ATI Capstone Leadership Exam
ACTUAL EXAM 2026/2027 | ATI
Leadership Capstone | Verified Q&A |
Pass Guaranteed - A+ Graded
SECTION 1: DELEGATION, SUPERVISION, & ASSIGNMENT (35 Questions)
Q1: A charge nurse on a busy medical-surgical unit has the following staff: 2 RNs, 1 PN, and 2 UAPs.
Which task is appropriate to delegate to the PN? A. Complete the initial admission assessment for a
newly admitted patient with chest pain B. Administer IV push morphine 2 mg to a post-op patient C.
Reinforce wound care teaching for a patient being discharged tomorrow [CORRECT] D. Perform the first
sterile dressing change on a fresh surgical wound
Correct Answer: C
Rationale: PNs can reinforce previously taught education and perform stable, routine care; initial
assessments, IV push medications, and first sterile dressing changes on fresh wounds require RN
judgment and scope.
Q2: The charge nurse is assigning a UAP to assist with morning care. Which patient should the charge
nurse assign to the UAP? A. A patient with new-onset confusion and unsteady gait B. A patient on strict
bed rest with a new Foley catheter C. A stable patient who is 2 days post-op and ambulating
independently [CORRECT] D. A patient with a new colostomy requiring pouch emptying
Correct Answer: C
Rationale: UAP scope includes stable patients with predictable outcomes; new confusion, new Foley
care education, and ostomy management exceed UAP scope or require nursing judgment.
Q3: A nurse is delegating tasks to a UAP. Which statement demonstrates proper delegation according to
the Five Rights of Delegation? A. "Please check the patient's vital signs and let me know if anything looks
,wrong." B. "Take Mr. Smith's blood pressure, heart rate, respiratory rate, and temperature every 4
hours and report the results to me by 1400." [CORRECT] C. "Go ahead and give the patient their
medications if they seem uncomfortable." D. "Can you evaluate how the patient is responding to the
new pain medication?"
Correct Answer: B
Rationale: Proper delegation requires right task, right circumstance, right person, right
direction/communication, and right supervision—specific instructions with clear reporting expectations
fulfill this.
Q4: An RN is supervising a PN who has been assigned four stable patients. The PN reports that one
patient has developed new crackles in the lungs and a temperature of 101.2°F. What is the RN's priority
action? A. Instruct the PN to administer the PRN antipyretic and continue monitoring B. Reassign the
patient to the RN and assess the patient immediately [CORRECT] C. Tell the PN to document the findings
and notify the provider D. Ask the PN to increase the patient's fluid intake and reassess in 2 hours
Correct Answer: B
Rationale: New crackles and fever indicate potential deterioration beyond stable PN scope; the RN must
reassume care and assess promptly to ensure patient safety.
Q5: A charge nurse is reviewing assignments for the shift. Which task can an experienced UAP perform
without direct supervision? A. Documenting intake and output for a stable patient [CORRECT] B.
Assessing a patient's pain level after receiving pain medication C. Teaching a patient how to use an
incentive spirometer D. Administering a scheduled oral medication
Correct Answer: A
Rationale: UAPs can collect and record data for stable patients under RN supervision; assessment,
teaching, and medication administration remain within RN/PN scope only.
Q6: A nurse manager is creating a staffing grid for the night shift. Which factor is most important when
determining the appropriate mix of RNs, PNs, and UAPs? A. The number of patients scheduled for
discharge in the morning B. The acuity level and stability of the patient population [CORRECT] C. The
personal preferences of the nursing staff D. The budget allocated for overtime pay
Correct Answer: B
Rationale: Patient acuity and stability directly determine the required skill mix; higher acuity requires
more RNs, while stable patients may be appropriately cared for by PNs and UAPs.
,Q7: A UAP reports to the RN that a patient has a blood pressure of 88/52 mmHg. The patient was
previously stable. What is the RN's first action? A. Instruct the UAP to recheck the blood pressure in 30
minutes B. Assess the patient immediately and verify the finding [CORRECT] C. Tell the UAP to elevate
the patient's legs and call back D. Document the finding and notify the provider
Correct Answer: B
Rationale: The RN must validate abnormal findings and assess the patient directly; delegating further
action without assessment violates supervision responsibilities and delays critical intervention.
Q8: Which task is appropriate for an RN to delegate to a PN in a long-term care facility? A. Developing
the initial plan of care for a new admission B. Administering a routine influenza vaccine via
intramuscular injection [CORRECT] C. Performing the comprehensive head-to-toe assessment on
admission D. Analyzing lab results and adjusting the care plan accordingly
Correct Answer: B
Rationale: PNs in LTC can administer routine medications and vaccines per protocol; care planning,
comprehensive assessments, and clinical analysis require RN scope.
Q9: A charge nurse notices that a newly hired UAP is performing a blood glucose check without having
demonstrated competency. What is the charge nurse's priority action? A. Allow the UAP to continue and
evaluate the result afterward B. Stop the UAP immediately and verify competency before allowing the
task to continue [CORRECT] C. Assign an RN to supervise the UAP during the procedure D. Document the
incident and address it at the next staff meeting
Correct Answer: B
Rationale: The right person principle requires verified competency before delegation; allowing an
unverified UAP to perform a skill creates immediate patient safety risk.
Q10: An RN is working with a PN and two UAPs. Which assignment demonstrates appropriate
delegation? A. The PN is assigned to admit a new patient with active chest pain B. One UAP is assigned
to ambulate a stable post-op patient, and the PN is assigned to monitor a patient on a new heparin drip
[CORRECT] C. The RN delegates the assessment of a patient with new-onset dyspnea to the PN D. Both
UAPs are assigned to provide total care for patients on continuous cardiac monitoring
Correct Answer: B
, Rationale: UAPs handle stable, routine tasks; PNs manage stable patients with predictable outcomes
including medication administration; RNs retain complex, unstable, or new patients.
Q11: A nurse is supervising a PN who asks to perform a sterile wound irrigation on a patient with a new
surgical wound. What is the appropriate response? A. "Yes, as long as you wear sterile gloves." B. "No,
this task requires RN assessment and judgment due to the newness of the wound." [CORRECT] C. "Yes,
but have the UAP assist you with the setup." D. "No, only the physician can perform sterile wound
irrigations."
Correct Answer: B
Rationale: New surgical wounds require RN assessment for signs of infection or dehiscence; sterile
irrigation of a fresh wound falls outside stable, routine PN scope.
Q12: A charge nurse receives a call from the emergency department that four patients are being
admitted. Which patient is most appropriate to assign to the PN? A. A patient with new-onset atrial
fibrillation and a heart rate of 150 bpm B. A patient with a stable blood pressure who needs a routine
post-op appendectomy admission C. A patient with chest pain of unknown origin requiring continuous
monitoring D. A patient with acute stroke symptoms and a new NIHSS score
Correct Answer: B
Rationale: Stable post-op admissions with predictable recovery trajectories fit PN scope; new
arrhythmias, undifferentiated chest pain, and acute strokes require immediate RN assessment and
intervention.
Q13: A UAP is assigned to a patient with a diagnosis of diabetes mellitus. The UAP asks if they can
administer the patient's scheduled insulin. What is the nurse's best response? A. "Yes, but only if the
patient is cooperative." B. "No, medication administration is outside your scope of practice." [CORRECT]
C. "Yes, if you have been checked off on insulin administration." D. "No, but you can draw up the dose
for me to give."
Correct Answer: B
Rationale: Medication administration, especially insulin with its narrow therapeutic index, is never
within UAP scope regardless of experience or training.
Q14: An RN is delegating morning vital signs to a UAP. Which instruction is most appropriate? A. "Take
everyone's vital signs and tell me if anything is abnormal." B. "Take vital signs on rooms 101, 103, and
ACTUAL EXAM 2026/2027 | ATI
Leadership Capstone | Verified Q&A |
Pass Guaranteed - A+ Graded
SECTION 1: DELEGATION, SUPERVISION, & ASSIGNMENT (35 Questions)
Q1: A charge nurse on a busy medical-surgical unit has the following staff: 2 RNs, 1 PN, and 2 UAPs.
Which task is appropriate to delegate to the PN? A. Complete the initial admission assessment for a
newly admitted patient with chest pain B. Administer IV push morphine 2 mg to a post-op patient C.
Reinforce wound care teaching for a patient being discharged tomorrow [CORRECT] D. Perform the first
sterile dressing change on a fresh surgical wound
Correct Answer: C
Rationale: PNs can reinforce previously taught education and perform stable, routine care; initial
assessments, IV push medications, and first sterile dressing changes on fresh wounds require RN
judgment and scope.
Q2: The charge nurse is assigning a UAP to assist with morning care. Which patient should the charge
nurse assign to the UAP? A. A patient with new-onset confusion and unsteady gait B. A patient on strict
bed rest with a new Foley catheter C. A stable patient who is 2 days post-op and ambulating
independently [CORRECT] D. A patient with a new colostomy requiring pouch emptying
Correct Answer: C
Rationale: UAP scope includes stable patients with predictable outcomes; new confusion, new Foley
care education, and ostomy management exceed UAP scope or require nursing judgment.
Q3: A nurse is delegating tasks to a UAP. Which statement demonstrates proper delegation according to
the Five Rights of Delegation? A. "Please check the patient's vital signs and let me know if anything looks
,wrong." B. "Take Mr. Smith's blood pressure, heart rate, respiratory rate, and temperature every 4
hours and report the results to me by 1400." [CORRECT] C. "Go ahead and give the patient their
medications if they seem uncomfortable." D. "Can you evaluate how the patient is responding to the
new pain medication?"
Correct Answer: B
Rationale: Proper delegation requires right task, right circumstance, right person, right
direction/communication, and right supervision—specific instructions with clear reporting expectations
fulfill this.
Q4: An RN is supervising a PN who has been assigned four stable patients. The PN reports that one
patient has developed new crackles in the lungs and a temperature of 101.2°F. What is the RN's priority
action? A. Instruct the PN to administer the PRN antipyretic and continue monitoring B. Reassign the
patient to the RN and assess the patient immediately [CORRECT] C. Tell the PN to document the findings
and notify the provider D. Ask the PN to increase the patient's fluid intake and reassess in 2 hours
Correct Answer: B
Rationale: New crackles and fever indicate potential deterioration beyond stable PN scope; the RN must
reassume care and assess promptly to ensure patient safety.
Q5: A charge nurse is reviewing assignments for the shift. Which task can an experienced UAP perform
without direct supervision? A. Documenting intake and output for a stable patient [CORRECT] B.
Assessing a patient's pain level after receiving pain medication C. Teaching a patient how to use an
incentive spirometer D. Administering a scheduled oral medication
Correct Answer: A
Rationale: UAPs can collect and record data for stable patients under RN supervision; assessment,
teaching, and medication administration remain within RN/PN scope only.
Q6: A nurse manager is creating a staffing grid for the night shift. Which factor is most important when
determining the appropriate mix of RNs, PNs, and UAPs? A. The number of patients scheduled for
discharge in the morning B. The acuity level and stability of the patient population [CORRECT] C. The
personal preferences of the nursing staff D. The budget allocated for overtime pay
Correct Answer: B
Rationale: Patient acuity and stability directly determine the required skill mix; higher acuity requires
more RNs, while stable patients may be appropriately cared for by PNs and UAPs.
,Q7: A UAP reports to the RN that a patient has a blood pressure of 88/52 mmHg. The patient was
previously stable. What is the RN's first action? A. Instruct the UAP to recheck the blood pressure in 30
minutes B. Assess the patient immediately and verify the finding [CORRECT] C. Tell the UAP to elevate
the patient's legs and call back D. Document the finding and notify the provider
Correct Answer: B
Rationale: The RN must validate abnormal findings and assess the patient directly; delegating further
action without assessment violates supervision responsibilities and delays critical intervention.
Q8: Which task is appropriate for an RN to delegate to a PN in a long-term care facility? A. Developing
the initial plan of care for a new admission B. Administering a routine influenza vaccine via
intramuscular injection [CORRECT] C. Performing the comprehensive head-to-toe assessment on
admission D. Analyzing lab results and adjusting the care plan accordingly
Correct Answer: B
Rationale: PNs in LTC can administer routine medications and vaccines per protocol; care planning,
comprehensive assessments, and clinical analysis require RN scope.
Q9: A charge nurse notices that a newly hired UAP is performing a blood glucose check without having
demonstrated competency. What is the charge nurse's priority action? A. Allow the UAP to continue and
evaluate the result afterward B. Stop the UAP immediately and verify competency before allowing the
task to continue [CORRECT] C. Assign an RN to supervise the UAP during the procedure D. Document the
incident and address it at the next staff meeting
Correct Answer: B
Rationale: The right person principle requires verified competency before delegation; allowing an
unverified UAP to perform a skill creates immediate patient safety risk.
Q10: An RN is working with a PN and two UAPs. Which assignment demonstrates appropriate
delegation? A. The PN is assigned to admit a new patient with active chest pain B. One UAP is assigned
to ambulate a stable post-op patient, and the PN is assigned to monitor a patient on a new heparin drip
[CORRECT] C. The RN delegates the assessment of a patient with new-onset dyspnea to the PN D. Both
UAPs are assigned to provide total care for patients on continuous cardiac monitoring
Correct Answer: B
, Rationale: UAPs handle stable, routine tasks; PNs manage stable patients with predictable outcomes
including medication administration; RNs retain complex, unstable, or new patients.
Q11: A nurse is supervising a PN who asks to perform a sterile wound irrigation on a patient with a new
surgical wound. What is the appropriate response? A. "Yes, as long as you wear sterile gloves." B. "No,
this task requires RN assessment and judgment due to the newness of the wound." [CORRECT] C. "Yes,
but have the UAP assist you with the setup." D. "No, only the physician can perform sterile wound
irrigations."
Correct Answer: B
Rationale: New surgical wounds require RN assessment for signs of infection or dehiscence; sterile
irrigation of a fresh wound falls outside stable, routine PN scope.
Q12: A charge nurse receives a call from the emergency department that four patients are being
admitted. Which patient is most appropriate to assign to the PN? A. A patient with new-onset atrial
fibrillation and a heart rate of 150 bpm B. A patient with a stable blood pressure who needs a routine
post-op appendectomy admission C. A patient with chest pain of unknown origin requiring continuous
monitoring D. A patient with acute stroke symptoms and a new NIHSS score
Correct Answer: B
Rationale: Stable post-op admissions with predictable recovery trajectories fit PN scope; new
arrhythmias, undifferentiated chest pain, and acute strokes require immediate RN assessment and
intervention.
Q13: A UAP is assigned to a patient with a diagnosis of diabetes mellitus. The UAP asks if they can
administer the patient's scheduled insulin. What is the nurse's best response? A. "Yes, but only if the
patient is cooperative." B. "No, medication administration is outside your scope of practice." [CORRECT]
C. "Yes, if you have been checked off on insulin administration." D. "No, but you can draw up the dose
for me to give."
Correct Answer: B
Rationale: Medication administration, especially insulin with its narrow therapeutic index, is never
within UAP scope regardless of experience or training.
Q14: An RN is delegating morning vital signs to a UAP. Which instruction is most appropriate? A. "Take
everyone's vital signs and tell me if anything is abnormal." B. "Take vital signs on rooms 101, 103, and
