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,
Communication, Patient Safety, Quality Improvement,
Ethical & Legal Responsibilities, Case Management,
Staffing, Disaster Triage & NGN-Style Clinical Judgment
Question 1: A nurse manager is implementing a shared governance model on a
medical-surgical unit. Which of the following actions best exemplifies the core
principle of this model?
A. The nurse manager creates all unit policies and procedures independently.
B. Staff nurses are given authority to make decisions regarding clinical practice
standards.
C. The charge nurse assigns all patient care assignments based on acuity.
D. The unit director approves all vacation requests for the nursing staff.
CORRECT ANSWER: B. Staff nurses are given authority to make decisions
regarding clinical practice standards.
Rationale: Shared governance is a professional practice model that empowers staff
nurses to have a voice and control over their practice, particularly in areas such as
clinical standards, quality improvement, and professional development. Option B is the
only choice that reflects this distribution of decision-making authority. Options A, C, and
D are traditional, hierarchical management styles that do not align with the principles of
shared governance.
Question 2: A charge nurse is assigning staff to patients for the upcoming shift.
Which of the following tasks should the charge nurse delegate to an unlicensed
assistive personnel (UAP)?
A. Administering a heparin injection to a patient with a deep vein thrombosis.
B. Teaching a patient how to use a patient-controlled analgesia (PCA) pump.
C. Measuring and recording a patient's intake and output.
D. Assessing a patient's surgical incision for signs of infection.
CORRECT ANSWER: C. Measuring and recording a patient's intake and output.
Rationale: The RN is responsible for the initial assessment, planning, and evaluation of
patient care, as well as any task requiring clinical judgment. Measuring and recording
intake and output is a standard, stable task that falls within the scope of practice for a
UAP, provided they have been trained and deemed competent. Options A, B, and D all
require the clinical judgment and licensure of a registered nurse.
,Question 3: A nurse is caring for a client who has a new prescription for a
continuous enteral feeding. Which of the following actions should the nurse
take to prevent aspiration?
A. Administer the feeding via a large-bore syringe.
B. Place the client in a supine position during the feeding.
C. Check the residual volume every 8 hours.
D. Elevate the head of the bed to 30 to 45 degrees.
CORRECT ANSWER: D. Elevate the head of the bed to 30 to 45 degrees.
Rationale: Elevating the head of the bed to 30 to 45 degrees is a critical intervention to
reduce the risk of aspiration during enteral feedings by promoting gastric emptying and
preventing reflux. Option A is incorrect; bolus feedings should be administered via
gravity, not a syringe. Option B is incorrect as the supine position increases aspiration
risk. Option C is correct but is not the primary action to prevent aspiration; checking
residuals is a monitoring action.
Question 4: A staff nurse is experiencing moral distress due to a perceived lack
of support from administration regarding safe staffing levels. Which of the
following is the most appropriate initial action for the nurse to take?
A. Submit a formal complaint to the state board of nursing.
B. Organize a union strike to demand better staffing.
C. Discuss the concerns with the nurse manager or unit supervisor.
D. Resign from the position immediately to avoid unsafe assignments.
CORRECT ANSWER: C. Discuss the concerns with the nurse manager or unit
supervisor.
Rationale: The first step in addressing workplace concerns is to utilize the chain of
command by discussing the issue with the immediate supervisor or nurse manager. This
provides an opportunity for open communication and problem-solving at the unit level.
Options A and B are extreme and not the initial step. Option D is an inappropriate
reaction without first attempting to resolve the conflict.
Question 5: A nurse leader is implementing a quality improvement (QI) project
to reduce catheter-associated urinary tract infections (CAUTIs). According to
the Plan-Do-Study-Act (PDSA) model, what action represents the "Study"
phase?
A. Implement a new evidence-based protocol for catheter insertion.
B. Identify a need for a CAUTI reduction initiative.
C. Analyze the collected data to evaluate the impact of the new protocol.
D. Plan to educate all staff on the new insertion protocol.
CORRECT ANSWER: C. Analyze the collected data to evaluate the impact of
the new protocol.
,Rationale: The PDSA cycle is a framework for QI. The "Study" phase involves analyzing
the data and outcomes gathered during the "Do" phase to see if the change resulted in
improvement. Option A is the "Do" phase. Option B is part of the planning/problem
identification stage. Option D is a component of the "Plan" phase.
Question 6: A charge nurse is preparing a schedule to cover a holiday. Which
of the following should the charge nurse prioritize to maintain staff morale?
A. Assigning the holiday shift to the newest staff nurses.
B. Creating a schedule that is fair and equitable for all staff.
C. Allowing staff to volunteer for the shift before making assignments.
D. Consulting the unit's collective bargaining agreement.
CORRECT ANSWER: B. Creating a schedule that is fair and equitable for all
staff.
Rationale: Fairness and equity in scheduling are paramount for maintaining staff morale
and reducing conflict. While allowing staff to volunteer (C) and consulting the contract
(D) are good practices, the primary goal is to create a perception of fairness. Option A is
demoralizing.
Question 7: A nurse is providing discharge teaching to a client who is going
home with a new colostomy. Which of the following statements by the client
indicates an accurate understanding of the teaching?
A. "I will need to change my colostomy pouch system every week."
B. "I should only eat foods that are low in fiber."
C. "I will need to avoid drinking carbonated beverages."
D. "I should empty my pouch when it is one-third to one-half full."
CORRECT ANSWER: D. "I should empty my pouch when it is one-third to one-
half full."
Rationale: Stoma pouches should be emptied when they are one-third to one-half full to
prevent leakage and pulling on the skin barrier. Option A is incorrect; the pouch should
be changed every 3-7 days or as needed. Option B is incorrect; a well-balanced diet
including fiber is encouraged. Option C is not a blanket recommendation; carbonation
may be tolerated.
Question 8: A nurse manager observes a staff nurse consistently arriving late
for shift report. Which of the following management strategies is most
effective in addressing this issue?
A. Publicly reprimanding the nurse during the next staff meeting.
B. Documenting the lateness in the nurse's personnel file without a conversation.
C. Discussing the issue privately with the nurse to identify barriers to punctuality.
D. Ignoring the behavior to avoid conflict with the staff nurse.
CORRECT ANSWER: C. Discussing the issue privately with the nurse to
identify barriers to punctuality.
, Rationale: The most effective management strategy for addressing performance issues
is a private, constructive conversation. This approach respects the employee's dignity,
allows for the identification of underlying problems, and facilitates a collaborative
solution. Options A, B, and D are unprofessional, avoidant, or punitive and do not
address the root cause.
Question 9: A charge nurse is making patient assignments for the shift. Which
patient should be assigned to the most experienced nurse on the team?
A. A patient who is 2 days post-operative following a laparoscopic cholecystectomy and
is ready for discharge.
B. A patient with stable angina who requires daily telemetry monitoring.
C. A patient who is post-operative day 1 following a right knee replacement.
D. A patient with unstable vital signs and new-onset atrial fibrillation.
CORRECT ANSWER: D. A patient with unstable vital signs and new-onset
atrial fibrillation.
Rationale: The most experienced nurse should be assigned to the patient with the most
complex and unstable condition. This ensures that the patient's needs are met by a
nurse with the highest level of clinical judgment and skill. Options A, B, and C describe
stable patients who could be managed by less experienced nurses.
Question 10: A nurse leader is reviewing the principles of "Just Culture" with
the nursing staff. Which of the following statements accurately reflects this
concept?
A. All errors in practice should result in disciplinary action.
B. The focus is on punishing individual practitioners for their mistakes.
C. Human error is viewed as a system failure, not just individual recklessness.
D. Any error made by a nurse should be reported to the state board.
CORRECT ANSWER: C. Human error is viewed as a system failure, not just
individual recklessness.
Rationale: Just Culture is a model that balances a focus on system improvement with
accountability. It distinguishes between human error, at-risk behavior, and reckless
behavior, recognizing that most errors are due to flawed processes, not ill intent.
Options A, B, and D are punitive and do not reflect a Just Culture perspective.
Question 11: A nurse is preparing to administer a blood transfusion. The client
begins to exhibit signs of a transfusion reaction. Which of the following
actions should the nurse take first?
A. Stop the transfusion.
B. Administer epinephrine.
C. Notify the provider.
D. Maintain the IV line with normal saline.
CORRECT ANSWER: A. Stop the transfusion.
Nursing Study Guide, Original Practice Questions &
Answers, Comprehensive Assessment Preparation,
Nursing Leadership & Management Review, Delegation,
Prioritization, Supervision, Conflict Resolution,
Communication, Patient Safety, Quality Improvement,
Ethical & Legal Responsibilities, Case Management,
Staffing, Disaster Triage & NGN-Style Clinical Judgment
Question 1: A nurse manager is implementing a shared governance model on a
medical-surgical unit. Which of the following actions best exemplifies the core
principle of this model?
A. The nurse manager creates all unit policies and procedures independently.
B. Staff nurses are given authority to make decisions regarding clinical practice
standards.
C. The charge nurse assigns all patient care assignments based on acuity.
D. The unit director approves all vacation requests for the nursing staff.
CORRECT ANSWER: B. Staff nurses are given authority to make decisions
regarding clinical practice standards.
Rationale: Shared governance is a professional practice model that empowers staff
nurses to have a voice and control over their practice, particularly in areas such as
clinical standards, quality improvement, and professional development. Option B is the
only choice that reflects this distribution of decision-making authority. Options A, C, and
D are traditional, hierarchical management styles that do not align with the principles of
shared governance.
Question 2: A charge nurse is assigning staff to patients for the upcoming shift.
Which of the following tasks should the charge nurse delegate to an unlicensed
assistive personnel (UAP)?
A. Administering a heparin injection to a patient with a deep vein thrombosis.
B. Teaching a patient how to use a patient-controlled analgesia (PCA) pump.
C. Measuring and recording a patient's intake and output.
D. Assessing a patient's surgical incision for signs of infection.
CORRECT ANSWER: C. Measuring and recording a patient's intake and output.
Rationale: The RN is responsible for the initial assessment, planning, and evaluation of
patient care, as well as any task requiring clinical judgment. Measuring and recording
intake and output is a standard, stable task that falls within the scope of practice for a
UAP, provided they have been trained and deemed competent. Options A, B, and D all
require the clinical judgment and licensure of a registered nurse.
,Question 3: A nurse is caring for a client who has a new prescription for a
continuous enteral feeding. Which of the following actions should the nurse
take to prevent aspiration?
A. Administer the feeding via a large-bore syringe.
B. Place the client in a supine position during the feeding.
C. Check the residual volume every 8 hours.
D. Elevate the head of the bed to 30 to 45 degrees.
CORRECT ANSWER: D. Elevate the head of the bed to 30 to 45 degrees.
Rationale: Elevating the head of the bed to 30 to 45 degrees is a critical intervention to
reduce the risk of aspiration during enteral feedings by promoting gastric emptying and
preventing reflux. Option A is incorrect; bolus feedings should be administered via
gravity, not a syringe. Option B is incorrect as the supine position increases aspiration
risk. Option C is correct but is not the primary action to prevent aspiration; checking
residuals is a monitoring action.
Question 4: A staff nurse is experiencing moral distress due to a perceived lack
of support from administration regarding safe staffing levels. Which of the
following is the most appropriate initial action for the nurse to take?
A. Submit a formal complaint to the state board of nursing.
B. Organize a union strike to demand better staffing.
C. Discuss the concerns with the nurse manager or unit supervisor.
D. Resign from the position immediately to avoid unsafe assignments.
CORRECT ANSWER: C. Discuss the concerns with the nurse manager or unit
supervisor.
Rationale: The first step in addressing workplace concerns is to utilize the chain of
command by discussing the issue with the immediate supervisor or nurse manager. This
provides an opportunity for open communication and problem-solving at the unit level.
Options A and B are extreme and not the initial step. Option D is an inappropriate
reaction without first attempting to resolve the conflict.
Question 5: A nurse leader is implementing a quality improvement (QI) project
to reduce catheter-associated urinary tract infections (CAUTIs). According to
the Plan-Do-Study-Act (PDSA) model, what action represents the "Study"
phase?
A. Implement a new evidence-based protocol for catheter insertion.
B. Identify a need for a CAUTI reduction initiative.
C. Analyze the collected data to evaluate the impact of the new protocol.
D. Plan to educate all staff on the new insertion protocol.
CORRECT ANSWER: C. Analyze the collected data to evaluate the impact of
the new protocol.
,Rationale: The PDSA cycle is a framework for QI. The "Study" phase involves analyzing
the data and outcomes gathered during the "Do" phase to see if the change resulted in
improvement. Option A is the "Do" phase. Option B is part of the planning/problem
identification stage. Option D is a component of the "Plan" phase.
Question 6: A charge nurse is preparing a schedule to cover a holiday. Which
of the following should the charge nurse prioritize to maintain staff morale?
A. Assigning the holiday shift to the newest staff nurses.
B. Creating a schedule that is fair and equitable for all staff.
C. Allowing staff to volunteer for the shift before making assignments.
D. Consulting the unit's collective bargaining agreement.
CORRECT ANSWER: B. Creating a schedule that is fair and equitable for all
staff.
Rationale: Fairness and equity in scheduling are paramount for maintaining staff morale
and reducing conflict. While allowing staff to volunteer (C) and consulting the contract
(D) are good practices, the primary goal is to create a perception of fairness. Option A is
demoralizing.
Question 7: A nurse is providing discharge teaching to a client who is going
home with a new colostomy. Which of the following statements by the client
indicates an accurate understanding of the teaching?
A. "I will need to change my colostomy pouch system every week."
B. "I should only eat foods that are low in fiber."
C. "I will need to avoid drinking carbonated beverages."
D. "I should empty my pouch when it is one-third to one-half full."
CORRECT ANSWER: D. "I should empty my pouch when it is one-third to one-
half full."
Rationale: Stoma pouches should be emptied when they are one-third to one-half full to
prevent leakage and pulling on the skin barrier. Option A is incorrect; the pouch should
be changed every 3-7 days or as needed. Option B is incorrect; a well-balanced diet
including fiber is encouraged. Option C is not a blanket recommendation; carbonation
may be tolerated.
Question 8: A nurse manager observes a staff nurse consistently arriving late
for shift report. Which of the following management strategies is most
effective in addressing this issue?
A. Publicly reprimanding the nurse during the next staff meeting.
B. Documenting the lateness in the nurse's personnel file without a conversation.
C. Discussing the issue privately with the nurse to identify barriers to punctuality.
D. Ignoring the behavior to avoid conflict with the staff nurse.
CORRECT ANSWER: C. Discussing the issue privately with the nurse to
identify barriers to punctuality.
, Rationale: The most effective management strategy for addressing performance issues
is a private, constructive conversation. This approach respects the employee's dignity,
allows for the identification of underlying problems, and facilitates a collaborative
solution. Options A, B, and D are unprofessional, avoidant, or punitive and do not
address the root cause.
Question 9: A charge nurse is making patient assignments for the shift. Which
patient should be assigned to the most experienced nurse on the team?
A. A patient who is 2 days post-operative following a laparoscopic cholecystectomy and
is ready for discharge.
B. A patient with stable angina who requires daily telemetry monitoring.
C. A patient who is post-operative day 1 following a right knee replacement.
D. A patient with unstable vital signs and new-onset atrial fibrillation.
CORRECT ANSWER: D. A patient with unstable vital signs and new-onset
atrial fibrillation.
Rationale: The most experienced nurse should be assigned to the patient with the most
complex and unstable condition. This ensures that the patient's needs are met by a
nurse with the highest level of clinical judgment and skill. Options A, B, and C describe
stable patients who could be managed by less experienced nurses.
Question 10: A nurse leader is reviewing the principles of "Just Culture" with
the nursing staff. Which of the following statements accurately reflects this
concept?
A. All errors in practice should result in disciplinary action.
B. The focus is on punishing individual practitioners for their mistakes.
C. Human error is viewed as a system failure, not just individual recklessness.
D. Any error made by a nurse should be reported to the state board.
CORRECT ANSWER: C. Human error is viewed as a system failure, not just
individual recklessness.
Rationale: Just Culture is a model that balances a focus on system improvement with
accountability. It distinguishes between human error, at-risk behavior, and reckless
behavior, recognizing that most errors are due to flawed processes, not ill intent.
Options A, B, and D are punitive and do not reflect a Just Culture perspective.
Question 11: A nurse is preparing to administer a blood transfusion. The client
begins to exhibit signs of a transfusion reaction. Which of the following
actions should the nurse take first?
A. Stop the transfusion.
B. Administer epinephrine.
C. Notify the provider.
D. Maintain the IV line with normal saline.
CORRECT ANSWER: A. Stop the transfusion.
