ATI RN LEADERSHIP
FORM B - COMPREHENSIVE PRACTICE EXAM
Latest 2026-2027 Edition
Aligned with ATI RN Leadership Standards & NCLEX-RN Competencies
Total Questions: 100 Multiple-Choice Questions
Cognitive Level: 25% Recall | 55% Application | 20% Analysis
Question Style: 75% Scenario-Based | 20% Direct Recall | 5% Analysis
Sections: 8 Integrated Content Domains
Format: 4 Options (A-D) with ONE Correct Answer
Rationales: Comprehensive Clinical Reasoning Provided
Exam Blueprint: Section 1: Management of Care (Q1-25) | Section 2: Legal & Ethical Issues (Q26-40) |
Section 3: Staff Management & HR (Q41-55) | Section 4: Quality Improvement & Patient Safety (Q56-70) |
Section 5: Leadership Theories & Styles (Q71-80) | Section 6: Financial Management (Q81-88) | Section
7: Emergency Preparedness (Q89-93) | Section 8: Integrated Clinical Scenarios (Q94-100).
VERIFIED A+ GRADED CONTENT | CLINICAL REASONING RATIONALES
,ATI RN LEADERSHIP - FORM B (2026-2027) Comprehensive Practice Exam
Section 1: Management of Care
Client Rights, Advocacy, Delegation, Supervision & Assignment (Q1-Q25)
Q1: A charge nurse is reviewing the Five Rights of Delegation with a newly licensed nurse. Which of the
following is NOT one of the Five Rights of Delegation?
A. Right Task
B. Right Circumstance
C. Right Documentation [CORRECT]
D. Right Person
Correct Answer: C. Right Documentation
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, and Right Supervision/Evaluation. Documentation is important but is not
one of the Five Rights; ATI emphasizes supervision and evaluation as the closing loop that ensures safe
delegation.
Q2: An RN on a medical-surgical unit is caring for four clients. Which task should the RN delegate to the
Unlicensed Assistive Personnel (UAP)?
A. Assessing a client's wound for signs of infection
B. Ambulating a stable postoperative client who is 2 days post-colonoscopy [CORRECT]
C. Teaching a newly diagnosed diabetic client about insulin administration
D. Evaluating the effectiveness of a newly administered PRN analgesic
Correct Answer: B. Ambulating a stable postoperative client who is 2 days post-colonoscopy
Rationale: UAP may perform routine ambulation of stable, predictable clients because it falls within
their scope. Assessment, teaching, and evaluation are non-delegatable nursing functions that require
RN judgment. The RN retains accountability for evaluating the client's tolerance after the UAP reports
back.
ATI RN Leadership Form B - 100 Verified Questions with Rationales Page 2
,ATI RN LEADERSHIP - FORM B (2026-2027) Comprehensive Practice Exam
Q3: Which of the following clients should the charge nurse assign to the LPN/LVN?
A. A client who is hemorrhaging from a femoral artery post-cardiac catheterization
B. A newly admitted client with acute exacerbation of heart failure requiring IV nitroglycerin titration
C. A stable client with a chronic non-infected pressure ulcer receiving routine wet-to-dry dressing
changes [CORRECT]
D. A client receiving their first unit of packed RBCs with a suspected transfusion reaction
Correct Answer: C. A stable client with a chronic non-infected pressure ulcer receiving routine
wet-to-dry dressing changes
Rationale: LPN scope includes caring for stable clients with predictable outcomes, such as routine
dressing changes. Hemorrhage, acute HF with titrated IV meds, and transfusion reactions require
RN-level assessment and complex intervention. ATI assignment principles prioritize matching client
acuity to staff competency.
Q4: A client is scheduled for an IV pyelography procedure. The RN delegates obtaining the informed consent
to the LPN. Which response by the LPN indicates understanding of informed consent?
A. "I will explain the procedure, risks, and benefits, and then sign as a witness."
B. "I can witness the client's signature, but the provider must explain the procedure, risks, and
benefits." [CORRECT]
C. "Because the provider already spoke to the client, I can answer any remaining questions the client has."
D. "I will sign the consent form to verify the client is competent to make the decision."
Correct Answer: B. "I can witness the client's signature, but the provider must explain the
procedure, risks, and benefits."
Rationale: The LPN may witness the client's signature but cannot obtain informed consent. Only the
provider performing the procedure (or designated qualified provider) is responsible for explaining the
procedure, risks, benefits, and alternatives. The RN may clarify but should refer substantive questions
back to the provider.
Q5: A client who is alert and oriented refuses a prescribed blood transfusion due to religious beliefs. Which
action should the nurse take first?
A. Administer the transfusion because it is life-saving
B. Notify the provider and document the client's refusal in the medical record [CORRECT]
C. Contact the ethics committee immediately
D. Ask the family to override the client's decision
Correct Answer: B. Notify the provider and document the client's refusal in the medical record
Rationale: An alert, oriented adult has the legal right to refuse treatment. The nurse must notify the
provider, ensure the client understands the consequences, and document the refusal with the client's
words. Forcing treatment constitutes battery. The ethics committee may be consulted later but is not the
first action.
ATI RN Leadership Form B - 100 Verified Questions with Rationales Page 3
, ATI RN LEADERSHIP - FORM B (2026-2027) Comprehensive Practice Exam
Q6: A nurse is caring for a client who has a living will and a DNR order. The client's spouse asks the nurse to
resuscitate the client if he stops breathing. What is the nurse's best response?
A. "I will follow your wishes because you are the next of kin."
B. "The living will and DNR order must be followed; I cannot perform resuscitation." [CORRECT]
C. "I will ask the provider to revoke the DNR order so we can resuscitate."
D. "We can call an attorney to change the advance directive right now."
Correct Answer: B. "The living will and DNR order must be followed; I cannot perform
resuscitation."
Rationale: A living will and DNR order are legal documents representing the client's autonomous
healthcare decisions. They take precedence over family wishes. The nurse must honor the directive;
violating it constitutes unwanted touching (battery). The spouse can be offered emotional support and
education about the document.
Q7: A family member who is not the client's healthcare proxy asks the nurse for information about the client's
diagnosis. Which response by the nurse demonstrates HIPAA compliance?
A. "I can share general information, but specifics require the client's permission." [CORRECT]
B. "Since you are family, I can give you the full diagnosis and treatment plan."
C. "I cannot share any information; you must ask the client directly."
D. "I will share the information only if you sign a confidentiality agreement."
Correct Answer: A. "I can share general information, but specifics require the client's permission."
Rationale: HIPAA allows nurses to share general information (e.g., room location, condition as
stable/guarded) with family members involved in the client's care, unless the client objects. Specific
diagnostic and treatment information requires the client's authorization. The nurse should verify the
client's preferences and document any restrictions.
Q8: An RN delegates taking vital signs to a UAP for a client who is 1 day postoperative. The UAP reports the
client's blood pressure is 88/52 mmHg. What should the RN do first?
A. Instruct the UAP to recheck the BP in 30 minutes
B. Immediately assess the client for signs of hemorrhage and shock [CORRECT]
C. Document the UAP's finding in the medical record
D. Call the provider to request IV fluids
Correct Answer: B. Immediately assess the client for signs of hemorrhage and shock
Rationale: The RN retains accountability for evaluation. A BP of 88/52 in a postoperative client
suggests possible hemorrhage/shock and requires immediate RN assessment. The RN cannot delegate
the clinical judgment of assessing and stabilizing the client; documentation and provider notification
occur after assessment.
ATI RN Leadership Form B - 100 Verified Questions with Rationales Page 4
FORM B - COMPREHENSIVE PRACTICE EXAM
Latest 2026-2027 Edition
Aligned with ATI RN Leadership Standards & NCLEX-RN Competencies
Total Questions: 100 Multiple-Choice Questions
Cognitive Level: 25% Recall | 55% Application | 20% Analysis
Question Style: 75% Scenario-Based | 20% Direct Recall | 5% Analysis
Sections: 8 Integrated Content Domains
Format: 4 Options (A-D) with ONE Correct Answer
Rationales: Comprehensive Clinical Reasoning Provided
Exam Blueprint: Section 1: Management of Care (Q1-25) | Section 2: Legal & Ethical Issues (Q26-40) |
Section 3: Staff Management & HR (Q41-55) | Section 4: Quality Improvement & Patient Safety (Q56-70) |
Section 5: Leadership Theories & Styles (Q71-80) | Section 6: Financial Management (Q81-88) | Section
7: Emergency Preparedness (Q89-93) | Section 8: Integrated Clinical Scenarios (Q94-100).
VERIFIED A+ GRADED CONTENT | CLINICAL REASONING RATIONALES
,ATI RN LEADERSHIP - FORM B (2026-2027) Comprehensive Practice Exam
Section 1: Management of Care
Client Rights, Advocacy, Delegation, Supervision & Assignment (Q1-Q25)
Q1: A charge nurse is reviewing the Five Rights of Delegation with a newly licensed nurse. Which of the
following is NOT one of the Five Rights of Delegation?
A. Right Task
B. Right Circumstance
C. Right Documentation [CORRECT]
D. Right Person
Correct Answer: C. Right Documentation
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, and Right Supervision/Evaluation. Documentation is important but is not
one of the Five Rights; ATI emphasizes supervision and evaluation as the closing loop that ensures safe
delegation.
Q2: An RN on a medical-surgical unit is caring for four clients. Which task should the RN delegate to the
Unlicensed Assistive Personnel (UAP)?
A. Assessing a client's wound for signs of infection
B. Ambulating a stable postoperative client who is 2 days post-colonoscopy [CORRECT]
C. Teaching a newly diagnosed diabetic client about insulin administration
D. Evaluating the effectiveness of a newly administered PRN analgesic
Correct Answer: B. Ambulating a stable postoperative client who is 2 days post-colonoscopy
Rationale: UAP may perform routine ambulation of stable, predictable clients because it falls within
their scope. Assessment, teaching, and evaluation are non-delegatable nursing functions that require
RN judgment. The RN retains accountability for evaluating the client's tolerance after the UAP reports
back.
ATI RN Leadership Form B - 100 Verified Questions with Rationales Page 2
,ATI RN LEADERSHIP - FORM B (2026-2027) Comprehensive Practice Exam
Q3: Which of the following clients should the charge nurse assign to the LPN/LVN?
A. A client who is hemorrhaging from a femoral artery post-cardiac catheterization
B. A newly admitted client with acute exacerbation of heart failure requiring IV nitroglycerin titration
C. A stable client with a chronic non-infected pressure ulcer receiving routine wet-to-dry dressing
changes [CORRECT]
D. A client receiving their first unit of packed RBCs with a suspected transfusion reaction
Correct Answer: C. A stable client with a chronic non-infected pressure ulcer receiving routine
wet-to-dry dressing changes
Rationale: LPN scope includes caring for stable clients with predictable outcomes, such as routine
dressing changes. Hemorrhage, acute HF with titrated IV meds, and transfusion reactions require
RN-level assessment and complex intervention. ATI assignment principles prioritize matching client
acuity to staff competency.
Q4: A client is scheduled for an IV pyelography procedure. The RN delegates obtaining the informed consent
to the LPN. Which response by the LPN indicates understanding of informed consent?
A. "I will explain the procedure, risks, and benefits, and then sign as a witness."
B. "I can witness the client's signature, but the provider must explain the procedure, risks, and
benefits." [CORRECT]
C. "Because the provider already spoke to the client, I can answer any remaining questions the client has."
D. "I will sign the consent form to verify the client is competent to make the decision."
Correct Answer: B. "I can witness the client's signature, but the provider must explain the
procedure, risks, and benefits."
Rationale: The LPN may witness the client's signature but cannot obtain informed consent. Only the
provider performing the procedure (or designated qualified provider) is responsible for explaining the
procedure, risks, benefits, and alternatives. The RN may clarify but should refer substantive questions
back to the provider.
Q5: A client who is alert and oriented refuses a prescribed blood transfusion due to religious beliefs. Which
action should the nurse take first?
A. Administer the transfusion because it is life-saving
B. Notify the provider and document the client's refusal in the medical record [CORRECT]
C. Contact the ethics committee immediately
D. Ask the family to override the client's decision
Correct Answer: B. Notify the provider and document the client's refusal in the medical record
Rationale: An alert, oriented adult has the legal right to refuse treatment. The nurse must notify the
provider, ensure the client understands the consequences, and document the refusal with the client's
words. Forcing treatment constitutes battery. The ethics committee may be consulted later but is not the
first action.
ATI RN Leadership Form B - 100 Verified Questions with Rationales Page 3
, ATI RN LEADERSHIP - FORM B (2026-2027) Comprehensive Practice Exam
Q6: A nurse is caring for a client who has a living will and a DNR order. The client's spouse asks the nurse to
resuscitate the client if he stops breathing. What is the nurse's best response?
A. "I will follow your wishes because you are the next of kin."
B. "The living will and DNR order must be followed; I cannot perform resuscitation." [CORRECT]
C. "I will ask the provider to revoke the DNR order so we can resuscitate."
D. "We can call an attorney to change the advance directive right now."
Correct Answer: B. "The living will and DNR order must be followed; I cannot perform
resuscitation."
Rationale: A living will and DNR order are legal documents representing the client's autonomous
healthcare decisions. They take precedence over family wishes. The nurse must honor the directive;
violating it constitutes unwanted touching (battery). The spouse can be offered emotional support and
education about the document.
Q7: A family member who is not the client's healthcare proxy asks the nurse for information about the client's
diagnosis. Which response by the nurse demonstrates HIPAA compliance?
A. "I can share general information, but specifics require the client's permission." [CORRECT]
B. "Since you are family, I can give you the full diagnosis and treatment plan."
C. "I cannot share any information; you must ask the client directly."
D. "I will share the information only if you sign a confidentiality agreement."
Correct Answer: A. "I can share general information, but specifics require the client's permission."
Rationale: HIPAA allows nurses to share general information (e.g., room location, condition as
stable/guarded) with family members involved in the client's care, unless the client objects. Specific
diagnostic and treatment information requires the client's authorization. The nurse should verify the
client's preferences and document any restrictions.
Q8: An RN delegates taking vital signs to a UAP for a client who is 1 day postoperative. The UAP reports the
client's blood pressure is 88/52 mmHg. What should the RN do first?
A. Instruct the UAP to recheck the BP in 30 minutes
B. Immediately assess the client for signs of hemorrhage and shock [CORRECT]
C. Document the UAP's finding in the medical record
D. Call the provider to request IV fluids
Correct Answer: B. Immediately assess the client for signs of hemorrhage and shock
Rationale: The RN retains accountability for evaluation. A BP of 88/52 in a postoperative client
suggests possible hemorrhage/shock and requires immediate RN assessment. The RN cannot delegate
the clinical judgment of assessing and stabilizing the client; documentation and provider notification
occur after assessment.
ATI RN Leadership Form B - 100 Verified Questions with Rationales Page 4
