ATI RN Leadership Enhanced NGN Proctored Exam 2026/2027 – Practice Guide
ATI RN Leadership 2026/2027
Enhanced NGN Proctored Examination
70 Questions and Answer Key with Verified Rationales
ATI Testing | RN Leadership Management Enhanced Next Generation NCLEX (NGN) Proctored Assessment
Undergraduate Nursing Student Focus
Core Domains
Delegation & Supervision Principles • Prioritization & Clinical Judgment Frameworks • Staff Management & Resource Allocation • Communication &
Conflict Resolution Strategies • Legal-Ethical Standards & Patient Advocacy • Quality Improvement & Patient Safety Initiatives • Interprofessional
Collaboration & Team Dynamics • Change Management & Organizational Leadership • Performance Evaluation & Professional Development • Care
Coordination Across Healthcare Settings
Exam Structure
The ATI RN Leadership Enhanced NGN Proctored Examination is a 70-question timed assessment (approximately 2 hours) featuring Next
Generation NCLEX-style items including case studies, bowtie, trend, matrix, multiple-response, and highlight formats. Content is aligned with ATI
Leadership Management blueprints and the NCSBN Clinical Judgment Measurement Model.
Answer Format: Correct answers in bold green; rationales in italic text. This practice set uses multiple-choice, multiple-response, and
prioritization items that reflect NGN clinical judgment competencies.
Five Rights of Delegation (Quick Reference)
Right Key Question
Right Task Is the task appropriate to delegate (within scope, relatively predictable outcome)?
Right Circumstance Is the patient stable and the setting appropriate?
Right Person Does the delegatee have the knowledge, skill, and competency?
Right Direction/Communication Are clear, complete instructions and expectations given?
Right Supervision/Evaluation Is appropriate monitoring, feedback, and evaluation provided?
Prioritization Frameworks (ABC + Additional Guides)
Airway → Breathing → Circulation → Safety/Disability → Exposure. Also consider: acute vs chronic, unstable vs stable, actual vs potential problems,
Maslow’s hierarchy, and time-sensitive interventions.
Page 1 of 13
, ATI RN Leadership Enhanced NGN Proctored Exam 2026/2027 – Practice Guide
1. Delegation & Supervision Principles
1. Which task is most appropriate for an RN to delegate to a licensed practical nurse (LPN/LVN)?
A. Developing the initial plan of care for a newly admitted unstable patient
B. Administering oral medications to a stable postoperative patient
C. Performing the initial comprehensive assessment
D. Evaluating the effectiveness of a new teaching plan
Correct Answer: B. Administering oral medications to a stable postoperative patient
Rationale: LPNs may administer most oral medications to stable patients within their scope. Initial assessment, care
planning, and evaluation of teaching remain RN responsibilities.
2. Which task should the RN NOT delegate to an unlicensed assistive personnel (UAP)?
A. Assisting a stable patient with ambulation
B. Measuring and recording vital signs on a stable patient
C. Evaluating a patient’s response to a new pain medication
D. Providing routine hygiene care
Correct Answer: C. Evaluating a patient’s response to a new pain medication
Rationale: Evaluation of patient response to interventions requires nursing judgment and cannot be delegated to UAP.
Ambulation, vital signs, and hygiene for stable patients are appropriate.
3. When applying the Five Rights of Delegation, the “Right Person” means:
A. Any available staff member
B. The individual who has the verified knowledge, skill, and competency to perform the task
C. Only the charge nurse
D. The person who volunteers first
Correct Answer: B. The individual who has the verified knowledge, skill, and competency to perform the task
Rationale: The right person must possess the appropriate education, training, and demonstrated competency for the specific
task.
4. An RN delegates vital signs to a UAP. The most important follow-up action is:
A. Assume the task was completed correctly
B. Verify that the vital signs were obtained and review any abnormal findings, providing feedback as needed
C. Document that the task was delegated and take no further action
D. Reassign the task to another UAP without communication
Correct Answer: B. Verify that the vital signs were obtained and review any abnormal findings, providing feedback
as needed
Rationale: Right supervision/evaluation requires the RN to follow up on delegated tasks, interpret results, and provide
feedback.
5. Which situation represents appropriate delegation?
A. Asking a UAP to assess a patient’s new onset of chest pain
B. Asking an LPN to reinforce discharge teaching previously provided by the RN
C. Asking a UAP to develop a teaching plan
D. Asking an LPN to perform the initial triage assessment in the ED
Correct Answer: B. Asking an LPN to reinforce discharge teaching previously provided by the RN
Rationale: Reinforcement of teaching is within LPN scope; initial assessment, teaching plan development, and complex
evaluation remain RN responsibilities.
6. A newly graduated RN is unsure whether a task can be delegated. The best action is:
A. Delegate it anyway to save time
B. Consult the state nurse practice act, facility policy, and a more experienced nurse or supervisor
C. Refuse all delegation
D. Ask the UAP to decide
Correct Answer: B. Consult the state nurse practice act, facility policy, and a more experienced nurse or supervisor
Rationale: Scope of practice and facility policies guide safe delegation. Seeking clarification protects patients and the nurse.
7. Which activity is within the typical scope of unlicensed assistive personnel?
A. Interpreting laboratory results
B. Administering oral medications
Page 2 of 13
ATI RN Leadership 2026/2027
Enhanced NGN Proctored Examination
70 Questions and Answer Key with Verified Rationales
ATI Testing | RN Leadership Management Enhanced Next Generation NCLEX (NGN) Proctored Assessment
Undergraduate Nursing Student Focus
Core Domains
Delegation & Supervision Principles • Prioritization & Clinical Judgment Frameworks • Staff Management & Resource Allocation • Communication &
Conflict Resolution Strategies • Legal-Ethical Standards & Patient Advocacy • Quality Improvement & Patient Safety Initiatives • Interprofessional
Collaboration & Team Dynamics • Change Management & Organizational Leadership • Performance Evaluation & Professional Development • Care
Coordination Across Healthcare Settings
Exam Structure
The ATI RN Leadership Enhanced NGN Proctored Examination is a 70-question timed assessment (approximately 2 hours) featuring Next
Generation NCLEX-style items including case studies, bowtie, trend, matrix, multiple-response, and highlight formats. Content is aligned with ATI
Leadership Management blueprints and the NCSBN Clinical Judgment Measurement Model.
Answer Format: Correct answers in bold green; rationales in italic text. This practice set uses multiple-choice, multiple-response, and
prioritization items that reflect NGN clinical judgment competencies.
Five Rights of Delegation (Quick Reference)
Right Key Question
Right Task Is the task appropriate to delegate (within scope, relatively predictable outcome)?
Right Circumstance Is the patient stable and the setting appropriate?
Right Person Does the delegatee have the knowledge, skill, and competency?
Right Direction/Communication Are clear, complete instructions and expectations given?
Right Supervision/Evaluation Is appropriate monitoring, feedback, and evaluation provided?
Prioritization Frameworks (ABC + Additional Guides)
Airway → Breathing → Circulation → Safety/Disability → Exposure. Also consider: acute vs chronic, unstable vs stable, actual vs potential problems,
Maslow’s hierarchy, and time-sensitive interventions.
Page 1 of 13
, ATI RN Leadership Enhanced NGN Proctored Exam 2026/2027 – Practice Guide
1. Delegation & Supervision Principles
1. Which task is most appropriate for an RN to delegate to a licensed practical nurse (LPN/LVN)?
A. Developing the initial plan of care for a newly admitted unstable patient
B. Administering oral medications to a stable postoperative patient
C. Performing the initial comprehensive assessment
D. Evaluating the effectiveness of a new teaching plan
Correct Answer: B. Administering oral medications to a stable postoperative patient
Rationale: LPNs may administer most oral medications to stable patients within their scope. Initial assessment, care
planning, and evaluation of teaching remain RN responsibilities.
2. Which task should the RN NOT delegate to an unlicensed assistive personnel (UAP)?
A. Assisting a stable patient with ambulation
B. Measuring and recording vital signs on a stable patient
C. Evaluating a patient’s response to a new pain medication
D. Providing routine hygiene care
Correct Answer: C. Evaluating a patient’s response to a new pain medication
Rationale: Evaluation of patient response to interventions requires nursing judgment and cannot be delegated to UAP.
Ambulation, vital signs, and hygiene for stable patients are appropriate.
3. When applying the Five Rights of Delegation, the “Right Person” means:
A. Any available staff member
B. The individual who has the verified knowledge, skill, and competency to perform the task
C. Only the charge nurse
D. The person who volunteers first
Correct Answer: B. The individual who has the verified knowledge, skill, and competency to perform the task
Rationale: The right person must possess the appropriate education, training, and demonstrated competency for the specific
task.
4. An RN delegates vital signs to a UAP. The most important follow-up action is:
A. Assume the task was completed correctly
B. Verify that the vital signs were obtained and review any abnormal findings, providing feedback as needed
C. Document that the task was delegated and take no further action
D. Reassign the task to another UAP without communication
Correct Answer: B. Verify that the vital signs were obtained and review any abnormal findings, providing feedback
as needed
Rationale: Right supervision/evaluation requires the RN to follow up on delegated tasks, interpret results, and provide
feedback.
5. Which situation represents appropriate delegation?
A. Asking a UAP to assess a patient’s new onset of chest pain
B. Asking an LPN to reinforce discharge teaching previously provided by the RN
C. Asking a UAP to develop a teaching plan
D. Asking an LPN to perform the initial triage assessment in the ED
Correct Answer: B. Asking an LPN to reinforce discharge teaching previously provided by the RN
Rationale: Reinforcement of teaching is within LPN scope; initial assessment, teaching plan development, and complex
evaluation remain RN responsibilities.
6. A newly graduated RN is unsure whether a task can be delegated. The best action is:
A. Delegate it anyway to save time
B. Consult the state nurse practice act, facility policy, and a more experienced nurse or supervisor
C. Refuse all delegation
D. Ask the UAP to decide
Correct Answer: B. Consult the state nurse practice act, facility policy, and a more experienced nurse or supervisor
Rationale: Scope of practice and facility policies guide safe delegation. Seeking clarification protects patients and the nurse.
7. Which activity is within the typical scope of unlicensed assistive personnel?
A. Interpreting laboratory results
B. Administering oral medications
Page 2 of 13
