ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
ATI RN LEADERSHIP — LATEST VERSION FORM A
Practice Exam | Exam Preparation | Real Exam Questions and Correct Answers
All Answers Are Correct | A+ Grade | 2026-2027 ATI RN Leadership Aligned
Examination structure: 150 multiple-choice questions across 8 sections, aligned with 2026-2027 ATI RN Leadership
standards and NCLEX-RN leadership competencies. Cognitive distribution: approximately 25% recall, 55% application,
and 20% analysis. Question styles include direct recall, scenario-based reasoning, and integrated clinical decision-making
covering delegation (RN/LPN/UAP scope), legal and ethical principles, quality improvement, leadership theories, financial
management, staff management, emergency preparedness, and comprehensive clinical scenarios. For each question,
exactly one option is correct; rationales explain why the correct answer is right and why the distractors reflect common
ATI Leadership errors. Recommended time: 3 hours.
Section 1: Management of Care (Q1–Q35)
Q1. An RN on a med-surg unit is planning care for four clients. Which client should the RN assign
to an experienced LPN/LVN?
A. A client admitted 2 hours ago with acute GI bleeding requiring continuous assessment and IV vasopressin
B. A client with a stage 3 sacral pressure injury requiring wet-to-dry dressing changes and stable vital signs
for 24 hours [CORRECT]
C. A client newly diagnosed with heart failure who needs extensive discharge teaching about medications and diet
D. A client who is 1 hour post-cardiac catheterization requiring frequent neurovascular and vital sign checks
Correct Answer: B
Rationale: Per the Five Rights of Delegation, LPNs/LVNs may care for stable clients with predictable outcomes and may
perform basic wound care and reinforce teaching. Choice B is correct: the client has been stable for 24 hours and the dressing
change is within LPN scope. Choices A, C, and D involve unstable clients, initial assessment, complex interventions, or
extensive initial teaching that must be performed by the RN. The RN retains assessment, diagnosis, planning, evaluation, and
initial education responsibilities.
Q2. A charge nurse is making client assignments for a UAP. Which task is most appropriate to
delegate to the UAP?
A. Measuring and recording intake and output, ambulating a stable client, and performing hygiene
[CORRECT]
B. Reinforcing discharge teaching about wound care for a postoperative client
C. Assessing a client's incision site for signs of infection
D. Administering oral medications to a stable client
Correct Answer: A
Rationale: Per the Five Rights of Delegation, UAPs may perform ADLs (hygiene, ambulation, positioning), measure vital
signs on stable clients, and record intake/output. Choice A is correct. Reinforcing teaching (B), assessment (C), and
medication administration (D) are outside the UAP scope. Assessment, initial teaching, and medication administration
require RN or LPN scope, depending on stability and route. The RN retains accountability for supervision and evaluation of
delegated tasks.
A+ Grade | All Answers Correct | Real Exam Preparation Page 1
,ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
Q3. A nurse witnesses a provider obtain informed consent from a client scheduled for a
colectomy. Which action by the nurse is most appropriate?
A. Explain the surgical procedure, risks, and benefits in detail to ensure the client understands
B. Confirm the client's identity, witness the signature, verify voluntariness, and notify the provider if the
client has unanswered questions [CORRECT]
C. Refuse to witness the consent because the nurse did not perform the assessment
D. Tell the client that they cannot refuse the surgery once consent is signed
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the signature, confirm client identity, verify that the consent is
voluntary, ensure the client has no unanswered questions, and notify the provider if clarification is needed. The provider (not
the nurse) is responsible for explaining the procedure, risks, benefits, and alternatives. Choice B is correct. Choice A
oversteps the nurse's role; choice C misstates the nurse's responsibility; choice D is false — a competent client may withdraw
consent at any time.
Q4. A competent adult client refuses a prescribed blood transfusion due to religious beliefs. Which
action by the nurse is most appropriate?
A. Administer the transfusion anyway because the provider ordered it
B. Respect the client's right to refuse, document the refusal, notify the provider, and continue to provide
alternative care [CORRECT]
C. Have the family override the client's decision
D. Transfer the client to another facility
Correct Answer: B
Rationale: A competent adult has the legal and ethical right to refuse any treatment, including life-saving transfusions, based
on autonomy (Patient Self-Determination Act). The nurse must respect the refusal, document it thoroughly, notify the
provider, and continue alternative care. Choice B is correct. Forced transfusion constitutes battery (A); family cannot
override a competent adult's decision (C); transfer is not the appropriate response (D).
Q5. A client is admitted with a suspected stroke and requires physical restraints to prevent
interference with the IV line. Which action is required by the nurse?
A. Apply restraints indefinitely until the client becomes cooperative
B. Obtain a provider order, ensure face-to-face evaluation within 1 hour of application, reassess every 2 hours
(or per facility policy), and use the least restrictive device [CORRECT]
C. Apply restraints without an order because the client is confused
D. Document only at the end of the shift
Correct Answer: B
Rationale: Restraints require a provider order, a face-to-face evaluation within 1 hour of application (per CMS standards),
use of the least restrictive effective device, ongoing reassessment (typically every 2 hours for physical restraints, every 4
hours for some settings), and detailed documentation. Choice B is correct. Choice A violates time limits and least-restrictive
principle; choice C is illegal (order required); choice D is inadequate documentation. Restraints are a last resort after
alternatives fail.
A+ Grade | All Answers Correct | Real Exam Preparation Page 2
,ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
Q6. Which of the following is a permitted disclosure of Protected Health Information (PHI) under
HIPAA without the client's specific authorization?
A. Releasing client information to a newspaper reporter
B. Sharing client information with the billing department for payment (treatment, payment, healthcare
operations) [CORRECT]
C. Discussing a client's diagnosis with a friend who calls the unit
D. Posting client photos on a personal social media account
Correct Answer: B
Rationale: HIPAA permits disclosure of PHI without specific authorization for treatment, payment, and healthcare
operations (TPO). Choice B is correct. Disclosures to media (A), unauthorized friends (C), and social media (D) are HIPAA
violations subject to civil and criminal penalties. Other permitted disclosures include mandatory reporting (abuse,
communicable diseases) and certain public health activities.
Q7. A nurse is preparing to delegate tasks for the shift. Which principle is part of the Five Rights of
Delegation?
A. Right Task, Right Circumstance, Right Person, Right Direction/Communication, Right
Supervision/Evaluation [CORRECT]
B. Right Time, Right Place, Right Person, Right Documentation, Right Medication
C. Right Task, Right Time, Right Patient, Right Documentation, Right Supervision
D. Right Person, Right Skill, Right Authority, Right Documentation, Right Communication
Correct Answer: A
Rationale: The Five Rights of Delegation (ANA/NCSBN) are: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, and Right Supervision/Evaluation. Choice A is correct. The other options confuse delegation
rights with medication rights or invent hybrid lists. The Five Rights ensure safe, legal delegation and protect client outcomes
while maintaining RN accountability.
Q8. An RN delegates ambulation of a stable postoperative client to a UAP. The UAP reports the
client became dizzy and short of breath during ambulation. What is the RN's most appropriate
action?
A. Tell the UAP to ambulate the client again later
B. Assess the client personally, obtain vital signs, determine whether the activity should continue, and
document the event [CORRECT]
C. Have the UAP ambulate the client a shorter distance
D. Reassign the client to another UAP
Correct Answer: B
Rationale: The RN retains accountability for delegated tasks and must personally assess the client when an adverse event
occurs, obtain vital signs, and use clinical judgment to determine next steps. Choice B is correct. Choice A ignores client
safety; choice C continues an unsafe activity without RN assessment; choice D avoids the issue. RN accountability for
supervision and evaluation cannot be delegated.
A+ Grade | All Answers Correct | Real Exam Preparation Page 3
, ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
Q9. A client has a Living Will and a Durable Power of Attorney for Healthcare (DPOA-HC) on file.
The client becomes unconscious and unable to make decisions. Which statement is correct?
A. The living will designate makes all decisions; the DPOA-HC is invalid
B. The DPOA-HC designee serves as the surrogate decision-maker, using the living will as guidance for the
client's wishes [CORRECT]
C. The provider makes all decisions without consulting anyone
D. The nurse makes decisions based on best interest
Correct Answer: B
Rationale: A DPOA-HC designates a surrogate to make healthcare decisions when the client cannot; the living will provides
written instructions about the client's wishes and serves as guidance for the surrogate and provider. Choice B is correct.
Choice A reverses the roles; choice C bypasses the legal surrogate; choice D is incorrect because the nurse does not make
these decisions. The Patient Self-Determination Act requires facilities to inform clients of these rights.
Q10. A client asks the nurse to explain the procedure, risks, and alternatives for an upcoming
cardiac catheterization because the provider did not adequately explain them. What is the nurse's
most appropriate action?
A. Explain the procedure thoroughly and document that consent was obtained
B. Notify the provider that the client has unanswered questions and request that the provider return to
discuss the procedure before consent is signed [CORRECT]
C. Tell the client to sign anyway and ask questions later
D. Have another nurse explain the procedure
Correct Answer: B
Rationale: Informed consent requires that the provider performing the procedure explain the procedure, risks, benefits,
alternatives, and consequences of refusal. If the client has unanswered questions, the nurse must notify the provider and
request the provider return before the consent is signed. Choice B is correct. Choice A is outside the nurse's role; choice C
invalidates informed consent; choice D does not meet legal requirements for consent.
Q11. Which task should NOT be delegated to a UAP?
A. Ambulating a stable client
B. Measuring and recording vital signs on a stable client
C. Performing an initial admission assessment of a newly admitted client [CORRECT]
D. Assisting a client with bathing and oral hygiene
Correct Answer: C
Rationale: Initial assessments cannot be delegated to UAPs. The nursing process (assessment, diagnosis, planning,
evaluation) is within the RN scope. Choice C is the correct answer (the task that should NOT be delegated). Choices A, B,
and D are appropriate UAP tasks. UAPs may measure vital signs but cannot interpret them or perform initial assessments.
Q12. A client with a DNR order stops breathing and has no pulse. The family at the bedside begs
the nurse to 'do something.' What is the nurse's most appropriate action?
A. Initiate CPR because the family is requesting it
B. Honor the DNR order, provide comfort measures, and explain the order to the family [CORRECT]
C. Call a code but not perform compressions
D. Ask the provider to revoke the DNR
Correct Answer: B
Rationale: A DNR (Do Not Resuscitate) order is a medical order that must be honored. The nurse provides comfort
measures and explains the order compassionately to the family. Choice B is correct. Initiating CPR violates the order (A);
calling a code without performing compressions is contradictory (C); the DNR should not be revoked based on family
request if the client's wishes are documented (D). The nurse should advocate for the client's documented wishes.
A+ Grade | All Answers Correct | Real Exam Preparation Page 4
ATI RN LEADERSHIP — LATEST VERSION FORM A
Practice Exam | Exam Preparation | Real Exam Questions and Correct Answers
All Answers Are Correct | A+ Grade | 2026-2027 ATI RN Leadership Aligned
Examination structure: 150 multiple-choice questions across 8 sections, aligned with 2026-2027 ATI RN Leadership
standards and NCLEX-RN leadership competencies. Cognitive distribution: approximately 25% recall, 55% application,
and 20% analysis. Question styles include direct recall, scenario-based reasoning, and integrated clinical decision-making
covering delegation (RN/LPN/UAP scope), legal and ethical principles, quality improvement, leadership theories, financial
management, staff management, emergency preparedness, and comprehensive clinical scenarios. For each question,
exactly one option is correct; rationales explain why the correct answer is right and why the distractors reflect common
ATI Leadership errors. Recommended time: 3 hours.
Section 1: Management of Care (Q1–Q35)
Q1. An RN on a med-surg unit is planning care for four clients. Which client should the RN assign
to an experienced LPN/LVN?
A. A client admitted 2 hours ago with acute GI bleeding requiring continuous assessment and IV vasopressin
B. A client with a stage 3 sacral pressure injury requiring wet-to-dry dressing changes and stable vital signs
for 24 hours [CORRECT]
C. A client newly diagnosed with heart failure who needs extensive discharge teaching about medications and diet
D. A client who is 1 hour post-cardiac catheterization requiring frequent neurovascular and vital sign checks
Correct Answer: B
Rationale: Per the Five Rights of Delegation, LPNs/LVNs may care for stable clients with predictable outcomes and may
perform basic wound care and reinforce teaching. Choice B is correct: the client has been stable for 24 hours and the dressing
change is within LPN scope. Choices A, C, and D involve unstable clients, initial assessment, complex interventions, or
extensive initial teaching that must be performed by the RN. The RN retains assessment, diagnosis, planning, evaluation, and
initial education responsibilities.
Q2. A charge nurse is making client assignments for a UAP. Which task is most appropriate to
delegate to the UAP?
A. Measuring and recording intake and output, ambulating a stable client, and performing hygiene
[CORRECT]
B. Reinforcing discharge teaching about wound care for a postoperative client
C. Assessing a client's incision site for signs of infection
D. Administering oral medications to a stable client
Correct Answer: A
Rationale: Per the Five Rights of Delegation, UAPs may perform ADLs (hygiene, ambulation, positioning), measure vital
signs on stable clients, and record intake/output. Choice A is correct. Reinforcing teaching (B), assessment (C), and
medication administration (D) are outside the UAP scope. Assessment, initial teaching, and medication administration
require RN or LPN scope, depending on stability and route. The RN retains accountability for supervision and evaluation of
delegated tasks.
A+ Grade | All Answers Correct | Real Exam Preparation Page 1
,ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
Q3. A nurse witnesses a provider obtain informed consent from a client scheduled for a
colectomy. Which action by the nurse is most appropriate?
A. Explain the surgical procedure, risks, and benefits in detail to ensure the client understands
B. Confirm the client's identity, witness the signature, verify voluntariness, and notify the provider if the
client has unanswered questions [CORRECT]
C. Refuse to witness the consent because the nurse did not perform the assessment
D. Tell the client that they cannot refuse the surgery once consent is signed
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the signature, confirm client identity, verify that the consent is
voluntary, ensure the client has no unanswered questions, and notify the provider if clarification is needed. The provider (not
the nurse) is responsible for explaining the procedure, risks, benefits, and alternatives. Choice B is correct. Choice A
oversteps the nurse's role; choice C misstates the nurse's responsibility; choice D is false — a competent client may withdraw
consent at any time.
Q4. A competent adult client refuses a prescribed blood transfusion due to religious beliefs. Which
action by the nurse is most appropriate?
A. Administer the transfusion anyway because the provider ordered it
B. Respect the client's right to refuse, document the refusal, notify the provider, and continue to provide
alternative care [CORRECT]
C. Have the family override the client's decision
D. Transfer the client to another facility
Correct Answer: B
Rationale: A competent adult has the legal and ethical right to refuse any treatment, including life-saving transfusions, based
on autonomy (Patient Self-Determination Act). The nurse must respect the refusal, document it thoroughly, notify the
provider, and continue alternative care. Choice B is correct. Forced transfusion constitutes battery (A); family cannot
override a competent adult's decision (C); transfer is not the appropriate response (D).
Q5. A client is admitted with a suspected stroke and requires physical restraints to prevent
interference with the IV line. Which action is required by the nurse?
A. Apply restraints indefinitely until the client becomes cooperative
B. Obtain a provider order, ensure face-to-face evaluation within 1 hour of application, reassess every 2 hours
(or per facility policy), and use the least restrictive device [CORRECT]
C. Apply restraints without an order because the client is confused
D. Document only at the end of the shift
Correct Answer: B
Rationale: Restraints require a provider order, a face-to-face evaluation within 1 hour of application (per CMS standards),
use of the least restrictive effective device, ongoing reassessment (typically every 2 hours for physical restraints, every 4
hours for some settings), and detailed documentation. Choice B is correct. Choice A violates time limits and least-restrictive
principle; choice C is illegal (order required); choice D is inadequate documentation. Restraints are a last resort after
alternatives fail.
A+ Grade | All Answers Correct | Real Exam Preparation Page 2
,ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
Q6. Which of the following is a permitted disclosure of Protected Health Information (PHI) under
HIPAA without the client's specific authorization?
A. Releasing client information to a newspaper reporter
B. Sharing client information with the billing department for payment (treatment, payment, healthcare
operations) [CORRECT]
C. Discussing a client's diagnosis with a friend who calls the unit
D. Posting client photos on a personal social media account
Correct Answer: B
Rationale: HIPAA permits disclosure of PHI without specific authorization for treatment, payment, and healthcare
operations (TPO). Choice B is correct. Disclosures to media (A), unauthorized friends (C), and social media (D) are HIPAA
violations subject to civil and criminal penalties. Other permitted disclosures include mandatory reporting (abuse,
communicable diseases) and certain public health activities.
Q7. A nurse is preparing to delegate tasks for the shift. Which principle is part of the Five Rights of
Delegation?
A. Right Task, Right Circumstance, Right Person, Right Direction/Communication, Right
Supervision/Evaluation [CORRECT]
B. Right Time, Right Place, Right Person, Right Documentation, Right Medication
C. Right Task, Right Time, Right Patient, Right Documentation, Right Supervision
D. Right Person, Right Skill, Right Authority, Right Documentation, Right Communication
Correct Answer: A
Rationale: The Five Rights of Delegation (ANA/NCSBN) are: Right Task, Right Circumstance, Right Person, Right
Direction/Communication, and Right Supervision/Evaluation. Choice A is correct. The other options confuse delegation
rights with medication rights or invent hybrid lists. The Five Rights ensure safe, legal delegation and protect client outcomes
while maintaining RN accountability.
Q8. An RN delegates ambulation of a stable postoperative client to a UAP. The UAP reports the
client became dizzy and short of breath during ambulation. What is the RN's most appropriate
action?
A. Tell the UAP to ambulate the client again later
B. Assess the client personally, obtain vital signs, determine whether the activity should continue, and
document the event [CORRECT]
C. Have the UAP ambulate the client a shorter distance
D. Reassign the client to another UAP
Correct Answer: B
Rationale: The RN retains accountability for delegated tasks and must personally assess the client when an adverse event
occurs, obtain vital signs, and use clinical judgment to determine next steps. Choice B is correct. Choice A ignores client
safety; choice C continues an unsafe activity without RN assessment; choice D avoids the issue. RN accountability for
supervision and evaluation cannot be delegated.
A+ Grade | All Answers Correct | Real Exam Preparation Page 3
, ATI RN Leadership | Form A | 2026-2027 Edition | 150 Questions & Correct Answers
Q9. A client has a Living Will and a Durable Power of Attorney for Healthcare (DPOA-HC) on file.
The client becomes unconscious and unable to make decisions. Which statement is correct?
A. The living will designate makes all decisions; the DPOA-HC is invalid
B. The DPOA-HC designee serves as the surrogate decision-maker, using the living will as guidance for the
client's wishes [CORRECT]
C. The provider makes all decisions without consulting anyone
D. The nurse makes decisions based on best interest
Correct Answer: B
Rationale: A DPOA-HC designates a surrogate to make healthcare decisions when the client cannot; the living will provides
written instructions about the client's wishes and serves as guidance for the surrogate and provider. Choice B is correct.
Choice A reverses the roles; choice C bypasses the legal surrogate; choice D is incorrect because the nurse does not make
these decisions. The Patient Self-Determination Act requires facilities to inform clients of these rights.
Q10. A client asks the nurse to explain the procedure, risks, and alternatives for an upcoming
cardiac catheterization because the provider did not adequately explain them. What is the nurse's
most appropriate action?
A. Explain the procedure thoroughly and document that consent was obtained
B. Notify the provider that the client has unanswered questions and request that the provider return to
discuss the procedure before consent is signed [CORRECT]
C. Tell the client to sign anyway and ask questions later
D. Have another nurse explain the procedure
Correct Answer: B
Rationale: Informed consent requires that the provider performing the procedure explain the procedure, risks, benefits,
alternatives, and consequences of refusal. If the client has unanswered questions, the nurse must notify the provider and
request the provider return before the consent is signed. Choice B is correct. Choice A is outside the nurse's role; choice C
invalidates informed consent; choice D does not meet legal requirements for consent.
Q11. Which task should NOT be delegated to a UAP?
A. Ambulating a stable client
B. Measuring and recording vital signs on a stable client
C. Performing an initial admission assessment of a newly admitted client [CORRECT]
D. Assisting a client with bathing and oral hygiene
Correct Answer: C
Rationale: Initial assessments cannot be delegated to UAPs. The nursing process (assessment, diagnosis, planning,
evaluation) is within the RN scope. Choice C is the correct answer (the task that should NOT be delegated). Choices A, B,
and D are appropriate UAP tasks. UAPs may measure vital signs but cannot interpret them or perform initial assessments.
Q12. A client with a DNR order stops breathing and has no pulse. The family at the bedside begs
the nurse to 'do something.' What is the nurse's most appropriate action?
A. Initiate CPR because the family is requesting it
B. Honor the DNR order, provide comfort measures, and explain the order to the family [CORRECT]
C. Call a code but not perform compressions
D. Ask the provider to revoke the DNR
Correct Answer: B
Rationale: A DNR (Do Not Resuscitate) order is a medical order that must be honored. The nurse provides comfort
measures and explains the order compassionately to the family. Choice B is correct. Initiating CPR violates the order (A);
calling a code without performing compressions is contradictory (C); the DNR should not be revoked based on family
request if the client's wishes are documented (D). The nurse should advocate for the client's documented wishes.
A+ Grade | All Answers Correct | Real Exam Preparation Page 4
