ORIGINAL ATI RN LEADERSHIP PROCTORED EXAM
, ORIGINAL ATI RN LEADERSHIP PROCTORED EXAM
Category 1: Prioritization & Delegation (1-15)
1. A nurse is caring for four clients. Which of the following clients should the nurse assess
first?
A. A client with COPD who requests pain medication for a headache.
B. A client with meningitis who has become confused and lethargic.
C. A client 2 days postoperative who wants to ambulate.
D. A client with diabetes who is requesting breakfast.
Answer: B
Rationale: A decrease in level of consciousness (confusion/lethargy) in a client with meningitis
indicates increased intracranial pressure, a life-threatening emergency. The other clients have
stable, non-urgent needs.
2. A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks is
appropriate for the nurse to delegate?
A. Assessing a client's surgical incision.
B. Teaching a client how to use an incentive spirometer.
C. Ambulating a stable client who had surgery yesterday.
D. Administering oral pain medication.
Answer: C
Rationale: The nurse can delegate routine tasks like ambulating a stable client to AP.
Assessment, teaching, and medication administration are tasks that cannot be delegated to AP.
3. A nurse is supervising an AP who is feeding a client with dysphagia. Which action by the AP
indicates correct technique?
A. Placing the client in a supine position.
B. Instructing the client to place their chin to their chest while swallowing.
C. Offering thin liquids with a straw.
D. Feeding the client quickly to finish the meal.
Answer: B
Rationale: The chin-tuck maneuver helps close the airway and prevents aspiration in clients
with dysphagia. The client should be upright, and thin liquids/straws often increase aspiration
risk.
, ORIGINAL ATI RN LEADERSHIP PROCTORED EXAM
4. A nurse is caring for a client who wanders the halls yelling obscenities. Which action should
the nurse take first?
A. Administer a PRN sedative.
B. Place the client in a wheelchair with a lap tray.
C. Contact family members to come sit with the client.
D. Guide the client to a quiet area and engage them in a diversional activity.
Answer: D
Rationale: The least restrictive intervention should be attempted first to de-escalate the
behavior. Sedatives and restraints (lap tray) are restrictive and require specific protocols.
5. A nurse is assigning client care to an LPN and an AP. Which client should the nurse assign to
the LPN?
A. A client who needs a bed bath.
B. A client who requires a sterile dressing change.
C. A client who needs vital signs taken.
D. A client who needs to be fed.
Answer: B
Rationale: LPNs can perform sterile dressing changes. Basic ADLs (bathing, feeding, vital signs)
should be delegated to the AP.
6. A nurse is caring for a client who has end-stage heart failure. The partner states they can no
longer handle caring for the client. Which action should the nurse take?
A. Tell the partner they must continue caring for the client.
B. Contact the case manager to discuss discharge options.
C. Ask the AP to talk to the partner.
D. Discharge the client home immediately.
Answer: B
Rationale: The case manager coordinates resources, respite care, and placement options for
clients with complex discharge needs and caregiver burnout.
, ORIGINAL ATI RN LEADERSHIP PROCTORED EXAM
Category 1: Prioritization & Delegation (1-15)
1. A nurse is caring for four clients. Which of the following clients should the nurse assess
first?
A. A client with COPD who requests pain medication for a headache.
B. A client with meningitis who has become confused and lethargic.
C. A client 2 days postoperative who wants to ambulate.
D. A client with diabetes who is requesting breakfast.
Answer: B
Rationale: A decrease in level of consciousness (confusion/lethargy) in a client with meningitis
indicates increased intracranial pressure, a life-threatening emergency. The other clients have
stable, non-urgent needs.
2. A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks is
appropriate for the nurse to delegate?
A. Assessing a client's surgical incision.
B. Teaching a client how to use an incentive spirometer.
C. Ambulating a stable client who had surgery yesterday.
D. Administering oral pain medication.
Answer: C
Rationale: The nurse can delegate routine tasks like ambulating a stable client to AP.
Assessment, teaching, and medication administration are tasks that cannot be delegated to AP.
3. A nurse is supervising an AP who is feeding a client with dysphagia. Which action by the AP
indicates correct technique?
A. Placing the client in a supine position.
B. Instructing the client to place their chin to their chest while swallowing.
C. Offering thin liquids with a straw.
D. Feeding the client quickly to finish the meal.
Answer: B
Rationale: The chin-tuck maneuver helps close the airway and prevents aspiration in clients
with dysphagia. The client should be upright, and thin liquids/straws often increase aspiration
risk.
, ORIGINAL ATI RN LEADERSHIP PROCTORED EXAM
4. A nurse is caring for a client who wanders the halls yelling obscenities. Which action should
the nurse take first?
A. Administer a PRN sedative.
B. Place the client in a wheelchair with a lap tray.
C. Contact family members to come sit with the client.
D. Guide the client to a quiet area and engage them in a diversional activity.
Answer: D
Rationale: The least restrictive intervention should be attempted first to de-escalate the
behavior. Sedatives and restraints (lap tray) are restrictive and require specific protocols.
5. A nurse is assigning client care to an LPN and an AP. Which client should the nurse assign to
the LPN?
A. A client who needs a bed bath.
B. A client who requires a sterile dressing change.
C. A client who needs vital signs taken.
D. A client who needs to be fed.
Answer: B
Rationale: LPNs can perform sterile dressing changes. Basic ADLs (bathing, feeding, vital signs)
should be delegated to the AP.
6. A nurse is caring for a client who has end-stage heart failure. The partner states they can no
longer handle caring for the client. Which action should the nurse take?
A. Tell the partner they must continue caring for the client.
B. Contact the case manager to discuss discharge options.
C. Ask the AP to talk to the partner.
D. Discharge the client home immediately.
Answer: B
Rationale: The case manager coordinates resources, respite care, and placement options for
clients with complex discharge needs and caregiver burnout.
