ATI RN Leadership CMS Proctored Exam | Latest Update 2026/2027 | 200 Questions and Verified Answers | NGN Test Bank | A+ Guide | Instant Download PDF

ATI RN Leadership CMS Proctored Exam | Latest Update 2026/2027 |
200 Questions and Verified Answers | NGN Test Bank | A+ Guide

Section 1: Delegation, Assignment & Supervision (Questions 1–40)


1. A charge nurse on a medical-surgical unit is delegating tasks for the shift. Which task is most
appropriate to delegate to a licensed practical nurse (LPN)?
A) Administering an initial admission assessment on a newly admitted patient with chest pain
B) Performing tracheostomy suctioning on a patient with a stable, long-term tracheostomy
C) Teaching a newly diagnosed diabetic patient how to administer insulin
D) Administering an IV push dose of metoprolol for a patient with rapid atrial fibrillation
Answer B: Performing tracheostomy suctioning on a patient with a stable, long-term tracheostomy
Rationale: The LPN can perform stable, predictable tasks such as tracheostomy care and suctioning for
stable patients. The RN must perform initial assessments, patient teaching, and IV push medications.




2. A registered nurse (RN) is planning care for four patients. Which task is appropriate to delegate to
an unlicensed assistive personnel (UAP)?
A) Evaluating the effectiveness of pain medication administered 30 minutes ago
B) Collecting a clean-catch urine specimen from a stable patient
C) Assessing a postoperative patient for signs of bleeding
D) Teaching a patient how to use an incentive spirometer after surgery
Answer B: Collecting a clean-catch urine specimen from a stable patient
Rationale: UAPs may collect specimens from stable patients. Assessment and patient teaching are outside
the UAP scope and must be performed by the RN.




3. A nurse manager is reviewing the five rights of delegation with staff. Which right of delegation is
violated when an RN delegates wound irrigation for a patient with a new, complex wound to a UAP?
A) Right task
B) Right circumstances
C) Right person

,D) Right direction/communication
Answer A: Right task
Rationale: Wound irrigation is an assessment-related skill requiring nursing judgment and is not
appropriate to delegate to a UAP. The right task requires that the delegated activity falls within the
delegatee's scope and competence.




4. An RN is supervising an LPN who is caring for a group of patients. The RN must provide initial
direction, periodic monitoring, and follow-up evaluation. This describes which component of
delegation?
A) Assignment
B) Supervision
C) Accountability
D) Authority
Answer B: Supervision
Rationale: Supervision includes providing initial directions, periodic monitoring and inspection of tasks, and
follow-up evaluation to ensure correct completion.




5. Which patient care activity should the RN perform rather than delegate to an LPN?
A) Administering oral medications to a stable patient with hypertension
B) Inserting a nasogastric (NG) tube and verifying placement by pH testing
C) Irrigating an established NG tube in a stable patient
D) Administering enteral feedings through an established gastrostomy tube
Answer B: Inserting a nasogastric (NG) tube and verifying placement by pH testing
Rationale: NG tube insertion and initial verification of placement require nursing assessment and judgment;
therefore, the RN must perform this task. LPNs may irrigate established tubes and administer enteral
feedings for stable patients.




6. A charge nurse is making shift assignments. Which task is appropriate to assign to a licensed
practical nurse?
A) Pick up the meal trays after lunch
B) Administer a nasogastric tube feeding
C) Plan break times for assistive personnel
D) Determine adequacy of ventilator settings

,Answer B: Administer a nasogastric tube feeding
Rationale: Administering a nasogastric tube feeding is within the LPN scope of practice for stable patients.
Picking up meal trays is UAP work, planning breaks is a management function, and determining ventilator
settings requires RN assessment.




7. An RN is delegating tasks to a UAP. Which of the following should the RN include in the delegation?
A) The patient's medical diagnosis
B) Specific instructions for the task, including expected outcomes
C) The patient's complete medical history
D) The patient's prognosis
Answer B: Specific instructions for the task, including expected outcomes
Rationale: The right direction/communication requires clear, specific instructions and expected outcomes.
The RN should provide necessary information for the task without overloading the UAP with irrelevant
details.




8. A nurse manager is observing an RN delegate a task to a UAP. Which of the following indicates
appropriate delegation?
A) The RN delegates assessment of a patient's wound to the UAP
B) The RN verifies the UAP's competency before delegating the task
C) The RN delegates medication administration to the UAP
D) The RN delegates teaching a patient about dietary restrictions to the UAP
Answer B: The RN verifies the UAP's competency before delegating the task
Rationale: The right person requires that the delegatee is competent to perform the task. Verification of
competency is essential before delegation.




9. A charge nurse is assigning a patient to an LPN. Which patient is appropriate for the LPN?
A) A patient who is 2 hours post-operative from a coronary artery bypass graft
B) A patient with a stable tracheostomy who requires routine suctioning
C) A patient with new-onset chest pain requiring telemetry monitoring
D) A patient who requires initial discharge teaching about warfarin
Answer B: A patient with stable tracheostomy who requires routine suctioning
Rationale: LPNs can care for stable patients with predictable outcomes. Post-operative, unstable, or
teaching-intensive patients require RN assignment.

, 10. The RN is supervising an LPN who is caring for a patient with a new colostomy. The LPN reports that
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j the stoma is dark and dusky. What should the RN do first?
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A) Ask the LPN to document the finding
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B) Assess the patient and stoma personally
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C) Tell the LPN to notify the provider
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D) Reassure the LPN that this is a normal finding
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Answer B: Assess the patient and stoma personally
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Rationale: Supervision requires the RN to personally assess any changes or concerns reported by the LPN. A
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j dark, dusky stoma may indicate ischemia and requires immediate RN assessment.
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11. A nurse manager is teaching staff about the difference between delegation and assignment. Which
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A) Assignment transfers responsibility for a task; delegation transfers both responsibility and accountability
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B) Delegation transfers responsibility; assignment transfers accountability
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C) Assignment and delegation are the same thing
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D) Delegation is only for RNs to LPNs; assignment is for RNs to UAPs
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Answer A: Assignment transfers responsibility for a task; delegation transfers both responsibility and
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Rationale: Assignment is the transfer of responsibility for a task; delegation transfers both responsibility and
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12. An RN is delegating the collection of a sterile urine specimen to a UAP. Which of the following should
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A) The patient's complete medical history
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B) The specific steps for collecting the specimen and the expected outcome
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C) The patient's diagnosis and prognosis
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D) The patient's family history
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Answer B: The specific steps for collecting the specimen and the expected outcome
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Rationale: The right direction/communication includes specific instructions and expected outcomes for the
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