ATI RN Leadership Exam – (2023) Actual Questions &
Answers (ATI NGN Questions)
Section 1: Delegation and Scope of Practice (Questions 1–30)
1. A charge nurse is delegating tasks on a medical-surgical unit. Which task should
be assigned to an LPN?
A) Initial assessment of a new admission with chest pain
B) Administration of IV push morphine to a postoperative patient
C) Routine tracheostomy care on a stable patient
D) Teaching a diabetic patient how to self-administer insulin
Correct Answer: C
Rationale: LPNs can perform stable, routine procedures like tracheostomy
care. Initial assessments (A), IV push medications (B), and patient teaching (D) are
within the RN scope of practice and cannot be delegated to an LPN. The RN
retains responsibility for assessment, teaching, and evaluation.
2. A nurse is preparing to delegate hygiene care to a UAP. Which statement by the
nurse demonstrates appropriate delegation?
A) "Give the patient a bath sometime this morning."
B) "Please bathe Mrs. Jones in room 210 before 9 AM and report any skin
redness."
C) "You know how to bathe patients, just do what you think is best."
D) "If you have time, please bathe the patient in 210."
Correct Answer: B
Rationale: Effective delegation includes clear instructions, a specific time
frame, and reporting expectations. Vague or optional directions (A, C, D) increase
the risk of incomplete care and missed findings. The nurse must communicate the
task, expected outcome, and parameters for reporting.
,3. According to the "Five Rights of Delegation," which determination should the
nurse make prior to assigning a task?
A) Whether the UAP has consented to the performance of delegated tasks
B) The patient's willingness to consent to care from the UAP
C) Whether the task can be more efficiently performed by the UAP
D) The degree of supervision the UAP will require to complete the task
Correct Answer: D
Rationale: The Five Rights of Delegation include the right task, right
circumstance, right person, right direction/communication, and right
supervision/evaluation. Determining the degree of supervision required is
essential to ensure patient safety and appropriate oversight.
4. A nurse manager is assigning clients to staff members. Which client should be
assigned to the most experienced RN?
A) Client with pneumonia on oral antibiotics
B) Client with a hip fracture awaiting surgery
C) Client with unstable atrial fibrillation on a continuous heparin drip
D) Client with a urinary tract infection on IV fluids
Correct Answer: C
Rationale: Unstable atrial fibrillation and a heparin drip require advanced
assessment and titration skills. Stable, predictable clients (A, B, D) can be assigned
to less experienced nurses. The most complex and unstable clients should be
assigned to the most experienced RN.
5. A nurse is working with assistive personnel (AP) in a long-term care facility.
Which task is most appropriate to delegate to the AP?
A) Administering oral medications to a stable patient
B) Performing a focused respiratory assessment on a postoperative patient
C) Recording intake and output for a patient with heart failure
D) Evaluating the effectiveness of a new pain management plan
,Correct Answer: C
Rationale: Recording intake and output is a routine, non-invasive task
within the AP's scope of practice. Medication administration (A), focused
assessments (B), and evaluation of interventions (D) require the clinical judgment
and licensure of an RN.
6. A nurse is delegating tasks to an LPN. Which task is appropriate for the LPN?
A) Performing a comprehensive admission assessment
B) Administering a nasogastric tube feeding
C) Developing the plan of care for a complex client
D) Evaluating client outcomes after teaching
Correct Answer: B
Rationale: LPNs can administer NG tube feedings as this is within their
scope of practice. Comprehensive assessments (A), care plan development (C),
and outcome evaluation (D) are responsibilities of the registered nurse and
require RN-level clinical judgment.
7. A charge nurse is making assignments. Which task should be delegated to a
UAP?
A) Assisting a stable client with bathing
B) Administering a blood transfusion
C) Assessing a client's pain level
D) Teaching a client about a new medication
Correct Answer: A
Rationale: Assisting a stable client with bathing is a routine, non-invasive
task that is appropriate for a UAP. Blood transfusions (B), pain assessments (C),
and patient teaching (D) require the licensure and clinical judgment of an RN.
, 8. A nurse is preparing to delegate a task to a UAP. Which action should the nurse
take first?
A) Ensure the UAP has the necessary knowledge and skills to perform the task
B) Ask the UAP if they are willing to perform the task
C) Document the delegation in the patient's chart
D) Notify the provider that the task has been delegated
Correct Answer: A
Rationale: Before delegating any task, the nurse must assess the UAP's
competence, scope of practice, and ability to perform the task safely. This is the
"right person" component of the Five Rights of Delegation. Documentation and
notification occur after appropriate delegation has been determined.
9. A nurse is delegating to a UAP. Which instruction is most appropriate?
A) "Check on the patient in room 302 and let me know if anything is wrong."
B) "Take vital signs on all your patients and report any abnormalities to me."
C) "Measure and record vital signs for Mrs. Smith every 4 hours and report a BP
above 150/90 immediately."
D) "Assess Mrs. Smith's condition and report back to me."
Correct Answer: C
Rationale: Effective delegation includes specific tasks, clear parameters,
and defined reporting criteria. Option C provides specific timing, clear
parameters, and explicit reporting instructions. Options A, B, and D are vague and
do not provide clear guidance for the UAP.
10. A nurse manager 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 diagnosis
D) Right supervision
Answers (ATI NGN Questions)
Section 1: Delegation and Scope of Practice (Questions 1–30)
1. A charge nurse is delegating tasks on a medical-surgical unit. Which task should
be assigned to an LPN?
A) Initial assessment of a new admission with chest pain
B) Administration of IV push morphine to a postoperative patient
C) Routine tracheostomy care on a stable patient
D) Teaching a diabetic patient how to self-administer insulin
Correct Answer: C
Rationale: LPNs can perform stable, routine procedures like tracheostomy
care. Initial assessments (A), IV push medications (B), and patient teaching (D) are
within the RN scope of practice and cannot be delegated to an LPN. The RN
retains responsibility for assessment, teaching, and evaluation.
2. A nurse is preparing to delegate hygiene care to a UAP. Which statement by the
nurse demonstrates appropriate delegation?
A) "Give the patient a bath sometime this morning."
B) "Please bathe Mrs. Jones in room 210 before 9 AM and report any skin
redness."
C) "You know how to bathe patients, just do what you think is best."
D) "If you have time, please bathe the patient in 210."
Correct Answer: B
Rationale: Effective delegation includes clear instructions, a specific time
frame, and reporting expectations. Vague or optional directions (A, C, D) increase
the risk of incomplete care and missed findings. The nurse must communicate the
task, expected outcome, and parameters for reporting.
,3. According to the "Five Rights of Delegation," which determination should the
nurse make prior to assigning a task?
A) Whether the UAP has consented to the performance of delegated tasks
B) The patient's willingness to consent to care from the UAP
C) Whether the task can be more efficiently performed by the UAP
D) The degree of supervision the UAP will require to complete the task
Correct Answer: D
Rationale: The Five Rights of Delegation include the right task, right
circumstance, right person, right direction/communication, and right
supervision/evaluation. Determining the degree of supervision required is
essential to ensure patient safety and appropriate oversight.
4. A nurse manager is assigning clients to staff members. Which client should be
assigned to the most experienced RN?
A) Client with pneumonia on oral antibiotics
B) Client with a hip fracture awaiting surgery
C) Client with unstable atrial fibrillation on a continuous heparin drip
D) Client with a urinary tract infection on IV fluids
Correct Answer: C
Rationale: Unstable atrial fibrillation and a heparin drip require advanced
assessment and titration skills. Stable, predictable clients (A, B, D) can be assigned
to less experienced nurses. The most complex and unstable clients should be
assigned to the most experienced RN.
5. A nurse is working with assistive personnel (AP) in a long-term care facility.
Which task is most appropriate to delegate to the AP?
A) Administering oral medications to a stable patient
B) Performing a focused respiratory assessment on a postoperative patient
C) Recording intake and output for a patient with heart failure
D) Evaluating the effectiveness of a new pain management plan
,Correct Answer: C
Rationale: Recording intake and output is a routine, non-invasive task
within the AP's scope of practice. Medication administration (A), focused
assessments (B), and evaluation of interventions (D) require the clinical judgment
and licensure of an RN.
6. A nurse is delegating tasks to an LPN. Which task is appropriate for the LPN?
A) Performing a comprehensive admission assessment
B) Administering a nasogastric tube feeding
C) Developing the plan of care for a complex client
D) Evaluating client outcomes after teaching
Correct Answer: B
Rationale: LPNs can administer NG tube feedings as this is within their
scope of practice. Comprehensive assessments (A), care plan development (C),
and outcome evaluation (D) are responsibilities of the registered nurse and
require RN-level clinical judgment.
7. A charge nurse is making assignments. Which task should be delegated to a
UAP?
A) Assisting a stable client with bathing
B) Administering a blood transfusion
C) Assessing a client's pain level
D) Teaching a client about a new medication
Correct Answer: A
Rationale: Assisting a stable client with bathing is a routine, non-invasive
task that is appropriate for a UAP. Blood transfusions (B), pain assessments (C),
and patient teaching (D) require the licensure and clinical judgment of an RN.
, 8. A nurse is preparing to delegate a task to a UAP. Which action should the nurse
take first?
A) Ensure the UAP has the necessary knowledge and skills to perform the task
B) Ask the UAP if they are willing to perform the task
C) Document the delegation in the patient's chart
D) Notify the provider that the task has been delegated
Correct Answer: A
Rationale: Before delegating any task, the nurse must assess the UAP's
competence, scope of practice, and ability to perform the task safely. This is the
"right person" component of the Five Rights of Delegation. Documentation and
notification occur after appropriate delegation has been determined.
9. A nurse is delegating to a UAP. Which instruction is most appropriate?
A) "Check on the patient in room 302 and let me know if anything is wrong."
B) "Take vital signs on all your patients and report any abnormalities to me."
C) "Measure and record vital signs for Mrs. Smith every 4 hours and report a BP
above 150/90 immediately."
D) "Assess Mrs. Smith's condition and report back to me."
Correct Answer: C
Rationale: Effective delegation includes specific tasks, clear parameters,
and defined reporting criteria. Option C provides specific timing, clear
parameters, and explicit reporting instructions. Options A, B, and D are vague and
do not provide clear guidance for the UAP.
10. A nurse manager 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 diagnosis
D) Right supervision
