ATI RN Leadership Proctored Exam 70
Practice Questions with Verified
Answers & Detailed Rationales
2026/2027 Edition | A+ Graded
EXAM OVERVIEW
The ATI RN Leadership Proctored Exam evaluates nursing students'
knowledge of leadership and management principles essential for
professional nursing practice. The exam covers key domains
including:
● Management of Care: Delegation, assignment, prioritization, and
supervision
● Safety & Infection Control: Risk management, emergency
response, and isolation precautions
● Ethical & Legal Issues: Informed consent, confidentiality,
advance directives, and advocacy
● Quality Improvement: Performance measurement, process
improvement, and benchmarking
● Professional Role: Leadership styles, change management,
conflict resolution, and communication
The exam features 70 questions in NGN (Next Generation NCLEX)
format, including multiple-choice, multiple-response, and clinical
judgment scenarios. A passing score is determined by ATI's national
benchmarking standards.
,SECTION 1: DELEGATION & SUPERVISION
(Questions 1-15)
Q1. A nurse is delegating tasks to an assistive personnel (AP). Which
task is appropriate to delegate?
A) Assessing a client's post-operative pain level
B) Teaching a client about insulin administration
C) Obtaining vital signs from a stable client
D) Developing a care plan for a newly admitted client
Answer: C) Obtaining vital signs from a stable client
Rationale: Delegation to APs must follow the Five Rights of Delegation.
Obtaining vital signs for a stable client is within the AP's scope of
practice, whereas assessing, teaching, and developing care plans
require RN-level clinical judgment and are not delegable tasks. The RN
retains accountability for the delegation decision.
Q2. Which of the following statements by a nurse indicates correct
understanding of the Five Rights of Delegation?
A) "I must ensure the right task is delegated to the right person at the
right time."
B) "I must ensure the right task, right circumstance, right person, right
direction/communication, and right supervision."
C) "The Five Rights apply only to delegating to assistive personnel."
D) "Delegation transfers accountability to the delegatee."
,Answer: B) "I must ensure the right task, right circumstance, right
person, right direction/communication, and right supervision."
Rationale: The Five Rights of Delegation are: Right Task, Right
Circumstance, Right Person, Right Direction/Communication, and Right
Supervision/Evaluation. These principles apply to all delegation
decisions, not just to APs. The RN retains accountability for the
delegation decision; accountability cannot be transferred.
Q3. An RN is assigning clients on a busy unit. A nurse from a
medical-surgical unit has floated to the obstetrical unit. Which client
should the charge nurse assign to the float nurse?
A) A primigravida client who is 1 day postoperative following a
cesarean section and has a PCA pump
B) A client with stable preeclampsia on magnesium sulfate who is not
in active labor
C) A client in active labor with fetal distress
D) A client with a postpartum hemorrhage
Answer: B) A client with stable preeclampsia on magnesium sulfate
who is not in active labor
Rationale: The float nurse from medical-surgical is unfamiliar with
obstetrical emergencies and complex OB care. The stable preeclampsia
client not in active labor is the most appropriate assignment as it allows
the float nurse to care for a stable patient while the OB nurses manage
acute and emergency situations. The other options require specialized
OB nursing expertise.
, Q4. An RN is preparing to delegate a sterile dressing change to an
LPN. Which condition must be met for this to be appropriate?
A) The wound is complex with tunneling
B) The LPN has demonstrated competency in the procedure
C) The RN will not supervise the procedure
D) The client is unstable with changing vital signs
Answer: B) The LPN has demonstrated competency in the procedure
Rationale: LPNs can perform sterile dressing changes on stable,
non-complex wounds if their competency is verified. The LPN must have
demonstrated competence in the procedure, the wound must be stable
(not complex with tunneling), and the RN remains responsible for
supervision. Complex wounds and unstable clients require RN
assessment and intervention.
Q5. A nurse is preparing to delegate collection of a specimen to an AP.
Which specimen can the nurse safely delegate?
A) Random stool specimen
B) Clean-catch midstream urine specimen for culture
C) Sputum specimen for acid-fast bacilli (AFB) culture
D) Blood culture
Answer: A) Random stool specimen
Rationale: Collection of a random stool specimen can be delegated to
an AP. Obtaining sterile urine specimens, sputum cultures, and blood
cultures require specific aseptic technique and licensed nursing
judgment. The RN must ensure the AP has been trained and is
competent to perform the delegated task.
Practice Questions with Verified
Answers & Detailed Rationales
2026/2027 Edition | A+ Graded
EXAM OVERVIEW
The ATI RN Leadership Proctored Exam evaluates nursing students'
knowledge of leadership and management principles essential for
professional nursing practice. The exam covers key domains
including:
● Management of Care: Delegation, assignment, prioritization, and
supervision
● Safety & Infection Control: Risk management, emergency
response, and isolation precautions
● Ethical & Legal Issues: Informed consent, confidentiality,
advance directives, and advocacy
● Quality Improvement: Performance measurement, process
improvement, and benchmarking
● Professional Role: Leadership styles, change management,
conflict resolution, and communication
The exam features 70 questions in NGN (Next Generation NCLEX)
format, including multiple-choice, multiple-response, and clinical
judgment scenarios. A passing score is determined by ATI's national
benchmarking standards.
,SECTION 1: DELEGATION & SUPERVISION
(Questions 1-15)
Q1. A nurse is delegating tasks to an assistive personnel (AP). Which
task is appropriate to delegate?
A) Assessing a client's post-operative pain level
B) Teaching a client about insulin administration
C) Obtaining vital signs from a stable client
D) Developing a care plan for a newly admitted client
Answer: C) Obtaining vital signs from a stable client
Rationale: Delegation to APs must follow the Five Rights of Delegation.
Obtaining vital signs for a stable client is within the AP's scope of
practice, whereas assessing, teaching, and developing care plans
require RN-level clinical judgment and are not delegable tasks. The RN
retains accountability for the delegation decision.
Q2. Which of the following statements by a nurse indicates correct
understanding of the Five Rights of Delegation?
A) "I must ensure the right task is delegated to the right person at the
right time."
B) "I must ensure the right task, right circumstance, right person, right
direction/communication, and right supervision."
C) "The Five Rights apply only to delegating to assistive personnel."
D) "Delegation transfers accountability to the delegatee."
,Answer: B) "I must ensure the right task, right circumstance, right
person, right direction/communication, and right supervision."
Rationale: The Five Rights of Delegation are: Right Task, Right
Circumstance, Right Person, Right Direction/Communication, and Right
Supervision/Evaluation. These principles apply to all delegation
decisions, not just to APs. The RN retains accountability for the
delegation decision; accountability cannot be transferred.
Q3. An RN is assigning clients on a busy unit. A nurse from a
medical-surgical unit has floated to the obstetrical unit. Which client
should the charge nurse assign to the float nurse?
A) A primigravida client who is 1 day postoperative following a
cesarean section and has a PCA pump
B) A client with stable preeclampsia on magnesium sulfate who is not
in active labor
C) A client in active labor with fetal distress
D) A client with a postpartum hemorrhage
Answer: B) A client with stable preeclampsia on magnesium sulfate
who is not in active labor
Rationale: The float nurse from medical-surgical is unfamiliar with
obstetrical emergencies and complex OB care. The stable preeclampsia
client not in active labor is the most appropriate assignment as it allows
the float nurse to care for a stable patient while the OB nurses manage
acute and emergency situations. The other options require specialized
OB nursing expertise.
, Q4. An RN is preparing to delegate a sterile dressing change to an
LPN. Which condition must be met for this to be appropriate?
A) The wound is complex with tunneling
B) The LPN has demonstrated competency in the procedure
C) The RN will not supervise the procedure
D) The client is unstable with changing vital signs
Answer: B) The LPN has demonstrated competency in the procedure
Rationale: LPNs can perform sterile dressing changes on stable,
non-complex wounds if their competency is verified. The LPN must have
demonstrated competence in the procedure, the wound must be stable
(not complex with tunneling), and the RN remains responsible for
supervision. Complex wounds and unstable clients require RN
assessment and intervention.
Q5. A nurse is preparing to delegate collection of a specimen to an AP.
Which specimen can the nurse safely delegate?
A) Random stool specimen
B) Clean-catch midstream urine specimen for culture
C) Sputum specimen for acid-fast bacilli (AFB) culture
D) Blood culture
Answer: A) Random stool specimen
Rationale: Collection of a random stool specimen can be delegated to
an AP. Obtaining sterile urine specimens, sputum cultures, and blood
cultures require specific aseptic technique and licensed nursing
judgment. The RN must ensure the AP has been trained and is
competent to perform the delegated task.
