ATI RN LEADERSHIP PROCTORED EXAM 2026 Q@A
1. A charge nurse is reviewing patient assignments for the day. Which patient
should be assigned to the most experienced RN?
A. A patient with stable diabetes requiring routine insulin administration
B. A patient 2 hours postoperative from abdominal surgery with unpredictable
pain levels
C. A patient with hypertension requiring morning blood pressure monitoring
D. A patient recovering from a minor procedure needing discharge education
Correct Answer: B
Explanation: Postoperative patients with unpredictable pain require advanced
clinical judgment, pain assessment skills, and potential intervention complexity
that only an experienced RN can manage safely. The other patients have stable,
routine needs suitable for less experienced staff.
2. During a staff meeting, two nurses argue loudly about a patient care decision.
What is the nurse manager's immediate priority action?
A. Interrupt the argument and ask both nurses to discuss the issue privately later
B. Document the behavior for future performance reviews
C. Address the conflict immediately by redirecting the conversation to the team's
focus
D. Call security to remove the nurses from the meeting
Correct Answer: C
Explanation: The nurse manager must address disruptive behavior
immediately to maintain meeting productivity and professional standards.
Redirecting maintains respect while preventing escalation. Documenting occurs
later, and security is unnecessary for verbal disagreement.
3. A nurse delegates wound care to an LPN. Which statement by the nurse
demonstrates appropriate delegation?
A. "I'll check on the wound care you're doing later."
B. "Please complete the wound care and report any unusual findings to me."
C. "You can do the wound care if you want to."
D. "The wound care is your responsibility now."
Correct Answer: B
Explanation: Appropriate delegation includes clear expectations, specific tasks,
and required communication of findings. Option B provides direction while
, maintaining accountability. Options A, C, and D lack clarity or proper follow-
through expectations.
4. A patient refuses chemotherapy and the family demands the nurse administer it
anyway. What should the nurse do first?
A. Administer the chemotherapy to comply with family wishes
B. Contact the healthcare provider to discuss the situation
C. Respect the patient's decision and document the refusal
D. Ask the family to leave the room
Correct Answer: C
Explanation: The patient's right to refuse treatment is legally and ethically
protected. The nurse must respect patient autonomy and document the refusal.
Administering against patient wishes violates ethical principles, and the
provider should be notified after documentation.
5. Which situation requires the nurse manager to implement a quality improvement
initiative?
A. One nurse consistently arrives 5 minutes late to shift
B. A 15% increase in healthcare-associated infections over 3 months
C. A patient complains about noisy visitors
D. Staff requests additional break time
Correct Answer: B
Explanation: A significant increase in HAIs indicates a systemic problem
requiring quality improvement. This affects patient safety and requires data-
driven intervention. The other issues are individual or minor concerns not
requiring systematic quality improvement.
6. A new graduate nurse asks about the difference between accountability and
responsibility. Which response is correct?
A. "Accountability is doing tasks; responsibility is being in charge."
B. "Responsibility is the obligation to perform; accountability is accepting
consequences for outcomes."
C. "They are the same thing in nursing."
D. "Accountability applies to managers; responsibility applies to all nurses."
Correct Answer: B
Explanation: Responsibility refers to the duty to perform assigned tasks, while
, accountability means accepting responsibility for the outcomes of those actions,
including consequences. This distinction is fundamental to nursing leadership.
7. During medication administration, a nurse realizes they gave the wrong
medication. What is the first action?
A. Document the error immediately
B. Notify the healthcare provider
C. Assess the patient for adverse effects
D. Call the pharmacy
Correct Answer: C
Explanation: Patient safety is paramount. The nurse must immediately assess
the patient for any adverse effects before taking other actions. Documentation,
provider notification, and pharmacy contact follow after ensuring patient
stability.
8. A charge nurse must assign tasks for the day. Which task is appropriate to
delegate to a UAP (Unlicensed Assistive Personnel)?
A. Administering oral pain medication
B. Assessing a patient's respiratory status
C. Feeding a patient with no swallowing difficulties
D. Inserting a urinary catheter
Correct Answer: C
Explanation: UAPs can perform routine, non-invasive tasks like feeding stable
patients without swallowing risks. Medication administration, assessments,
and invasive procedures require licensed personnel (RN or LPN).
9. Which action demonstrates effective conflict resolution between two staff nurses?
A. The nurse manager ignores the conflict to let them resolve it themselves
B. The nurse manager facilitates a meeting where both nurses express their
concerns and work toward a solution
C. One nurse is told to apologize regardless of fault
D. The nurses are separated and given different shifts permanently
Correct Answer: B
Explanation: Effective conflict resolution involves facilitated communication,
mutual understanding, and collaborative problem-solving. Ignoring, forcing
, apologies, or permanent separation don't address the root cause or promote
teamwork.
10. A nurse notices a pattern of medication errors on the unit. What should the nurse
do first?
A. Report the specific nurses making errors to the nurse manager
B. Document each error and submit a quality report to the nurse manager
C. Discuss the pattern with the nurse manager without identifying individuals
initially
D. Ignore the pattern as it's not their responsibility
Correct Answer: C
Explanation: The nurse should first discuss the pattern with the nurse manager
to address systemic issues before focusing on individual accountability. This
approach promotes quality improvement and prevents a punitive culture that
might hide errors.
11. Which patient assignment is most appropriate for an LPN (Licensed Practical
Nurse)?
A. A patient with unstable diabetes requiring frequent insulin adjustments
B. A patient with stable chronic kidney disease on a consistent medication
regimen
C. A patient 1 hour postoperative from cardiac surgery
D. A patient requiring complex wound assessment and care planning
Correct Answer: B
Explanation: LPNs can manage stable patients with consistent medication
regimens and routine care. Unstable conditions, immediate postoperative care,
and complex assessments require RN-level clinical judgment.
12. A nurse manager is conducting performance evaluations. Which statement
reflects effective feedback?
A. "You need to improve your communication skills."
B. "Your communication with families has improved significantly over the past
quarter, as shown by their satisfaction scores."
C. "You're doing okay most of the time."
D. "Other nurses communicate better than you do."
Correct Answer: B
1. A charge nurse is reviewing patient assignments for the day. Which patient
should be assigned to the most experienced RN?
A. A patient with stable diabetes requiring routine insulin administration
B. A patient 2 hours postoperative from abdominal surgery with unpredictable
pain levels
C. A patient with hypertension requiring morning blood pressure monitoring
D. A patient recovering from a minor procedure needing discharge education
Correct Answer: B
Explanation: Postoperative patients with unpredictable pain require advanced
clinical judgment, pain assessment skills, and potential intervention complexity
that only an experienced RN can manage safely. The other patients have stable,
routine needs suitable for less experienced staff.
2. During a staff meeting, two nurses argue loudly about a patient care decision.
What is the nurse manager's immediate priority action?
A. Interrupt the argument and ask both nurses to discuss the issue privately later
B. Document the behavior for future performance reviews
C. Address the conflict immediately by redirecting the conversation to the team's
focus
D. Call security to remove the nurses from the meeting
Correct Answer: C
Explanation: The nurse manager must address disruptive behavior
immediately to maintain meeting productivity and professional standards.
Redirecting maintains respect while preventing escalation. Documenting occurs
later, and security is unnecessary for verbal disagreement.
3. A nurse delegates wound care to an LPN. Which statement by the nurse
demonstrates appropriate delegation?
A. "I'll check on the wound care you're doing later."
B. "Please complete the wound care and report any unusual findings to me."
C. "You can do the wound care if you want to."
D. "The wound care is your responsibility now."
Correct Answer: B
Explanation: Appropriate delegation includes clear expectations, specific tasks,
and required communication of findings. Option B provides direction while
, maintaining accountability. Options A, C, and D lack clarity or proper follow-
through expectations.
4. A patient refuses chemotherapy and the family demands the nurse administer it
anyway. What should the nurse do first?
A. Administer the chemotherapy to comply with family wishes
B. Contact the healthcare provider to discuss the situation
C. Respect the patient's decision and document the refusal
D. Ask the family to leave the room
Correct Answer: C
Explanation: The patient's right to refuse treatment is legally and ethically
protected. The nurse must respect patient autonomy and document the refusal.
Administering against patient wishes violates ethical principles, and the
provider should be notified after documentation.
5. Which situation requires the nurse manager to implement a quality improvement
initiative?
A. One nurse consistently arrives 5 minutes late to shift
B. A 15% increase in healthcare-associated infections over 3 months
C. A patient complains about noisy visitors
D. Staff requests additional break time
Correct Answer: B
Explanation: A significant increase in HAIs indicates a systemic problem
requiring quality improvement. This affects patient safety and requires data-
driven intervention. The other issues are individual or minor concerns not
requiring systematic quality improvement.
6. A new graduate nurse asks about the difference between accountability and
responsibility. Which response is correct?
A. "Accountability is doing tasks; responsibility is being in charge."
B. "Responsibility is the obligation to perform; accountability is accepting
consequences for outcomes."
C. "They are the same thing in nursing."
D. "Accountability applies to managers; responsibility applies to all nurses."
Correct Answer: B
Explanation: Responsibility refers to the duty to perform assigned tasks, while
, accountability means accepting responsibility for the outcomes of those actions,
including consequences. This distinction is fundamental to nursing leadership.
7. During medication administration, a nurse realizes they gave the wrong
medication. What is the first action?
A. Document the error immediately
B. Notify the healthcare provider
C. Assess the patient for adverse effects
D. Call the pharmacy
Correct Answer: C
Explanation: Patient safety is paramount. The nurse must immediately assess
the patient for any adverse effects before taking other actions. Documentation,
provider notification, and pharmacy contact follow after ensuring patient
stability.
8. A charge nurse must assign tasks for the day. Which task is appropriate to
delegate to a UAP (Unlicensed Assistive Personnel)?
A. Administering oral pain medication
B. Assessing a patient's respiratory status
C. Feeding a patient with no swallowing difficulties
D. Inserting a urinary catheter
Correct Answer: C
Explanation: UAPs can perform routine, non-invasive tasks like feeding stable
patients without swallowing risks. Medication administration, assessments,
and invasive procedures require licensed personnel (RN or LPN).
9. Which action demonstrates effective conflict resolution between two staff nurses?
A. The nurse manager ignores the conflict to let them resolve it themselves
B. The nurse manager facilitates a meeting where both nurses express their
concerns and work toward a solution
C. One nurse is told to apologize regardless of fault
D. The nurses are separated and given different shifts permanently
Correct Answer: B
Explanation: Effective conflict resolution involves facilitated communication,
mutual understanding, and collaborative problem-solving. Ignoring, forcing
, apologies, or permanent separation don't address the root cause or promote
teamwork.
10. A nurse notices a pattern of medication errors on the unit. What should the nurse
do first?
A. Report the specific nurses making errors to the nurse manager
B. Document each error and submit a quality report to the nurse manager
C. Discuss the pattern with the nurse manager without identifying individuals
initially
D. Ignore the pattern as it's not their responsibility
Correct Answer: C
Explanation: The nurse should first discuss the pattern with the nurse manager
to address systemic issues before focusing on individual accountability. This
approach promotes quality improvement and prevents a punitive culture that
might hide errors.
11. Which patient assignment is most appropriate for an LPN (Licensed Practical
Nurse)?
A. A patient with unstable diabetes requiring frequent insulin adjustments
B. A patient with stable chronic kidney disease on a consistent medication
regimen
C. A patient 1 hour postoperative from cardiac surgery
D. A patient requiring complex wound assessment and care planning
Correct Answer: B
Explanation: LPNs can manage stable patients with consistent medication
regimens and routine care. Unstable conditions, immediate postoperative care,
and complex assessments require RN-level clinical judgment.
12. A nurse manager is conducting performance evaluations. Which statement
reflects effective feedback?
A. "You need to improve your communication skills."
B. "Your communication with families has improved significantly over the past
quarter, as shown by their satisfaction scores."
C. "You're doing okay most of the time."
D. "Other nurses communicate better than you do."
Correct Answer: B
