ATI260 ATI Leadership Proctored Exam – ATI
Leadership Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Assessment
Preparation, Nursing Leadership & Management
Review, Delegation, Prioritization, Supervision,
Conflict Resolution, Ethical & Legal Responsibilities,
Patient Safety, Quality Improvement, Case
Management, Communication, Staff Management,
Disaster Triage & NGN-Style Clinical Judgment
Question 1: A nurse manager is reviewing the budget for the upcoming fiscal
year. Which of the following types of budget forecasting takes into account the
previous year's actual expenditures and adjusts for anticipated changes in
volume and cost?
A. Zero-based budgeting
B. Fixed budgeting
C. Incremental budgeting
D. Performance-based budgeting
CORRECT ANSWER: C. Incremental budgeting
Rationale: Incremental budgeting starts with the previous period's actual spending and
adjusts it for expected increases or decreases in costs and volume. Zero-based
budgeting starts from zero each period, fixed budgeting sets strict limits not adjusted for
volume, and performance-based budgeting links funding to measurable outcomes.
Question 2: A charge nurse is delegating tasks to licensed practical nurses
(LPNs) and unlicensed assistive personnel (UAP). Which of the following tasks
is appropriate to delegate to the UAP?
A. Administering oral medications to a stable patient
B. Performing a sterile wound dressing change
C. Feeding a patient with dysphagia who is on aspiration precautions
D. Obtaining a routine capillary blood glucose level
CORRECT ANSWER: D. Obtaining a routine capillary blood glucose level
Rationale: Obtaining routine capillary blood glucose is within the scope of practice for
UAP after proper training and competency verification. Administering medications,
sterile wound care, and feeding dysphagic patients require licensed nursing assessment
and judgment.
Question 3: A nurse on a medical-surgical unit is caring for a patient who is a
member of a religious group that refuses blood transfusions. The patient
,requires surgery with a high probability of transfusion. Which of the following
actions should the nurse take?
A. Inform the patient that a transfusion will be given if medically necessary.
B. Ask the patient to sign a waiver releasing the hospital from liability.
C. Notify the surgeon of the patient's preference and consult the hospital's ethics
committee.
D. Arrange for a court order mandating the transfusion.
CORRECT ANSWER: C. Notify the surgeon of the patient's preference and
consult the hospital's ethics committee.
Rationale: The nurse must respect the patient's autonomy and religious beliefs while
ensuring that the healthcare team is aware of the patient's wishes. The ethics committee
can help navigate complex situations involving life-saving treatment and patient refusal.
Question 4: A unit manager is evaluating the cost-effectiveness of a new
wound care product. Which of the following metrics would provide the most
comprehensive analysis of the product's financial impact?
A. The unit cost of the dressing
B. The number of dressing changes per day
C. The total cost of care including nursing time and healing outcomes
D. The patient's length of stay
CORRECT ANSWER: C. The total cost of care including nursing time and
healing outcomes
Rationale: A comprehensive cost-effectiveness analysis looks beyond just the purchase
price to include nursing time, frequency of changes, infection rates, and healing
outcomes. This provides the true financial and clinical value of the product.
Question 5: A nurse leader is implementing a shared governance model on the
unit. Which of the following is a primary characteristic of this model?
A. Administrative decisions are made by the nurse manager without input from staff.
B. Staff nurses have a formal role in decision-making regarding clinical practice and unit
operations.
C. The primary goal is to reduce the number of nurses on the unit.
D. All decisions are made by a union representative.
CORRECT ANSWER: B. Staff nurses have a formal role in decision-making
regarding clinical practice and unit operations.
Rationale: Shared governance empowers nurses at the point of care to participate in
decisions about practice, quality, and professional development, fostering ownership and
accountability. It decentralizes decision-making.
,Question 6: During a disaster drill, the hospital's emergency operations plan is
activated. Which of the following positions is responsible for coordinating
patient care services and allocating beds?
A. Incident Commander
B. Operations Section Chief
C. Logistics Section Chief
D. Planning Section Chief
CORRECT ANSWER: B. Operations Section Chief
Rationale: In the Hospital Incident Command System (HICS), the Operations Section
Chief is responsible for managing the tactical operations, including patient care, triage,
transport, and allocation of beds. The Incident Commander oversees the overall
response.
Question 7: A nurse manager is addressing a high turnover rate on the unit.
Which of the following interventions would most likely improve nurse
retention?
A. Increasing the patient-to-nurse ratio
B. Implementing a peer recognition and mentorship program
C. Reducing the frequency of performance appraisals
D. Requiring mandatory overtime to cover shifts
CORRECT ANSWER: B. Implementing a peer recognition and mentorship
program
Rationale: Peer recognition, mentorship, and professional development opportunities are
key drivers of nurse job satisfaction and retention. Increasing ratios and mandatory
overtime contribute to burnout and turnover.
Question 8: A patient is being discharged to home with a new colostomy. The
nurse is planning discharge teaching. Which of the following is the primary
responsibility of the nurse in this scenario?
A. To ensure that the patient demonstrates proper colostomy care before discharge.
B. To arrange for a home health aide to change the appliance daily.
C. To tell the patient's family how to care for the stoma.
D. To provide a list of online resources for ostomy care.
CORRECT ANSWER: A. To ensure that the patient demonstrates proper
colostomy care before discharge.
, Rationale: The nurse's primary responsibility is to ensure that the patient (or caregiver)
has the knowledge and ability to perform necessary self-care. Return demonstration is
the best way to validate learning.
Question 9: A nurse is a member of the hospital's ethics committee. The
committee is reviewing a case involving a patient with end-stage renal disease
who wishes to discontinue dialysis. Which of the following ethical principles is
being tested?
A. Justice
B. Beneficence
C. Autonomy
D. Fidelity
CORRECT ANSWER: C. Autonomy
Rationale: Autonomy is the ethical principle that recognizes the right of a competent
individual to make informed decisions about their own medical care, including the right
to refuse life-sustaining treatment. This principle is central to the withdrawal of dialysis.
Question 10: A nurse leader is planning to use a democratic leadership style to
implement a new charting system. Which of the following actions is consistent
with this style?
A. The leader mandates that the new system must be used immediately.
B. The leader forms a committee of staff nurses to provide input on the transition plan.
C. The leader makes all decisions regarding the implementation schedule.
D. The leader avoids participating in the change process.
CORRECT ANSWER: B. The leader forms a committee of staff nurses to
provide input on the transition plan.
Rationale: A democratic leadership style is participative, encouraging input,
collaboration, and group decision-making. Forming a committee to provide input on the
transition plan exemplifies this style.
Question 11: A hospital is implementing a new fall prevention program. Which
of the following represents a nurse-sensitive quality indicator that could be
used to evaluate the program's effectiveness?
A. The cost of the new bed alarms
B. The number of patient falls with injury per 1,000 patient days
C. The patient satisfaction score regarding food quality
D. The number of licensed beds in the facility
Leadership Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Assessment
Preparation, Nursing Leadership & Management
Review, Delegation, Prioritization, Supervision,
Conflict Resolution, Ethical & Legal Responsibilities,
Patient Safety, Quality Improvement, Case
Management, Communication, Staff Management,
Disaster Triage & NGN-Style Clinical Judgment
Question 1: A nurse manager is reviewing the budget for the upcoming fiscal
year. Which of the following types of budget forecasting takes into account the
previous year's actual expenditures and adjusts for anticipated changes in
volume and cost?
A. Zero-based budgeting
B. Fixed budgeting
C. Incremental budgeting
D. Performance-based budgeting
CORRECT ANSWER: C. Incremental budgeting
Rationale: Incremental budgeting starts with the previous period's actual spending and
adjusts it for expected increases or decreases in costs and volume. Zero-based
budgeting starts from zero each period, fixed budgeting sets strict limits not adjusted for
volume, and performance-based budgeting links funding to measurable outcomes.
Question 2: A charge nurse is delegating tasks to licensed practical nurses
(LPNs) and unlicensed assistive personnel (UAP). Which of the following tasks
is appropriate to delegate to the UAP?
A. Administering oral medications to a stable patient
B. Performing a sterile wound dressing change
C. Feeding a patient with dysphagia who is on aspiration precautions
D. Obtaining a routine capillary blood glucose level
CORRECT ANSWER: D. Obtaining a routine capillary blood glucose level
Rationale: Obtaining routine capillary blood glucose is within the scope of practice for
UAP after proper training and competency verification. Administering medications,
sterile wound care, and feeding dysphagic patients require licensed nursing assessment
and judgment.
Question 3: A nurse on a medical-surgical unit is caring for a patient who is a
member of a religious group that refuses blood transfusions. The patient
,requires surgery with a high probability of transfusion. Which of the following
actions should the nurse take?
A. Inform the patient that a transfusion will be given if medically necessary.
B. Ask the patient to sign a waiver releasing the hospital from liability.
C. Notify the surgeon of the patient's preference and consult the hospital's ethics
committee.
D. Arrange for a court order mandating the transfusion.
CORRECT ANSWER: C. Notify the surgeon of the patient's preference and
consult the hospital's ethics committee.
Rationale: The nurse must respect the patient's autonomy and religious beliefs while
ensuring that the healthcare team is aware of the patient's wishes. The ethics committee
can help navigate complex situations involving life-saving treatment and patient refusal.
Question 4: A unit manager is evaluating the cost-effectiveness of a new
wound care product. Which of the following metrics would provide the most
comprehensive analysis of the product's financial impact?
A. The unit cost of the dressing
B. The number of dressing changes per day
C. The total cost of care including nursing time and healing outcomes
D. The patient's length of stay
CORRECT ANSWER: C. The total cost of care including nursing time and
healing outcomes
Rationale: A comprehensive cost-effectiveness analysis looks beyond just the purchase
price to include nursing time, frequency of changes, infection rates, and healing
outcomes. This provides the true financial and clinical value of the product.
Question 5: A nurse leader is implementing a shared governance model on the
unit. Which of the following is a primary characteristic of this model?
A. Administrative decisions are made by the nurse manager without input from staff.
B. Staff nurses have a formal role in decision-making regarding clinical practice and unit
operations.
C. The primary goal is to reduce the number of nurses on the unit.
D. All decisions are made by a union representative.
CORRECT ANSWER: B. Staff nurses have a formal role in decision-making
regarding clinical practice and unit operations.
Rationale: Shared governance empowers nurses at the point of care to participate in
decisions about practice, quality, and professional development, fostering ownership and
accountability. It decentralizes decision-making.
,Question 6: During a disaster drill, the hospital's emergency operations plan is
activated. Which of the following positions is responsible for coordinating
patient care services and allocating beds?
A. Incident Commander
B. Operations Section Chief
C. Logistics Section Chief
D. Planning Section Chief
CORRECT ANSWER: B. Operations Section Chief
Rationale: In the Hospital Incident Command System (HICS), the Operations Section
Chief is responsible for managing the tactical operations, including patient care, triage,
transport, and allocation of beds. The Incident Commander oversees the overall
response.
Question 7: A nurse manager is addressing a high turnover rate on the unit.
Which of the following interventions would most likely improve nurse
retention?
A. Increasing the patient-to-nurse ratio
B. Implementing a peer recognition and mentorship program
C. Reducing the frequency of performance appraisals
D. Requiring mandatory overtime to cover shifts
CORRECT ANSWER: B. Implementing a peer recognition and mentorship
program
Rationale: Peer recognition, mentorship, and professional development opportunities are
key drivers of nurse job satisfaction and retention. Increasing ratios and mandatory
overtime contribute to burnout and turnover.
Question 8: A patient is being discharged to home with a new colostomy. The
nurse is planning discharge teaching. Which of the following is the primary
responsibility of the nurse in this scenario?
A. To ensure that the patient demonstrates proper colostomy care before discharge.
B. To arrange for a home health aide to change the appliance daily.
C. To tell the patient's family how to care for the stoma.
D. To provide a list of online resources for ostomy care.
CORRECT ANSWER: A. To ensure that the patient demonstrates proper
colostomy care before discharge.
, Rationale: The nurse's primary responsibility is to ensure that the patient (or caregiver)
has the knowledge and ability to perform necessary self-care. Return demonstration is
the best way to validate learning.
Question 9: A nurse is a member of the hospital's ethics committee. The
committee is reviewing a case involving a patient with end-stage renal disease
who wishes to discontinue dialysis. Which of the following ethical principles is
being tested?
A. Justice
B. Beneficence
C. Autonomy
D. Fidelity
CORRECT ANSWER: C. Autonomy
Rationale: Autonomy is the ethical principle that recognizes the right of a competent
individual to make informed decisions about their own medical care, including the right
to refuse life-sustaining treatment. This principle is central to the withdrawal of dialysis.
Question 10: A nurse leader is planning to use a democratic leadership style to
implement a new charting system. Which of the following actions is consistent
with this style?
A. The leader mandates that the new system must be used immediately.
B. The leader forms a committee of staff nurses to provide input on the transition plan.
C. The leader makes all decisions regarding the implementation schedule.
D. The leader avoids participating in the change process.
CORRECT ANSWER: B. The leader forms a committee of staff nurses to
provide input on the transition plan.
Rationale: A democratic leadership style is participative, encouraging input,
collaboration, and group decision-making. Forming a committee to provide input on the
transition plan exemplifies this style.
Question 11: A hospital is implementing a new fall prevention program. Which
of the following represents a nurse-sensitive quality indicator that could be
used to evaluate the program's effectiveness?
A. The cost of the new bed alarms
B. The number of patient falls with injury per 1,000 patient days
C. The patient satisfaction score regarding food quality
D. The number of licensed beds in the facility
