ATI RN LEADERSHIP PROCTORED
ASSESSMENT 2026/2027
COMPREHENSIVE EXAM
1. A nurse manager is dealing with a conflict between two staff nurses regarding the holiday
schedule. The manager decides to use a ‘smoothing’ strategy. Which of the following actions
should the manager take?
A. Focus on the areas of agreement rather than the differences.
B. Force the nurses to reach an immediate agreement.
C. Suggest that each nurse give up something to reach a middle ground.
D. Collaborate to find a new solution that satisfies both nurses.
Answer: A
Conceptual Explanation: Smoothing is a conflict resolution strategy where the focus is on
areas of agreement to minimize the conflict, though it does not usually resolve the
underlying problem.
2. A charge nurse is delegating tasks to an Assistive Personnel (AP). Which of the following
tasks is appropriate to delegate?
A. Measuring and recording a client’s intake and output.
,B. Providing discharge instructions to a stable client.
C. Performing a simple dressing change on a post-operative wound.
D. Evaluating a client’s response to pain medication.
Answer: A
Conceptual Explanation: Measuring intake and output is a routine task within the scope
of practice for AP. Evaluation, teaching, and complex procedures require the judgment of a
licensed nurse.
3. A nurse is caring for a group of clients. Which client should the nurse assess first?
A. A client who is scheduled for physical therapy in 30 minutes.
B. A client who needs a dressing change for a chronic pressure ulcer.
C. A client with a new onset of confusion and restlessness.
D. A client requesting a PRN medication for mild nausea.
Answer: C
Conceptual Explanation: Using the ABC framework and prioritizing acute vs chronic, a
new onset of confusion can indicate hypoxia or neurological changes and requires
immediate assessment.
4. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘Unfreezing’ stage?
A. Training the staff on how to use the new software.
, B. Integrating the new system into the daily unit routine.
C. Creating dissatisfaction with the current paper-based system.
D. Auditing the accuracy of the new electronic entries.
Answer: C
Conceptual Explanation: Unfreezing involves creating the need for change and preparing
the group for the realization that the current status quo is no longer productive.
5. A nurse is reviewing the Code of Ethics for Nurses. Which ethical principle is the nurse
demonstrating when supporting a client’s right to refuse a recommended surgery?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
Answer: D
Conceptual Explanation: Autonomy is the right of the client to make their own decisions
about their healthcare, even if those decisions conflict with the medical team’s advice.
6. Which of the following is an example of an ‘Outcome Audit’ in a quality improvement
program?
A. Evaluating the availability of specialized equipment on the unit.
B. Checking if nurses followed the hand hygiene protocol before procedures.
ASSESSMENT 2026/2027
COMPREHENSIVE EXAM
1. A nurse manager is dealing with a conflict between two staff nurses regarding the holiday
schedule. The manager decides to use a ‘smoothing’ strategy. Which of the following actions
should the manager take?
A. Focus on the areas of agreement rather than the differences.
B. Force the nurses to reach an immediate agreement.
C. Suggest that each nurse give up something to reach a middle ground.
D. Collaborate to find a new solution that satisfies both nurses.
Answer: A
Conceptual Explanation: Smoothing is a conflict resolution strategy where the focus is on
areas of agreement to minimize the conflict, though it does not usually resolve the
underlying problem.
2. A charge nurse is delegating tasks to an Assistive Personnel (AP). Which of the following
tasks is appropriate to delegate?
A. Measuring and recording a client’s intake and output.
,B. Providing discharge instructions to a stable client.
C. Performing a simple dressing change on a post-operative wound.
D. Evaluating a client’s response to pain medication.
Answer: A
Conceptual Explanation: Measuring intake and output is a routine task within the scope
of practice for AP. Evaluation, teaching, and complex procedures require the judgment of a
licensed nurse.
3. A nurse is caring for a group of clients. Which client should the nurse assess first?
A. A client who is scheduled for physical therapy in 30 minutes.
B. A client who needs a dressing change for a chronic pressure ulcer.
C. A client with a new onset of confusion and restlessness.
D. A client requesting a PRN medication for mild nausea.
Answer: C
Conceptual Explanation: Using the ABC framework and prioritizing acute vs chronic, a
new onset of confusion can indicate hypoxia or neurological changes and requires
immediate assessment.
4. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action represents the ‘Unfreezing’ stage?
A. Training the staff on how to use the new software.
, B. Integrating the new system into the daily unit routine.
C. Creating dissatisfaction with the current paper-based system.
D. Auditing the accuracy of the new electronic entries.
Answer: C
Conceptual Explanation: Unfreezing involves creating the need for change and preparing
the group for the realization that the current status quo is no longer productive.
5. A nurse is reviewing the Code of Ethics for Nurses. Which ethical principle is the nurse
demonstrating when supporting a client’s right to refuse a recommended surgery?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
Answer: D
Conceptual Explanation: Autonomy is the right of the client to make their own decisions
about their healthcare, even if those decisions conflict with the medical team’s advice.
6. Which of the following is an example of an ‘Outcome Audit’ in a quality improvement
program?
A. Evaluating the availability of specialized equipment on the unit.
B. Checking if nurses followed the hand hygiene protocol before procedures.
