ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
ATI RN Leadership 2026
Enhanced NGN Practice Exam
Total Questions Question Type Time Limit
70 Multiple Choice (Single 2 Hours
Answer) (Recommended)
Instructions:
1. Read each question carefully before selecting the best answer.
2. Select only one answer for each question (A, B, C, or D).
3. There is no penalty for guessing; answer every question.
4. The answer key with detailed rationales is provided at the end of this exam.
5. Topics covered include: delegation, prioritization, leadership styles,
conflict resolution, legal and ethical issues, quality improvement, staffing,
communication, and change management.
Answer key at the end
1. Anurse manager is assigning tasks for the upcoming shift. Which task is most
appropriate to delegate to an unlicensed assistive personnel (UAP)?
A. Administering oral medications to a stable patient
B. Performing a focused respiratory assessment on a postoperative patient
C. Recording intake and output for a patient with heart failure
D. Evaluating the effectiveness of a new pain management plan
2. The nurse receives change-of-shift report on four patients. Which patient should
the nurse assess first?
A. A patient who is scheduled for a computed tomography (CT) scan at 1000
B. A patient with type 2 diabetes who has a blood glucose level of 180 mg/dL
C. A patient with chronic obstructive pulmonary disease (COPD) who has a
respiratory rate of 28 breaths per minute
D. A patient who is 2 days postoperative and reports pain at the incision site of
4 on a 0-to-10 scale
3. Anurse manager notices that staff morale on the unit has been declining
over the past month. Several nurses have expressed feeling micromanaged
and untrusted. Which leadership style is the manager most likely using, and
Page 1
,ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
what change would be most beneficial?
A. Democratic leadership; the manager should make all decisions
independently to improve efficiency
B. Autocratic leadership; the manager should shift toward a more participative
approach to empower staff
C. Laissez-faire leadership; the manager should implement stricter policies
and closer supervision
D. Transformational leadership; the manager should reduce goal-setting and
focus entirely on day-to-day tasks
4. A nurse is caring for a patient who refuses a blood transfusion based on
religious beliefs. The patient is competent and fully oriented. What is the
nurse's most appropriate action?
A. Obtain a court order to override the patient's refusal
B. Administer the blood transfusion while the patient is sleeping
C. Respect the patient's autonomous decision and document the refusal
D. Contact the patient's family to persuade the patient to accept the transfusion
Page 2
,ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
5. Ahospital unit is implementing a new quality improvement initiative to
reduce hospital-acquired pressure injuries. Which tool is most appropriate for
identifying the root cause of a specific pressure injury event?
A. Gantt chart
B. Fishbone (Ishikawa) diagram
C. Run chart
D. Pareto chart
6. A charge nurse is making patient assignments for the shift. There is a newly
licensed RN, an experienced RN, and two UAPs on the team. Which assignment
strategy demonstrates the best use of scope of practice?
A. Assign the newly licensed RN to the most critically ill patient to gain
experience
B. Assign the experienced RN to the most complex patient and pair the new
RN with a stable patient
C. Assign both UAPs to vital signs and ambulation for all patients to
maximize efficiency
D. Assign the newly licensed RN to float to another unit where staffing is
short
7. Two nurses on the unit have an ongoing disagreement about the procedure for
administering intravenous
(IV) medications. The conflict is affecting team cohesion and patient care. What is
the nurse manager's best initial approach?
A. Transfer one of the nurses to a different unit to separate them
B. Ignore the conflict and hope it resolves on its own over time
C. Facilitate a collaborative discussion between the two nurses to reach a
consensus
D. Reprimand both nurses formally for unprofessional behavior
8. A
nurse is receiving a telephone order from a healthcare provider for a
new medication. What is the correct sequence of actions?
A. Write the order, administer the medication, then read back the order to the
provider
B. Read back the complete order to the provider, document as a telephone
order, and obtain the provider's co-signature within 24 hours
C. Ask the provider to send a written order instead, then administer the
medication
D. Administer the medication immediately, then document the order after the
Page 3
, ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
shift
9. A nurse manager is reviewing the staffing schedule and notices that the
patient acuity on the unit has increased significantly over the past week, but the
number of nursing staff has remained the same. What is the manager's most
appropriate action?
A. Wait until the next staffing committee meeting to address the issue
B. Reassign non-nursing tasks to reduce nurse workload
C. Adjust the staffing plan by requesting additional nurses or per diem staff to
match patient acuity
D. Advise nurses to work faster to compensate for the increased workload
10. A hospital is transitioning from paper charting to an electronic health
record (EHR) system. Several experienced nurses are resistant to the change,
expressing concern about their ability to learn the new technology. Which
strategy should the nurse leader use to address this resistance?
A. Mandate that all nurses complete the training within one week or face
disciplinary action
B. Involve the resistant nurses as super-users and peer mentors to build
ownership of the change
C. Exempt experienced nurses from using the EHR and allow them to
continue paper charting
D. Ignore the resistance and focus only on training the newer, more receptive
staff members
Page 4
ATI RN Leadership 2026
Enhanced NGN Practice Exam
Total Questions Question Type Time Limit
70 Multiple Choice (Single 2 Hours
Answer) (Recommended)
Instructions:
1. Read each question carefully before selecting the best answer.
2. Select only one answer for each question (A, B, C, or D).
3. There is no penalty for guessing; answer every question.
4. The answer key with detailed rationales is provided at the end of this exam.
5. Topics covered include: delegation, prioritization, leadership styles,
conflict resolution, legal and ethical issues, quality improvement, staffing,
communication, and change management.
Answer key at the end
1. Anurse manager is assigning tasks for the upcoming shift. Which task is most
appropriate to delegate to an unlicensed assistive personnel (UAP)?
A. Administering oral medications to a stable patient
B. Performing a focused respiratory assessment on a postoperative patient
C. Recording intake and output for a patient with heart failure
D. Evaluating the effectiveness of a new pain management plan
2. The nurse receives change-of-shift report on four patients. Which patient should
the nurse assess first?
A. A patient who is scheduled for a computed tomography (CT) scan at 1000
B. A patient with type 2 diabetes who has a blood glucose level of 180 mg/dL
C. A patient with chronic obstructive pulmonary disease (COPD) who has a
respiratory rate of 28 breaths per minute
D. A patient who is 2 days postoperative and reports pain at the incision site of
4 on a 0-to-10 scale
3. Anurse manager notices that staff morale on the unit has been declining
over the past month. Several nurses have expressed feeling micromanaged
and untrusted. Which leadership style is the manager most likely using, and
Page 1
,ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
what change would be most beneficial?
A. Democratic leadership; the manager should make all decisions
independently to improve efficiency
B. Autocratic leadership; the manager should shift toward a more participative
approach to empower staff
C. Laissez-faire leadership; the manager should implement stricter policies
and closer supervision
D. Transformational leadership; the manager should reduce goal-setting and
focus entirely on day-to-day tasks
4. A nurse is caring for a patient who refuses a blood transfusion based on
religious beliefs. The patient is competent and fully oriented. What is the
nurse's most appropriate action?
A. Obtain a court order to override the patient's refusal
B. Administer the blood transfusion while the patient is sleeping
C. Respect the patient's autonomous decision and document the refusal
D. Contact the patient's family to persuade the patient to accept the transfusion
Page 2
,ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
5. Ahospital unit is implementing a new quality improvement initiative to
reduce hospital-acquired pressure injuries. Which tool is most appropriate for
identifying the root cause of a specific pressure injury event?
A. Gantt chart
B. Fishbone (Ishikawa) diagram
C. Run chart
D. Pareto chart
6. A charge nurse is making patient assignments for the shift. There is a newly
licensed RN, an experienced RN, and two UAPs on the team. Which assignment
strategy demonstrates the best use of scope of practice?
A. Assign the newly licensed RN to the most critically ill patient to gain
experience
B. Assign the experienced RN to the most complex patient and pair the new
RN with a stable patient
C. Assign both UAPs to vital signs and ambulation for all patients to
maximize efficiency
D. Assign the newly licensed RN to float to another unit where staffing is
short
7. Two nurses on the unit have an ongoing disagreement about the procedure for
administering intravenous
(IV) medications. The conflict is affecting team cohesion and patient care. What is
the nurse manager's best initial approach?
A. Transfer one of the nurses to a different unit to separate them
B. Ignore the conflict and hope it resolves on its own over time
C. Facilitate a collaborative discussion between the two nurses to reach a
consensus
D. Reprimand both nurses formally for unprofessional behavior
8. A
nurse is receiving a telephone order from a healthcare provider for a
new medication. What is the correct sequence of actions?
A. Write the order, administer the medication, then read back the order to the
provider
B. Read back the complete order to the provider, document as a telephone
order, and obtain the provider's co-signature within 24 hours
C. Ask the provider to send a written order instead, then administer the
medication
D. Administer the medication immediately, then document the order after the
Page 3
, ATI RN Leadership 2026 - Enhanced NGN Practice Exam 70 Questions | Multiple Choice
shift
9. A nurse manager is reviewing the staffing schedule and notices that the
patient acuity on the unit has increased significantly over the past week, but the
number of nursing staff has remained the same. What is the manager's most
appropriate action?
A. Wait until the next staffing committee meeting to address the issue
B. Reassign non-nursing tasks to reduce nurse workload
C. Adjust the staffing plan by requesting additional nurses or per diem staff to
match patient acuity
D. Advise nurses to work faster to compensate for the increased workload
10. A hospital is transitioning from paper charting to an electronic health
record (EHR) system. Several experienced nurses are resistant to the change,
expressing concern about their ability to learn the new technology. Which
strategy should the nurse leader use to address this resistance?
A. Mandate that all nurses complete the training within one week or face
disciplinary action
B. Involve the resistant nurses as super-users and peer mentors to build
ownership of the change
C. Exempt experienced nurses from using the EHR and allow them to
continue paper charting
D. Ignore the resistance and focus only on training the newer, more receptive
staff members
Page 4
