ATI LeAdershIp exAm | CompLeTe
NGN exAm prep wITh VerIfIed
ANswers ALreAdY GrAded A+
Section 1: Delegation & Staff Management (Questions 1-20)
1. A charge nurse is assigning client care to an RN, an LPN, and an AP. Which of the following
tasks should the charge nurse delegate to the LPN?
A) Administering IV push medications
B) Performing a comprehensive admission assessment
C) Inserting a urinary catheter
D) Developing a plan of care
Answer: C
Rationale: Inserting a urinary catheter is within the LPN scope of practice in most
states. Comprehensive assessments and plan of care development must be performed by the
RN. IV push medications are typically RN-only in many states. The Five Rights of
Delegation (Right Task, Right Circumstance, Right Person, Right Direction/Communication, Right
Supervision) guide delegation decisions .
2. A nurse is delegating a task to an AP. Which statement by the AP indicates understanding of
the Five Rights of Delegation?
A) "I will perform the task and let you know if I have questions."
B) "I will document the task in the client's medical record."
C) "I will report any changes in the client's condition to you."
D) All of the above
Answer: D
Rationale: The Five Rights of Delegation include Right Direction/Communication (clear
instructions), Right Supervision (reporting changes, asking questions), and Right
1
, Task (documenting appropriately). All of these demonstrate understanding of delegation
principles .
3. A charge nurse is making assignments on a medical-surgical unit. Which client should the
charge nurse assign to the most experienced RN?
A) A client who is 1 day postoperative following a hip replacement
B) A client who is newly diagnosed with diabetes and requires teaching
C) A client who is 12 hours postoperative following a laryngectomy
D) A client who requires a blood transfusion
Answer: C
Rationale: A client who is 12 hours postoperative following a laryngectomy is potentially
unstable and requires close airway monitoring. The most experienced RN should be assigned to
this client. The other clients are stable and can be assigned to less experienced nurses. Priority-
setting frameworks (Maslow, ABCs, Safety) guide assignment decisions .
4. A nurse is caring for a group of clients. Which client should the nurse assess first?
A) A client who had a myocardial infarction 2 days ago and reports mild chest pain
B) A client who is 1 day postoperative with pain rated 4/10
C) A client who is scheduled for discharge
D) A client who is requesting a PRN medication for nausea
Answer: A
Rationale: A client with a recent MI who reports chest pain requires immediate assessment to
rule out further cardiac ischemia. Pain rated 4/10, scheduled discharge, and nausea medication
requests are lower priority. ABCs and life-threatening conditions take precedence .
5. A charge nurse is evaluating the assignments of an RN. Which of the following client
assignments is appropriate for the RN to delegate to an AP?
A) Measuring and recording intake and output
B) Administering a tube feeding
C) Changing a sterile dressing
D) Assessing a client's pain level
2
, Answer: A
Rationale: Measuring and recording intake and output is a routine, non-invasive task that can
be delegated to an AP. Sterile dressing changes and tube feedings require licensed nursing
skills; pain assessment requires nursing judgment and cannot be delegated to AP .
6. A nurse is caring for a client who is confused and attempting to pull out his IV. The nurse
places the client in restraints. Which of the following actions should the nurse take?
A) Tie the restraints to the side rails
B) Tie the restraints to the bed frame with a quick-release knot
C) Apply the restraints tightly to prevent movement
D) Remove the restraints every 4 hours
Answer: B
Rationale: Restraints should be tied to the bed frame (not side rails) with a quick-release
knot to allow rapid release in an emergency . Restraints should be removed every 2 hours for
range of motion and circulation checks, not every 4 hours.
7. A nurse manager is reviewing the staff's use of SBAR communication. Which of the
following is the correct order of SBAR?
A) Situation, Background, Assessment, Recommendation
B) Background, Situation, Assessment, Recommendation
C) Assessment, Background, Situation, Recommendation
D) Situation, Assessment, Background, Recommendation
Answer: A
Rationale: SBAR stands for Situation (what is happening now), Background (relevant
history), Assessment (what you think is happening), and Recommendation (what you think
should be done) . This standardized communication tool improves handoff communication and
patient safety.
8. A nurse is preparing to give a shift report using SBAR. Which of the following statements is
part of the "Situation" component?
A) "The client has a history of hypertension and diabetes."
B) "The client's blood pressure is 180/100, and she reports a severe headache."
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, C) "I think the client may be having a hypertensive crisis."
D) "I recommend we notify the provider and consider IV antihypertensives."
Answer: B
Rationale: The "Situation" component includes the current, immediate concern or problem.
Options A (history) is Background; C (thinking) is Assessment; D (recommendation) is
Recommendation .
9. A charge nurse is evaluating the skill mix on a unit. Which of the following is the
appropriate ratio for an RN to AP?
A) 1:1
B) 1:2
C) 1:4
D) 2:1
Answer: B
Rationale: The appropriate RN to AP ratio is generally 1:2 or based on unit needs. This ensures
adequate supervision and quality care. Staffing ratios should be adjusted based on client
acuity and staff competence .
10. A nurse is supervising an AP who is providing care to a client with pneumonia. Which of
the following actions by the AP requires the nurse to intervene?
A) Assisting the client with repositioning
B) Offering the client fluids
C) Measuring and recording intake and output
D) Administering oral medications to the client
Answer: D
Rationale: Administering oral medications requires nursing judgment and is outside the scope
of practice for AP. The nurse should intervene. The other tasks are within the AP's scope with
appropriate training .
11. A nurse is managing a client with a new tracheostomy. Which staff member should the
nurse assign to provide care to this client?
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NGN exAm prep wITh VerIfIed
ANswers ALreAdY GrAded A+
Section 1: Delegation & Staff Management (Questions 1-20)
1. A charge nurse is assigning client care to an RN, an LPN, and an AP. Which of the following
tasks should the charge nurse delegate to the LPN?
A) Administering IV push medications
B) Performing a comprehensive admission assessment
C) Inserting a urinary catheter
D) Developing a plan of care
Answer: C
Rationale: Inserting a urinary catheter is within the LPN scope of practice in most
states. Comprehensive assessments and plan of care development must be performed by the
RN. IV push medications are typically RN-only in many states. The Five Rights of
Delegation (Right Task, Right Circumstance, Right Person, Right Direction/Communication, Right
Supervision) guide delegation decisions .
2. A nurse is delegating a task to an AP. Which statement by the AP indicates understanding of
the Five Rights of Delegation?
A) "I will perform the task and let you know if I have questions."
B) "I will document the task in the client's medical record."
C) "I will report any changes in the client's condition to you."
D) All of the above
Answer: D
Rationale: The Five Rights of Delegation include Right Direction/Communication (clear
instructions), Right Supervision (reporting changes, asking questions), and Right
1
, Task (documenting appropriately). All of these demonstrate understanding of delegation
principles .
3. A charge nurse is making assignments on a medical-surgical unit. Which client should the
charge nurse assign to the most experienced RN?
A) A client who is 1 day postoperative following a hip replacement
B) A client who is newly diagnosed with diabetes and requires teaching
C) A client who is 12 hours postoperative following a laryngectomy
D) A client who requires a blood transfusion
Answer: C
Rationale: A client who is 12 hours postoperative following a laryngectomy is potentially
unstable and requires close airway monitoring. The most experienced RN should be assigned to
this client. The other clients are stable and can be assigned to less experienced nurses. Priority-
setting frameworks (Maslow, ABCs, Safety) guide assignment decisions .
4. A nurse is caring for a group of clients. Which client should the nurse assess first?
A) A client who had a myocardial infarction 2 days ago and reports mild chest pain
B) A client who is 1 day postoperative with pain rated 4/10
C) A client who is scheduled for discharge
D) A client who is requesting a PRN medication for nausea
Answer: A
Rationale: A client with a recent MI who reports chest pain requires immediate assessment to
rule out further cardiac ischemia. Pain rated 4/10, scheduled discharge, and nausea medication
requests are lower priority. ABCs and life-threatening conditions take precedence .
5. A charge nurse is evaluating the assignments of an RN. Which of the following client
assignments is appropriate for the RN to delegate to an AP?
A) Measuring and recording intake and output
B) Administering a tube feeding
C) Changing a sterile dressing
D) Assessing a client's pain level
2
, Answer: A
Rationale: Measuring and recording intake and output is a routine, non-invasive task that can
be delegated to an AP. Sterile dressing changes and tube feedings require licensed nursing
skills; pain assessment requires nursing judgment and cannot be delegated to AP .
6. A nurse is caring for a client who is confused and attempting to pull out his IV. The nurse
places the client in restraints. Which of the following actions should the nurse take?
A) Tie the restraints to the side rails
B) Tie the restraints to the bed frame with a quick-release knot
C) Apply the restraints tightly to prevent movement
D) Remove the restraints every 4 hours
Answer: B
Rationale: Restraints should be tied to the bed frame (not side rails) with a quick-release
knot to allow rapid release in an emergency . Restraints should be removed every 2 hours for
range of motion and circulation checks, not every 4 hours.
7. A nurse manager is reviewing the staff's use of SBAR communication. Which of the
following is the correct order of SBAR?
A) Situation, Background, Assessment, Recommendation
B) Background, Situation, Assessment, Recommendation
C) Assessment, Background, Situation, Recommendation
D) Situation, Assessment, Background, Recommendation
Answer: A
Rationale: SBAR stands for Situation (what is happening now), Background (relevant
history), Assessment (what you think is happening), and Recommendation (what you think
should be done) . This standardized communication tool improves handoff communication and
patient safety.
8. A nurse is preparing to give a shift report using SBAR. Which of the following statements is
part of the "Situation" component?
A) "The client has a history of hypertension and diabetes."
B) "The client's blood pressure is 180/100, and she reports a severe headache."
3
, C) "I think the client may be having a hypertensive crisis."
D) "I recommend we notify the provider and consider IV antihypertensives."
Answer: B
Rationale: The "Situation" component includes the current, immediate concern or problem.
Options A (history) is Background; C (thinking) is Assessment; D (recommendation) is
Recommendation .
9. A charge nurse is evaluating the skill mix on a unit. Which of the following is the
appropriate ratio for an RN to AP?
A) 1:1
B) 1:2
C) 1:4
D) 2:1
Answer: B
Rationale: The appropriate RN to AP ratio is generally 1:2 or based on unit needs. This ensures
adequate supervision and quality care. Staffing ratios should be adjusted based on client
acuity and staff competence .
10. A nurse is supervising an AP who is providing care to a client with pneumonia. Which of
the following actions by the AP requires the nurse to intervene?
A) Assisting the client with repositioning
B) Offering the client fluids
C) Measuring and recording intake and output
D) Administering oral medications to the client
Answer: D
Rationale: Administering oral medications requires nursing judgment and is outside the scope
of practice for AP. The nurse should intervene. The other tasks are within the AP's scope with
appropriate training .
11. A nurse is managing a client with a new tracheostomy. Which staff member should the
nurse assign to provide care to this client?
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