ATI Leadership | Prioritization & NCLEX-RN Decision-Making Practice
Pack | U.S. Nursing 2026/2027 |Questions |Answers |Rationales
1. A charge nurse is delegating tasks to an assistive personnel (AP). Which of the
following tasks is appropriate for the nurse to delegate?
A. Evaluating a client’s response to pain medication
B. Performing a sterile dressing change on a central line
C. Teaching a client how to use an incentive spirometer
D. Assisting a client with a sitz bath after a vaginal delivery
Answer: D
Rationale: Assisting with a sitz bath is a routine task that falls within the scope of practice
for an AP. Evaluation, sterile procedures, and teaching require the skills and knowledge of a
licensed nurse.
2. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with pneumonia who has a new onset of confusion
B. A client with a history of heart failure who has 2+ pitting edema
C. A client who is 24 hours post-op and reports pain as 6 out of 10
D. A client with a wound infection and a temperature of 38.3 C (101 F)
Answer: A
Rationale: New onset confusion can be a sign of hypoxia or sepsis and requires immediate
assessment (ABC priority). Edema, moderate pain, and low-grade fever are expected
findings for those conditions.
,3. A nurse manager is discussing the Five Rights of Delegation with a group of
newly licensed nurses. Which of the following should be included?
A. Right place
B. Right circumstance
C. Right documentation
D. Right cost
Answer: B
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person,
Right Direction/Communication, and Right Supervision/Evaluation.
4. A nurse is assigning tasks to a licensed practical nurse (LPN). Which of the
following clients should be assigned to the LPN?
A. A client who is being admitted for chest pain and needs an initial assessment
B. A client who is scheduled for a surgical procedure and needs informed consent explained
C. A client with a tracheostomy who requires routine suctioning
D. A client with a new diagnosis of diabetes who needs insulin teaching
Answer: C
Rationale: LPNs can perform routine procedures like tracheostomy suctioning for stable
clients. Initial assessments, informed consent explanations, and initial education require an
RN.
5. A nurse is planning to use the SBAR communication tool during a hand-off
report. Which information belongs in the ‘B’ (Background) section?
A. The client’s current vital signs
B. The nurse’s recommendation for a change in treatment
C. The client’s medical history and reason for admission
D. A statement of the problem being reported
Answer: C
, Rationale: In SBAR, ‘B’ stands for Background, which includes the client’s history, allergies,
and admission diagnosis. ‘S’ is Situation, ‘A’ is Assessment (current status/vitals), and ‘R’ is
Recommendation.
6. A charge nurse is observing a nurse providing care to a client who has a living
will. The client’s family is asking the nurse to perform life-saving measures that
the client has refused in the document. Which action should the nurse take?
A. Follow the family’s wishes to avoid a lawsuit
B. Refer the matter to the hospital ethics committee immediately
C. Honor the client’s wishes as stated in the living will
D. Perform the measures and discuss it with the client later
Answer: C
Rationale: A living will is a legal document that expresses the client’s wishes regarding
end-of-life care. The nurse’s legal and ethical obligation is to follow the client’s advance
directives.
7. Which of the following leadership styles is characterized by a leader who
makes decisions without consulting the staff and dictates all tasks?
A. Democratic
B. Autocratic
C. Laissez-faire
D. Transactional
Answer: B
Rationale: Autocratic (or authoritarian) leadership involves centralized decision-making
with little to no input from others. Democratic involves staff input, and Laissez-faire is
hands-off.
Pack | U.S. Nursing 2026/2027 |Questions |Answers |Rationales
1. A charge nurse is delegating tasks to an assistive personnel (AP). Which of the
following tasks is appropriate for the nurse to delegate?
A. Evaluating a client’s response to pain medication
B. Performing a sterile dressing change on a central line
C. Teaching a client how to use an incentive spirometer
D. Assisting a client with a sitz bath after a vaginal delivery
Answer: D
Rationale: Assisting with a sitz bath is a routine task that falls within the scope of practice
for an AP. Evaluation, sterile procedures, and teaching require the skills and knowledge of a
licensed nurse.
2. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with pneumonia who has a new onset of confusion
B. A client with a history of heart failure who has 2+ pitting edema
C. A client who is 24 hours post-op and reports pain as 6 out of 10
D. A client with a wound infection and a temperature of 38.3 C (101 F)
Answer: A
Rationale: New onset confusion can be a sign of hypoxia or sepsis and requires immediate
assessment (ABC priority). Edema, moderate pain, and low-grade fever are expected
findings for those conditions.
,3. A nurse manager is discussing the Five Rights of Delegation with a group of
newly licensed nurses. Which of the following should be included?
A. Right place
B. Right circumstance
C. Right documentation
D. Right cost
Answer: B
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person,
Right Direction/Communication, and Right Supervision/Evaluation.
4. A nurse is assigning tasks to a licensed practical nurse (LPN). Which of the
following clients should be assigned to the LPN?
A. A client who is being admitted for chest pain and needs an initial assessment
B. A client who is scheduled for a surgical procedure and needs informed consent explained
C. A client with a tracheostomy who requires routine suctioning
D. A client with a new diagnosis of diabetes who needs insulin teaching
Answer: C
Rationale: LPNs can perform routine procedures like tracheostomy suctioning for stable
clients. Initial assessments, informed consent explanations, and initial education require an
RN.
5. A nurse is planning to use the SBAR communication tool during a hand-off
report. Which information belongs in the ‘B’ (Background) section?
A. The client’s current vital signs
B. The nurse’s recommendation for a change in treatment
C. The client’s medical history and reason for admission
D. A statement of the problem being reported
Answer: C
, Rationale: In SBAR, ‘B’ stands for Background, which includes the client’s history, allergies,
and admission diagnosis. ‘S’ is Situation, ‘A’ is Assessment (current status/vitals), and ‘R’ is
Recommendation.
6. A charge nurse is observing a nurse providing care to a client who has a living
will. The client’s family is asking the nurse to perform life-saving measures that
the client has refused in the document. Which action should the nurse take?
A. Follow the family’s wishes to avoid a lawsuit
B. Refer the matter to the hospital ethics committee immediately
C. Honor the client’s wishes as stated in the living will
D. Perform the measures and discuss it with the client later
Answer: C
Rationale: A living will is a legal document that expresses the client’s wishes regarding
end-of-life care. The nurse’s legal and ethical obligation is to follow the client’s advance
directives.
7. Which of the following leadership styles is characterized by a leader who
makes decisions without consulting the staff and dictates all tasks?
A. Democratic
B. Autocratic
C. Laissez-faire
D. Transactional
Answer: B
Rationale: Autocratic (or authoritarian) leadership involves centralized decision-making
with little to no input from others. Democratic involves staff input, and Laissez-faire is
hands-off.
