: 12 | Format: Multiple Choice
Name: ________________________ Date: ________________________
Score: ________ / 60 Grade: ________
INSTRUCTIONS
Select the BEST answer for each question. Each question is worth 1 point.
Correct answers are shown in bold cyan blue with detailed leadership and management rationales.
Questions assess NCLEX-RN leadership competencies, delegation rules, legal/ethical standards, and clinical application.
SCORING GUIDE
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Passing Score: 70% (42/60) | A Grade: 90% (54/60) | A+ Grade: 95% (57/60)
SECTION I: Management of Care — Delegation, Assignment & Prioritization (7 Questions)
1. A nurse on a medical-surgical unit receives the following patient assignments: a client with stable COPD
requiring oxygen monitoring, a client 2 days post-cholecystectomy awaiting discharge, a client newly admitted
with chest pain and scheduled for a cardiac catheterization, and a client with diabetes receiving insulin. Which
client should the nurse assess first?
A. The client with stable COPD requiring oxygen monitoring
B. The client 2 days post-cholecystectomy awaiting discharge
C. The client newly admitted with chest pain scheduled for cardiac catheterization
D. The client with diabetes receiving insulin
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, ATI RN Leadership Proctored Retake Exam 2026 | Nursing Management
Correct Answer: C. The client newly admitted with chest pain scheduled for cardiac catheterization
Rationale: The client newly admitted with chest pain and scheduled for a cardiac catheterization should be assessed first
using the ABC (Airway, Breathing, Circulation) approach and the principle of prioritizing acute over stable conditions.
Chest pain may indicate acute coronary syndrome (ACS), which is a potentially life-threatening cardiac emergency
requiring immediate assessment and intervention. The stable COPD client, the client awaiting discharge, and the client
receiving routine insulin are all stable and require less urgent attention. The nurse must always prioritize patients whose
conditions are unstable or potentially life-threatening.
2. Which of the following tasks is appropriate for a registered nurse to delegate to an unlicensed assistive
personnel (UAP)?
A. Assessing a client's postoperative wound for signs of infection
B. Administering oral medications to a stable client
C. Measuring and recording vital signs on a stable postoperative client
D. Teaching a client about insulin self-administration technique
Correct Answer: C. Measuring and recording vital signs on a stable postoperative client
Rationale: Measuring and recording vital signs on a stable postoperative client is an appropriate task to delegate to a
UAP. According to the Five Rights of Delegation, the task must be within the UAP's scope of practice and the delegator
must provide appropriate direction and supervision. Vital signs on a stable client do not require nursing judgment for
interpretation and are a routine, repetitive task that UAPs are trained to perform. Assessment, medication administration
(even oral), and patient education require nursing knowledge, critical thinking, and licensure and cannot be delegated to
unlicensed personnel.
3. The charge nurse is making assignments for the shift. Which client should be assigned to the most
experienced RN on the team?
A. A client with a urinary tract infection receiving IV antibiotics
B. A client 1 day post-appendectomy who is ambulating independently
C. A client with a new tracheostomy who requires frequent suctioning and airway assessment
D. A client with hypertension whose blood pressure is well controlled on medications
Correct Answer: C. A client with a new tracheostomy who requires frequent suctioning and airway assessment
Rationale: The client with a new tracheostomy requiring frequent suctioning and airway assessment should be assigned
to the most experienced RN. This client has a high-risk airway that requires continuous assessment, specialized nursing
skills (tracheostomy suctioning, stoma care, and emergency airway management knowledge), and the ability to rapidly
recognize and respond to complications such as tracheostomy displacement, bleeding, or mucus plugging. The other
clients have stable, predictable conditions that can be safely managed by nurses with less experience. Patient acuity and
complexity must guide assignment decisions.
4. A nurse is caring for four clients. After receiving shift report, which client should the nurse see first?
A. A client with type 2 diabetes who needs a fasting blood glucose drawn
B. A client who is 1 hour post-thyroidectomy and has a tracheal deviation noted during the previous
assessment
C. A client with heart failure who needs daily weights and diuretic administration
D. A client with pneumonia who has a scheduled chest X-ray at 0900
Correct Answer: B. A client who is 1 hour post-thyroidectomy and has a tracheal deviation noted during the
previous assessment
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, ATI RN Leadership Proctored Retake Exam 2026 | Nursing Management
Rationale: The client who is 1 hour post-thyroidectomy with tracheal deviation requires immediate assessment and
intervention. Tracheal deviation following thyroidectomy can indicate a life-threatening complication such as tracheal
compression from a postoperative hematoma, which can rapidly lead to airway obstruction and respiratory failure. This is
a medical emergency requiring immediate notification of the surgeon and potential intervention. The other tasks, while
important, are not immediately life-threatening and can be addressed after the unstable client is stabilized. Using ABC
prioritization, airway always takes precedence.
5. A nurse is delegating tasks to a UAP. According to the Five Rights of Delegation, which right addresses
whether the task is appropriate to delegate under current circumstances?
A. Right task
B. Right circumstance
C. Right person
D. Right direction/communication
Correct Answer: B. Right circumstance
Rationale: The right circumstance means the nurse must evaluate the current clinical situation and determine whether it is
appropriate to delegate a specific task at that time. Even if a task is normally delegable, circumstances may change. For
example, measuring vital signs may normally be delegated to a UAP, but if a patient is hemodynamically unstable or
post-operative, the nurse should perform the assessment personally to detect subtle changes. The right task refers to
whether the task falls within the scope of practice for delegation. The right person ensures the delegatee has the
appropriate competence. The right direction/communication ensures clear instructions are provided.
6. Which of the following scenarios best demonstrates the nurse acting as a patient advocate?
A. Documenting a client's refusal of medication in the medical record
B. Informing the healthcare provider when a client expresses a desire to discontinue treatment and
facilitating a discussion about goals of care
C. Administering a prescribed medication even though the nurse has concerns about the dose
D. Completing incident reports only when directed by the charge nurse
Correct Answer: B. Informing the healthcare provider when a client expresses a desire to discontinue
treatment and facilitating a discussion about goals of care
Rationale: Informing the healthcare provider when a client expresses a desire to discontinue treatment and facilitating a
goals-of-care discussion best demonstrates the nurse's role as a patient advocate. Patient advocacy involves supporting the
patient's right to make informed decisions about their care, ensuring their voice is heard, and helping them navigate the
healthcare system. Documenting a refusal of medication is a legal responsibility but not advocacy per se. Administering a
medication despite concerns without questioning the order is a failure of advocacy. Incident reports should be completed
whenever an event warrants documentation, not only when directed.
7. A nurse is triaging clients in the emergency department after a mass casualty incident. Which client should be
tagged as red (immediate) according to disaster triage protocols?
A. A client with a minor laceration on the forearm who is ambulatory
B. A client with an open femur fracture and controlled bleeding with distal pulses intact
C. A client with severe burns over 40% of the body and signs of inhalation injury
D. A client who is unresponsive with no palpable pulse or respirations
Correct Answer: C. A client with severe burns over 40% of the body and signs of inhalation injury
Rationale: In disaster triage using the START (Simple Triage and Rapid Treatment) system, a client with severe burns
over 40% of the body and signs of inhalation injury is tagged red (immediate), requiring urgent care within minutes to
Page 3 of 23
ATI NURSING
RN LEADERSHIP PROCTORED RETAKE EXAM
Nursing Leadership & Management | Latest 2026 Edition
60 Questions with Correct Answers and Detailed Rationales
Total Questions: 60 | Total Sections: 12 | Format: Multiple Choice
Name: ________________________ Date: ________________________
Score: ________ / 60 Grade: ________
INSTRUCTIONS
Select the BEST answer for each question. Each question is worth 1 point.
Correct answers are shown in bold cyan blue with detailed leadership and management rationales.
Questions assess NCLEX-RN leadership competencies, delegation rules, legal/ethical standards, and clinical application.
SCORING GUIDE
S I I I I VVVVI XXXT
e IIV IIIX IIo
c I II It
t I a
i l
o
n
P7 6 5 7 5 5 4 5 4 5 4 3 6
o 0
i
n
t
s
S
c
o
r
e
Passing Score: 70% (42/60) | A Grade: 90% (54/60) | A+ Grade: 95% (57/60)
SECTION I: Management of Care — Delegation, Assignment & Prioritization (7 Questions)
1. A nurse on a medical-surgical unit receives the following patient assignments: a client with stable COPD
requiring oxygen monitoring, a client 2 days post-cholecystectomy awaiting discharge, a client newly admitted
with chest pain and scheduled for a cardiac catheterization, and a client with diabetes receiving insulin. Which
client should the nurse assess first?
A. The client with stable COPD requiring oxygen monitoring
B. The client 2 days post-cholecystectomy awaiting discharge
C. The client newly admitted with chest pain scheduled for cardiac catheterization
D. The client with diabetes receiving insulin
Page 1 of 23
, ATI RN Leadership Proctored Retake Exam 2026 | Nursing Management
Correct Answer: C. The client newly admitted with chest pain scheduled for cardiac catheterization
Rationale: The client newly admitted with chest pain and scheduled for a cardiac catheterization should be assessed first
using the ABC (Airway, Breathing, Circulation) approach and the principle of prioritizing acute over stable conditions.
Chest pain may indicate acute coronary syndrome (ACS), which is a potentially life-threatening cardiac emergency
requiring immediate assessment and intervention. The stable COPD client, the client awaiting discharge, and the client
receiving routine insulin are all stable and require less urgent attention. The nurse must always prioritize patients whose
conditions are unstable or potentially life-threatening.
2. Which of the following tasks is appropriate for a registered nurse to delegate to an unlicensed assistive
personnel (UAP)?
A. Assessing a client's postoperative wound for signs of infection
B. Administering oral medications to a stable client
C. Measuring and recording vital signs on a stable postoperative client
D. Teaching a client about insulin self-administration technique
Correct Answer: C. Measuring and recording vital signs on a stable postoperative client
Rationale: Measuring and recording vital signs on a stable postoperative client is an appropriate task to delegate to a
UAP. According to the Five Rights of Delegation, the task must be within the UAP's scope of practice and the delegator
must provide appropriate direction and supervision. Vital signs on a stable client do not require nursing judgment for
interpretation and are a routine, repetitive task that UAPs are trained to perform. Assessment, medication administration
(even oral), and patient education require nursing knowledge, critical thinking, and licensure and cannot be delegated to
unlicensed personnel.
3. The charge nurse is making assignments for the shift. Which client should be assigned to the most
experienced RN on the team?
A. A client with a urinary tract infection receiving IV antibiotics
B. A client 1 day post-appendectomy who is ambulating independently
C. A client with a new tracheostomy who requires frequent suctioning and airway assessment
D. A client with hypertension whose blood pressure is well controlled on medications
Correct Answer: C. A client with a new tracheostomy who requires frequent suctioning and airway assessment
Rationale: The client with a new tracheostomy requiring frequent suctioning and airway assessment should be assigned
to the most experienced RN. This client has a high-risk airway that requires continuous assessment, specialized nursing
skills (tracheostomy suctioning, stoma care, and emergency airway management knowledge), and the ability to rapidly
recognize and respond to complications such as tracheostomy displacement, bleeding, or mucus plugging. The other
clients have stable, predictable conditions that can be safely managed by nurses with less experience. Patient acuity and
complexity must guide assignment decisions.
4. A nurse is caring for four clients. After receiving shift report, which client should the nurse see first?
A. A client with type 2 diabetes who needs a fasting blood glucose drawn
B. A client who is 1 hour post-thyroidectomy and has a tracheal deviation noted during the previous
assessment
C. A client with heart failure who needs daily weights and diuretic administration
D. A client with pneumonia who has a scheduled chest X-ray at 0900
Correct Answer: B. A client who is 1 hour post-thyroidectomy and has a tracheal deviation noted during the
previous assessment
Page 2 of 23
, ATI RN Leadership Proctored Retake Exam 2026 | Nursing Management
Rationale: The client who is 1 hour post-thyroidectomy with tracheal deviation requires immediate assessment and
intervention. Tracheal deviation following thyroidectomy can indicate a life-threatening complication such as tracheal
compression from a postoperative hematoma, which can rapidly lead to airway obstruction and respiratory failure. This is
a medical emergency requiring immediate notification of the surgeon and potential intervention. The other tasks, while
important, are not immediately life-threatening and can be addressed after the unstable client is stabilized. Using ABC
prioritization, airway always takes precedence.
5. A nurse is delegating tasks to a UAP. According to the Five Rights of Delegation, which right addresses
whether the task is appropriate to delegate under current circumstances?
A. Right task
B. Right circumstance
C. Right person
D. Right direction/communication
Correct Answer: B. Right circumstance
Rationale: The right circumstance means the nurse must evaluate the current clinical situation and determine whether it is
appropriate to delegate a specific task at that time. Even if a task is normally delegable, circumstances may change. For
example, measuring vital signs may normally be delegated to a UAP, but if a patient is hemodynamically unstable or
post-operative, the nurse should perform the assessment personally to detect subtle changes. The right task refers to
whether the task falls within the scope of practice for delegation. The right person ensures the delegatee has the
appropriate competence. The right direction/communication ensures clear instructions are provided.
6. Which of the following scenarios best demonstrates the nurse acting as a patient advocate?
A. Documenting a client's refusal of medication in the medical record
B. Informing the healthcare provider when a client expresses a desire to discontinue treatment and
facilitating a discussion about goals of care
C. Administering a prescribed medication even though the nurse has concerns about the dose
D. Completing incident reports only when directed by the charge nurse
Correct Answer: B. Informing the healthcare provider when a client expresses a desire to discontinue
treatment and facilitating a discussion about goals of care
Rationale: Informing the healthcare provider when a client expresses a desire to discontinue treatment and facilitating a
goals-of-care discussion best demonstrates the nurse's role as a patient advocate. Patient advocacy involves supporting the
patient's right to make informed decisions about their care, ensuring their voice is heard, and helping them navigate the
healthcare system. Documenting a refusal of medication is a legal responsibility but not advocacy per se. Administering a
medication despite concerns without questioning the order is a failure of advocacy. Incident reports should be completed
whenever an event warrants documentation, not only when directed.
7. A nurse is triaging clients in the emergency department after a mass casualty incident. Which client should be
tagged as red (immediate) according to disaster triage protocols?
A. A client with a minor laceration on the forearm who is ambulatory
B. A client with an open femur fracture and controlled bleeding with distal pulses intact
C. A client with severe burns over 40% of the body and signs of inhalation injury
D. A client who is unresponsive with no palpable pulse or respirations
Correct Answer: C. A client with severe burns over 40% of the body and signs of inhalation injury
Rationale: In disaster triage using the START (Simple Triage and Rapid Treatment) system, a client with severe burns
over 40% of the body and signs of inhalation injury is tagged red (immediate), requiring urgent care within minutes to
Page 3 of 23
