ATI RN PROCTORED EXAMINATION · NGN
EDITION
RN Leadership &
Management
70 Next Generation NCLEX (NGN) questions with
comprehensive rationales, aligned with the 2026-
2027 ATI RN Leadership and Management blueprint
and the clinical judgment measurement model.
Covers client rights, delegation, legal-ethical practice,
leadership theory, safety, and clinical prioritization.
70 NGN Questions and Answers
Management of Care · Safety and Infection Control · Health Promotion ·
Psychosocial Integrity · Basic Care and Comfort · Pharmacological Therapies ·
Reduction of Risk Potential · Physiological Adaptation
2 0 2 6 - 2 0 2 7 U P D AT E D E D I T I O N · F O R M A
,ATI RN Leadership and Management Proctored Exam - 70 NGN Questions and Answers (2026-2027)
ATI RN LEADERSHIP AND MANAGEMENT
PROCTORED EXAMINATION
70 Next Generation NCLEX (NGN) Questions and Answers with Comprehensive Rationales | 2026-2027
Updated Edition
Aligned with the ATI RN Leadership and Management blueprint and the NGN Clinical Judgment
Measurement Model (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action,
evaluate outcomes). Cognitive distribution: 25% recall, 50% application, 25% analysis. Sections mirror the
NCLEX client-need categories.
Examination Blueprint Overview
Section Content Focus Questions
Client rights and advocacy, delegation and supervision, legal and
ethical practice, leadership styles, quality improvement and risk
1. Management of Care 1-30
management, prioritization frameworks, case management,
staffing, and resource allocation
Isolation precautions, PPE selection and removal, hand hygiene,
2. Safety and Infection Control client safety, restraints, fire safety, disaster response, and 31-40
emergency codes
3. Health Promotion and Health screening, immunizations, client education and
41-45
Maintenance teach-back, developmental stages, and health literacy
Grief and loss, therapeutic communication, crisis intervention,
4. Psychosocial Integrity 46-50
end-of-life care, and cultural and spiritual care
Pain management, enteral nutrition, elimination, mobility and
5. Basic Care and Comfort 51-55
immobility, and skin integrity and wound care
Medication administration and high-alert safety, dosage
6. Pharmacological and
calculation, blood product administration, controlled substances, 56-60
Parenteral Therapies
and adverse effects
Laboratory value interpretation, diagnostic testing, complication
7. Reduction of Risk Potential prevention, early deterioration recognition, and post-procedure 61-65
care
Sepsis and shock, fluid and electrolyte emergencies, acid-base
8. Physiological Adaptation interpretation, medical emergency response, and postoperative 66-70
complications
Next Generation NCLEX (NGN) Aligned | 2026-2027 Edition 1
,ATI RN Leadership and Management Proctored Exam - 70 NGN Questions and Answers (2026-2027)
SECTION 1 - Management of Care
Questions 1-30 | Client rights and advocacy, delegation and supervision, legal and ethical practice, leadership styles, quality
improvement and risk management, prioritization frameworks, case management, staffing, and resource allocation
Q1: A client with a signed consent form for a laparoscopic cholecystectomy tells the
preoperative nurse, 'I changed my mind about the surgery after the surgeon left. What happens if
they just take my gallbladder out another way?' Which action should the nurse take first?
A. Notify the surgeon that the client requires clarification of the procedure before surgery
proceeds [CORRECT]
B. Reinforce the benefits of the procedure so the client feels confident about proceeding
C. Ask the client to sign a second consent form with a witness present
D. Document that informed consent was obtained and send the client to the preoperative
holding area
Correct Answer: A
Rationale: The client's question reveals a gap in understanding of the procedure, which defeats the purpose of
informed consent; the provider is legally responsible for explaining the procedure, risks, benefits, and
alternatives, so the nurse's first action is to notify the surgeon before the case proceeds. In clinical judgment
terms, the cue is the client's expressed uncertainty, and the correct action is referral back to the provider rather
than patching the consent. Reinforcing benefits (B) borders on coercion and threatens autonomy. A second
consent form (C) does not correct the knowledge deficit and creates a false legal record. Sending the client to
holding (D) ignores an unresolved consent problem; consent may be withdrawn at any time before the
procedure begins.
Q2: A nurse is caring for a 78-year-old client admitted with heart failure whose chart contains a
signed provider order for 'do not resuscitate' based on the client's advance directive. During a
meal, the client goes into cardiac arrest, and the client's adult son shouts, 'Do everything! I don't
care what the papers say!' Which action should the nurse take?
A. Ask the son to leave the room and begin resuscitation
B. Ask the son to sign a statement overriding the DNR order
C. Honor the DNR order and provide comfort measures while supporting the son
[CORRECT]
D. Contact the hospital ethics committee before making any decisions
Correct Answer: C
Rationale: A valid DNR order based on the client's advance directive reflects the client's legal right to
self-determination and must be honored regardless of family objection; the nurse provides dignity-focused
comfort care and supports the grieving son. Beginning resuscitation (A) violates the client's expressed wishes
and constitutes battery. A family member cannot override a valid DNR (B); only the client, while competent,
or a legal representative acting on the client's documented wishes may pursue an order change with the
provider. Delaying to contact the ethics committee (D) is unnecessary because the directive is unambiguous;
ethics consultation is reserved for genuine conflicts. This item tests legal-ethical knowledge applied under
acute time pressure.
Next Generation NCLEX (NGN) Aligned | 2026-2027 Edition 2
, ATI RN Leadership and Management Proctored Exam - 70 NGN Questions and Answers (2026-2027)
Q3: A woman telephones the medical-surgical unit stating she is the sister of a client admitted
after a motor-vehicle crash and asks for details about the client's condition. The client is awake
and has not restricted visitors. Which response by the nurse is appropriate?
A. Give a general condition report because the caller identified herself as family
B. Offer to speak with the client first to determine whether information may be shared with
the caller [CORRECT]
C. Refuse to acknowledge the client's presence on the unit and end the call abruptly
D. Provide only the client's room number and admission date
Correct Answer: B
Rationale: Privacy regulations permit disclosure to persons involved in the client's care only when the client
agrees or, given the opportunity, does not object; because this client is awake and capable, the nurse consults
the client before sharing anything. Even a self-identified family member (A) has no automatic right to
information under privacy law. Ending the call abruptly (C) is unprofessional and unnecessary when a simple
compliant pathway exists. The room number and admission date (D) are still protected health information
when given to an unverified caller. The correct clinical judgment is the least restrictive, autonomy-preserving
action: verify with the client, then share only what the client permits.
Q4: While assessing a 6-year-old, the school nurse notes patterned bruises in various stages of
healing on the child's back and buttocks. The child says, 'Please don't tell, Dad will be mad.'
Which action should the nurse take first?
A. Confront the father privately about the injuries before any notification
B. Document the findings and wait to see whether similar bruises appear next week
C. Notify the child's health care provider for further evaluation
D. Report the suspected abuse to the appropriate state child-protective agency as required
by law [CORRECT]
Correct Answer: D
Rationale: Nurses are mandated reporters; when assessment findings are consistent with nonaccidental
trauma, the nurse is legally required to notify the child-protective agency or designated authority promptly, and
only reasonable suspicion, not proof, is needed. Confronting the father (A) may endanger the child and
compromise the investigation. Waiting for corroborating data (B) delays legally mandated protection.
Notifying the provider (C) may occur as part of coordination, but the binding legal duty is the state report.
Good-faith reporters are immune from liability, while failure to report risks both licensure and the child's
safety; the child's request for silence never overrides the reporting statute.
Next Generation NCLEX (NGN) Aligned | 2026-2027 Edition 3
EDITION
RN Leadership &
Management
70 Next Generation NCLEX (NGN) questions with
comprehensive rationales, aligned with the 2026-
2027 ATI RN Leadership and Management blueprint
and the clinical judgment measurement model.
Covers client rights, delegation, legal-ethical practice,
leadership theory, safety, and clinical prioritization.
70 NGN Questions and Answers
Management of Care · Safety and Infection Control · Health Promotion ·
Psychosocial Integrity · Basic Care and Comfort · Pharmacological Therapies ·
Reduction of Risk Potential · Physiological Adaptation
2 0 2 6 - 2 0 2 7 U P D AT E D E D I T I O N · F O R M A
,ATI RN Leadership and Management Proctored Exam - 70 NGN Questions and Answers (2026-2027)
ATI RN LEADERSHIP AND MANAGEMENT
PROCTORED EXAMINATION
70 Next Generation NCLEX (NGN) Questions and Answers with Comprehensive Rationales | 2026-2027
Updated Edition
Aligned with the ATI RN Leadership and Management blueprint and the NGN Clinical Judgment
Measurement Model (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action,
evaluate outcomes). Cognitive distribution: 25% recall, 50% application, 25% analysis. Sections mirror the
NCLEX client-need categories.
Examination Blueprint Overview
Section Content Focus Questions
Client rights and advocacy, delegation and supervision, legal and
ethical practice, leadership styles, quality improvement and risk
1. Management of Care 1-30
management, prioritization frameworks, case management,
staffing, and resource allocation
Isolation precautions, PPE selection and removal, hand hygiene,
2. Safety and Infection Control client safety, restraints, fire safety, disaster response, and 31-40
emergency codes
3. Health Promotion and Health screening, immunizations, client education and
41-45
Maintenance teach-back, developmental stages, and health literacy
Grief and loss, therapeutic communication, crisis intervention,
4. Psychosocial Integrity 46-50
end-of-life care, and cultural and spiritual care
Pain management, enteral nutrition, elimination, mobility and
5. Basic Care and Comfort 51-55
immobility, and skin integrity and wound care
Medication administration and high-alert safety, dosage
6. Pharmacological and
calculation, blood product administration, controlled substances, 56-60
Parenteral Therapies
and adverse effects
Laboratory value interpretation, diagnostic testing, complication
7. Reduction of Risk Potential prevention, early deterioration recognition, and post-procedure 61-65
care
Sepsis and shock, fluid and electrolyte emergencies, acid-base
8. Physiological Adaptation interpretation, medical emergency response, and postoperative 66-70
complications
Next Generation NCLEX (NGN) Aligned | 2026-2027 Edition 1
,ATI RN Leadership and Management Proctored Exam - 70 NGN Questions and Answers (2026-2027)
SECTION 1 - Management of Care
Questions 1-30 | Client rights and advocacy, delegation and supervision, legal and ethical practice, leadership styles, quality
improvement and risk management, prioritization frameworks, case management, staffing, and resource allocation
Q1: A client with a signed consent form for a laparoscopic cholecystectomy tells the
preoperative nurse, 'I changed my mind about the surgery after the surgeon left. What happens if
they just take my gallbladder out another way?' Which action should the nurse take first?
A. Notify the surgeon that the client requires clarification of the procedure before surgery
proceeds [CORRECT]
B. Reinforce the benefits of the procedure so the client feels confident about proceeding
C. Ask the client to sign a second consent form with a witness present
D. Document that informed consent was obtained and send the client to the preoperative
holding area
Correct Answer: A
Rationale: The client's question reveals a gap in understanding of the procedure, which defeats the purpose of
informed consent; the provider is legally responsible for explaining the procedure, risks, benefits, and
alternatives, so the nurse's first action is to notify the surgeon before the case proceeds. In clinical judgment
terms, the cue is the client's expressed uncertainty, and the correct action is referral back to the provider rather
than patching the consent. Reinforcing benefits (B) borders on coercion and threatens autonomy. A second
consent form (C) does not correct the knowledge deficit and creates a false legal record. Sending the client to
holding (D) ignores an unresolved consent problem; consent may be withdrawn at any time before the
procedure begins.
Q2: A nurse is caring for a 78-year-old client admitted with heart failure whose chart contains a
signed provider order for 'do not resuscitate' based on the client's advance directive. During a
meal, the client goes into cardiac arrest, and the client's adult son shouts, 'Do everything! I don't
care what the papers say!' Which action should the nurse take?
A. Ask the son to leave the room and begin resuscitation
B. Ask the son to sign a statement overriding the DNR order
C. Honor the DNR order and provide comfort measures while supporting the son
[CORRECT]
D. Contact the hospital ethics committee before making any decisions
Correct Answer: C
Rationale: A valid DNR order based on the client's advance directive reflects the client's legal right to
self-determination and must be honored regardless of family objection; the nurse provides dignity-focused
comfort care and supports the grieving son. Beginning resuscitation (A) violates the client's expressed wishes
and constitutes battery. A family member cannot override a valid DNR (B); only the client, while competent,
or a legal representative acting on the client's documented wishes may pursue an order change with the
provider. Delaying to contact the ethics committee (D) is unnecessary because the directive is unambiguous;
ethics consultation is reserved for genuine conflicts. This item tests legal-ethical knowledge applied under
acute time pressure.
Next Generation NCLEX (NGN) Aligned | 2026-2027 Edition 2
, ATI RN Leadership and Management Proctored Exam - 70 NGN Questions and Answers (2026-2027)
Q3: A woman telephones the medical-surgical unit stating she is the sister of a client admitted
after a motor-vehicle crash and asks for details about the client's condition. The client is awake
and has not restricted visitors. Which response by the nurse is appropriate?
A. Give a general condition report because the caller identified herself as family
B. Offer to speak with the client first to determine whether information may be shared with
the caller [CORRECT]
C. Refuse to acknowledge the client's presence on the unit and end the call abruptly
D. Provide only the client's room number and admission date
Correct Answer: B
Rationale: Privacy regulations permit disclosure to persons involved in the client's care only when the client
agrees or, given the opportunity, does not object; because this client is awake and capable, the nurse consults
the client before sharing anything. Even a self-identified family member (A) has no automatic right to
information under privacy law. Ending the call abruptly (C) is unprofessional and unnecessary when a simple
compliant pathway exists. The room number and admission date (D) are still protected health information
when given to an unverified caller. The correct clinical judgment is the least restrictive, autonomy-preserving
action: verify with the client, then share only what the client permits.
Q4: While assessing a 6-year-old, the school nurse notes patterned bruises in various stages of
healing on the child's back and buttocks. The child says, 'Please don't tell, Dad will be mad.'
Which action should the nurse take first?
A. Confront the father privately about the injuries before any notification
B. Document the findings and wait to see whether similar bruises appear next week
C. Notify the child's health care provider for further evaluation
D. Report the suspected abuse to the appropriate state child-protective agency as required
by law [CORRECT]
Correct Answer: D
Rationale: Nurses are mandated reporters; when assessment findings are consistent with nonaccidental
trauma, the nurse is legally required to notify the child-protective agency or designated authority promptly, and
only reasonable suspicion, not proof, is needed. Confronting the father (A) may endanger the child and
compromise the investigation. Waiting for corroborating data (B) delays legally mandated protection.
Notifying the provider (C) may occur as part of coordination, but the binding legal duty is the state report.
Good-faith reporters are immune from liability, while failure to report risks both licensure and the child's
safety; the child's request for silence never overrides the reporting statute.
Next Generation NCLEX (NGN) Aligned | 2026-2027 Edition 3
