ATI Nursing Leadership 2026/2027 | ACTUAL-Style
Practice Questions & Answers, ATI RN Leadership
and Management Exam Prep, Nursing Delegation,
Prioritization, Assignment Decisions, Patient Safety,
Quality Improvement, Ethical and Legal Issues,
Conflict Resolution, and Detailed Rationales
Question 1: A nurse is preparing to delegate vital sign measurement for
a stable postoperative client to assistive personnel (AP). Which of the
following actions should the nurse take first?
A. Instruct the AP to report any abnormal findings immediately
B. Verify the AP's competency in vital sign measurement
C. Document the delegation in the client's medical record
D. Inform the client that the AP will be taking vital signs
CORRECT ANSWER: B. Verify the AP's competency in vital sign
measurement
Rationale: Before delegating any task, the nurse must first verify that the
delegatee has the appropriate education, training, and demonstrated
competency to perform the task safely. The Five Rights of Delegation
include the right person, and competency verification is a prerequisite to
safe delegation. While instructing the AP to report abnormal findings (A),
documenting the delegation (C), and informing the client (D) are all
appropriate actions, they occur after competency has been verified.
Question 2: A nurse manager is reviewing the stages of conflict
resolution with staff. Which of the following sequences represents the
correct order of the conflict process?
A. Latent conflict → Perceived conflict → Felt conflict → Manifest conflict →
Conflict aftermath
B. Perceived conflict → Latent conflict → Manifest conflict → Felt conflict →
Conflict aftermath
C. Felt conflict → Latent conflict → Perceived conflict → Conflict aftermath →
Manifest conflict
D. Manifest conflict → Felt conflict → Latent conflict → Perceived conflict →
Conflict aftermath
CORRECT ANSWER: A. Latent conflict → Perceived conflict → Felt
conflict → Manifest conflict → Conflict aftermath
,Rationale: The conflict process begins with latent conflict (awareness of
potential situations that can create conflict), progresses to perceived
conflict (discussion of the situation in an impersonal manner), then felt
conflict (personal involvement of those affected), then manifest conflict
(taking action), and concludes with conflict aftermath (recognition of
positive and negative outcomes from how the situation was managed). This
sequence reflects the standard framework for understanding how conflicts
develop and resolve in organizational settings .
Question 3: A nurse is caring for a client who has a DNR (do-not-
resuscitate) order and experiences cardiac arrest. The assistive
personnel (AP) reports to the nurse that the client has no pulse. Which
of the following actions should the nurse take?
A. Initiate CPR immediately
B. Verify the DNR order and withhold resuscitation
C. Call a code blue and begin chest compressions
D. Ask the AP to continue assessing the client while the nurse checks the
chart
CORRECT ANSWER: B. Verify the DNR order and withhold resuscitation
Rationale: For clients with valid DNR orders, CPR is not initiated when
cardiac arrest occurs. The nurse is responsible for verifying the DNR order
and making clinical decisions in such situations. Initiating CPR (A or C)
would violate the client's expressed wishes and the legal directive. Asking
the AP to continue assessment while checking the chart (D) delays
appropriate action; the nurse should be familiar with the client's code
status and act accordingly .
Question 4: A nurse is using Maslow's hierarchy of needs to prioritize
care for a group of clients. Which of the following clients should the
nurse address first?
A. A client who is crying and states, "No one cares about me"
B. A client who reports feeling dizzy when standing up
C. A client who is asking about discharge instructions
D. A client who wants to discuss their anxiety about surgery
CORRECT ANSWER: B. A client who reports feeling dizzy when standing
up
,Rationale: Maslow's hierarchy prioritizes physiological needs first, which
include oxygen, circulation, and physical safety. Dizziness upon standing
may indicate orthostatic hypotension or inadequate cerebral perfusion,
representing an immediate physiological concern. Emotional needs (A and
D) and discharge planning (C) are important but fall higher on Maslow's
hierarchy and do not pose an immediate threat to physiological stability.
Question 5: A charge nurse observes an LPN telling a client they will
return with a medication for nausea but does not return. Which ethical
principle should the charge nurse reinforce with the LPN?
A. Justice
B. Veracity
C. Fidelity
D. Nonmaleficence
CORRECT ANSWER: C. Fidelity
Rationale: Fidelity refers to keeping promises and being faithful to
commitments made to clients. By telling the client they would return with
medication and then failing to do so, the LPN has violated the principle of
fidelity. Justice (A) relates to fairness and equal treatment. Veracity (B)
refers to truthfulness and honesty. Nonmaleficence (D) means to do no
harm .
Question 6: A nurse is preparing to administer an opioid to a
postoperative client. Which of the following assessment findings
requires the nurse to withhold the medication and notify the provider?
A. Pain rating of 8 on a scale of 0 to 10
B. Respiratory rate of 9 breaths per minute
C. Blood pressure of 108/68 mm Hg
D. Last bowel movement was 2 days ago
CORRECT ANSWER: B. Respiratory rate of 9 breaths per minute
Rationale: Opioids depress the central nervous system and can cause
respiratory depression. A respiratory rate below 12 breaths per minute is a
contraindication to opioid administration and requires withholding the
medication and notifying the provider immediately. A high pain rating (A)
indicates the need for pain management but does not contraindicate
opioid use if vital signs are stable. Blood pressure of 108/68 (C) is within
, normal limits. Constipation (D) is a common side effect but not a reason to
withhold the medication .
Question 7: A nurse is prioritizing care for four clients. Which client
should the nurse assess first?
A. A client who had abdominal surgery 6 hours ago and has a heart rate of
120/min
B. A client who is 1 day postoperative following hip arthroplasty and reports
pain of 5/10
C. A client who has diabetes mellitus and a blood glucose level of 110
mg/dL
D. A client who has a new diagnosis of cancer and is crying
CORRECT ANSWER: A. A client who had abdominal surgery 6 hours ago
and has a heart rate of 120/min
Rationale: A sustained tachycardia of 120/min in a postoperative client
may indicate early signs of hypovolemia, hemorrhage, or shock, which are
potentially life-threatening complications requiring immediate
assessment. Pain management (B), a normal blood glucose level (C), and
emotional support (D) are important but do not represent immediate
physiological threats .
Question 8: A nurse is reviewing the five rights of delegation. Which of
the following is NOT one of the five rights?
A. Right task
B. Right circumstance
C. Right documentation
D. Right supervision
CORRECT ANSWER: C. Right documentation
Rationale: The five rights of delegation are: right task, right circumstance,
right person, right direction/communication, and right
supervision/evaluation. "Right documentation" is not included as one of
the five rights, though documentation of delegated tasks remains an
important nursing responsibility .
Question 9: A nurse is teaching a client about informed consent. Which
statement by the client indicates correct understanding?
Practice Questions & Answers, ATI RN Leadership
and Management Exam Prep, Nursing Delegation,
Prioritization, Assignment Decisions, Patient Safety,
Quality Improvement, Ethical and Legal Issues,
Conflict Resolution, and Detailed Rationales
Question 1: A nurse is preparing to delegate vital sign measurement for
a stable postoperative client to assistive personnel (AP). Which of the
following actions should the nurse take first?
A. Instruct the AP to report any abnormal findings immediately
B. Verify the AP's competency in vital sign measurement
C. Document the delegation in the client's medical record
D. Inform the client that the AP will be taking vital signs
CORRECT ANSWER: B. Verify the AP's competency in vital sign
measurement
Rationale: Before delegating any task, the nurse must first verify that the
delegatee has the appropriate education, training, and demonstrated
competency to perform the task safely. The Five Rights of Delegation
include the right person, and competency verification is a prerequisite to
safe delegation. While instructing the AP to report abnormal findings (A),
documenting the delegation (C), and informing the client (D) are all
appropriate actions, they occur after competency has been verified.
Question 2: A nurse manager is reviewing the stages of conflict
resolution with staff. Which of the following sequences represents the
correct order of the conflict process?
A. Latent conflict → Perceived conflict → Felt conflict → Manifest conflict →
Conflict aftermath
B. Perceived conflict → Latent conflict → Manifest conflict → Felt conflict →
Conflict aftermath
C. Felt conflict → Latent conflict → Perceived conflict → Conflict aftermath →
Manifest conflict
D. Manifest conflict → Felt conflict → Latent conflict → Perceived conflict →
Conflict aftermath
CORRECT ANSWER: A. Latent conflict → Perceived conflict → Felt
conflict → Manifest conflict → Conflict aftermath
,Rationale: The conflict process begins with latent conflict (awareness of
potential situations that can create conflict), progresses to perceived
conflict (discussion of the situation in an impersonal manner), then felt
conflict (personal involvement of those affected), then manifest conflict
(taking action), and concludes with conflict aftermath (recognition of
positive and negative outcomes from how the situation was managed). This
sequence reflects the standard framework for understanding how conflicts
develop and resolve in organizational settings .
Question 3: A nurse is caring for a client who has a DNR (do-not-
resuscitate) order and experiences cardiac arrest. The assistive
personnel (AP) reports to the nurse that the client has no pulse. Which
of the following actions should the nurse take?
A. Initiate CPR immediately
B. Verify the DNR order and withhold resuscitation
C. Call a code blue and begin chest compressions
D. Ask the AP to continue assessing the client while the nurse checks the
chart
CORRECT ANSWER: B. Verify the DNR order and withhold resuscitation
Rationale: For clients with valid DNR orders, CPR is not initiated when
cardiac arrest occurs. The nurse is responsible for verifying the DNR order
and making clinical decisions in such situations. Initiating CPR (A or C)
would violate the client's expressed wishes and the legal directive. Asking
the AP to continue assessment while checking the chart (D) delays
appropriate action; the nurse should be familiar with the client's code
status and act accordingly .
Question 4: A nurse is using Maslow's hierarchy of needs to prioritize
care for a group of clients. Which of the following clients should the
nurse address first?
A. A client who is crying and states, "No one cares about me"
B. A client who reports feeling dizzy when standing up
C. A client who is asking about discharge instructions
D. A client who wants to discuss their anxiety about surgery
CORRECT ANSWER: B. A client who reports feeling dizzy when standing
up
,Rationale: Maslow's hierarchy prioritizes physiological needs first, which
include oxygen, circulation, and physical safety. Dizziness upon standing
may indicate orthostatic hypotension or inadequate cerebral perfusion,
representing an immediate physiological concern. Emotional needs (A and
D) and discharge planning (C) are important but fall higher on Maslow's
hierarchy and do not pose an immediate threat to physiological stability.
Question 5: A charge nurse observes an LPN telling a client they will
return with a medication for nausea but does not return. Which ethical
principle should the charge nurse reinforce with the LPN?
A. Justice
B. Veracity
C. Fidelity
D. Nonmaleficence
CORRECT ANSWER: C. Fidelity
Rationale: Fidelity refers to keeping promises and being faithful to
commitments made to clients. By telling the client they would return with
medication and then failing to do so, the LPN has violated the principle of
fidelity. Justice (A) relates to fairness and equal treatment. Veracity (B)
refers to truthfulness and honesty. Nonmaleficence (D) means to do no
harm .
Question 6: A nurse is preparing to administer an opioid to a
postoperative client. Which of the following assessment findings
requires the nurse to withhold the medication and notify the provider?
A. Pain rating of 8 on a scale of 0 to 10
B. Respiratory rate of 9 breaths per minute
C. Blood pressure of 108/68 mm Hg
D. Last bowel movement was 2 days ago
CORRECT ANSWER: B. Respiratory rate of 9 breaths per minute
Rationale: Opioids depress the central nervous system and can cause
respiratory depression. A respiratory rate below 12 breaths per minute is a
contraindication to opioid administration and requires withholding the
medication and notifying the provider immediately. A high pain rating (A)
indicates the need for pain management but does not contraindicate
opioid use if vital signs are stable. Blood pressure of 108/68 (C) is within
, normal limits. Constipation (D) is a common side effect but not a reason to
withhold the medication .
Question 7: A nurse is prioritizing care for four clients. Which client
should the nurse assess first?
A. A client who had abdominal surgery 6 hours ago and has a heart rate of
120/min
B. A client who is 1 day postoperative following hip arthroplasty and reports
pain of 5/10
C. A client who has diabetes mellitus and a blood glucose level of 110
mg/dL
D. A client who has a new diagnosis of cancer and is crying
CORRECT ANSWER: A. A client who had abdominal surgery 6 hours ago
and has a heart rate of 120/min
Rationale: A sustained tachycardia of 120/min in a postoperative client
may indicate early signs of hypovolemia, hemorrhage, or shock, which are
potentially life-threatening complications requiring immediate
assessment. Pain management (B), a normal blood glucose level (C), and
emotional support (D) are important but do not represent immediate
physiological threats .
Question 8: A nurse is reviewing the five rights of delegation. Which of
the following is NOT one of the five rights?
A. Right task
B. Right circumstance
C. Right documentation
D. Right supervision
CORRECT ANSWER: C. Right documentation
Rationale: The five rights of delegation are: right task, right circumstance,
right person, right direction/communication, and right
supervision/evaluation. "Right documentation" is not included as one of
the five rights, though documentation of delegated tasks remains an
important nursing responsibility .
Question 9: A nurse is teaching a client about informed consent. Which
statement by the client indicates correct understanding?
