ATI RN LEADERSHIP EXAM PREP
NGN-Style Questions with Detailed Rationales
2026’
QUESTION 1
A charge nurse is assigning client care assignments for the shift. Which client should the charge nurse
assign to a newly licensed practical nurse (LPN)?
A) A client with a newly placed tracheostomy requiring frequent suctioning
B) A client with stable chronic obstructive pulmonary disease (COPD) requiring routine medications
C) A client with acute respiratory distress syndrome (ARDS) on a ventilator
D) A client with a chest tube requiring hourly output monitoring
ANSWER✔✨-: B
Rationale for Option A: Incorrect. A newly licensed LPN should not be assigned to a client with a newly
placed tracheostomy requiring frequent suctioning as this client is unstable and requires a higher level
of assessment and nursing judgment typically provided by a registered nurse (RN).
Rationale for Option B: Correct. A client with stable COPD requiring routine medications is appropriate
for assignment to a newly licensed LPN. The client is stable, and medication administration is within the
LPN scope of practice. This assignment allows the LPN to practice within their skill level while
maintaining client safety.
,Rationale for Option C: Incorrect. A client with ARDS on a ventilator is critically ill and requires
continuous assessment, monitoring, and complex interventions that fall outside the scope of practice for
an LPN. This client should be assigned to an experienced RN.
Rationale for Option D: Incorrect. A client with a chest tube requiring hourly output monitoring requires
assessment of drainage characteristics and respiratory status. The LPN can monitor output and
document, but the comprehensive assessment should be performed by an RN. This assignment may be
appropriate for an experienced LPN with specific training, but is not ideal for a newly licensed LPN.
QUESTION 2
A nurse manager is implementing a new evidence-based practice protocol for fall prevention on a
medical-surgical unit. Which strategy should the nurse manager use to promote staff adoption of the
new protocol?
A) Mandate immediate implementation without staff input
B) Provide education sessions and involve staff in the implementation process
C) Implement the protocol only on weekends to test effectiveness
D) Delay implementation until all staff members request the change
ANSWER✔✨-: B
Rationale for Option A: Incorrect. Mandating immediate implementation without staff input is an
autocratic approach that creates resistance to change. Staff members are more likely to adopt new
practices when they feel their input is valued and they understand the rationale for the change.
Rationale for Option B: Correct. Providing education sessions and involving staff in the implementation
process promotes buy-in and ownership of the change. When staff understand the evidence behind the
new protocol and have contributed to the implementation plan, they are more likely to adopt the
,change successfully. This approach aligns with Kotter's change management model and Lewin's change
theory.
Rationale for Option C: Incorrect. Implementing the protocol only on weekends would create
inconsistency in practice and confuse staff. Evidence-based practice changes require consistent
application across all shifts and days to be effective and to evaluate outcomes accurately.
Rationale for Option D: Incorrect. Delaying implementation until all staff request the change is not
practical or evidence-based. Change is often met with resistance, and waiting for universal acceptance
would significantly delay improvement in patient outcomes. The nurse manager should lead the change
while addressing concerns and providing support.
QUESTION 3
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP) on a busy medical-surgical
unit. Which task is appropriate for the nurse to delegate to the UAP?
A) Administering oral medications to a stable client
B) Assessing a client's surgical wound for signs of infection
C) Obtaining a client's daily weight
D) Teaching a client about diabetic foot care
ANSWER✔✨-: C
Rationale for Option A: Incorrect. Administering medications, even oral medications, is not within the
scope of practice for UAP. Medication administration requires nursing judgment and is a responsibility
that cannot be delegated to UAP.
, Rationale for Option B: Incorrect. Assessment of a wound for signs of infection requires nursing
knowledge and clinical judgment. Assessment is a nursing responsibility that cannot be delegated to
UAP as it involves interpretation of findings and decision-making.
Rationale for Option C: Correct. Obtaining a client's daily weight is a routine, non-invasive task that falls
within the scope of practice for UAP. The nurse is responsible for ensuring the UAP is competent to
perform the task and for interpreting the results.
Rationale for Option D: Incorrect. Teaching about diabetic foot care requires specialized knowledge and
assessment of the client's learning readiness. Client education is a nursing responsibility that cannot be
delegated to UAP.
QUESTION 4
A charge nurse observes a staff nurse administering an incorrect dose of medication to a client. The
client is stable and did not experience adverse effects. Which action should the charge nurse take first?
A) Complete an incident report
B) Notify the client's healthcare provider
C) Speak with the staff nurse privately about the error
D) Report the nurse to the state board of nursing
ANSWER✔✨-: C
Rationale for Option A: Incorrect. While completing an incident report is important, it should not be the
first action. The charge nurse should first address the situation with the staff nurse to understand what
occurred and ensure the client's immediate safety.
NGN-Style Questions with Detailed Rationales
2026’
QUESTION 1
A charge nurse is assigning client care assignments for the shift. Which client should the charge nurse
assign to a newly licensed practical nurse (LPN)?
A) A client with a newly placed tracheostomy requiring frequent suctioning
B) A client with stable chronic obstructive pulmonary disease (COPD) requiring routine medications
C) A client with acute respiratory distress syndrome (ARDS) on a ventilator
D) A client with a chest tube requiring hourly output monitoring
ANSWER✔✨-: B
Rationale for Option A: Incorrect. A newly licensed LPN should not be assigned to a client with a newly
placed tracheostomy requiring frequent suctioning as this client is unstable and requires a higher level
of assessment and nursing judgment typically provided by a registered nurse (RN).
Rationale for Option B: Correct. A client with stable COPD requiring routine medications is appropriate
for assignment to a newly licensed LPN. The client is stable, and medication administration is within the
LPN scope of practice. This assignment allows the LPN to practice within their skill level while
maintaining client safety.
,Rationale for Option C: Incorrect. A client with ARDS on a ventilator is critically ill and requires
continuous assessment, monitoring, and complex interventions that fall outside the scope of practice for
an LPN. This client should be assigned to an experienced RN.
Rationale for Option D: Incorrect. A client with a chest tube requiring hourly output monitoring requires
assessment of drainage characteristics and respiratory status. The LPN can monitor output and
document, but the comprehensive assessment should be performed by an RN. This assignment may be
appropriate for an experienced LPN with specific training, but is not ideal for a newly licensed LPN.
QUESTION 2
A nurse manager is implementing a new evidence-based practice protocol for fall prevention on a
medical-surgical unit. Which strategy should the nurse manager use to promote staff adoption of the
new protocol?
A) Mandate immediate implementation without staff input
B) Provide education sessions and involve staff in the implementation process
C) Implement the protocol only on weekends to test effectiveness
D) Delay implementation until all staff members request the change
ANSWER✔✨-: B
Rationale for Option A: Incorrect. Mandating immediate implementation without staff input is an
autocratic approach that creates resistance to change. Staff members are more likely to adopt new
practices when they feel their input is valued and they understand the rationale for the change.
Rationale for Option B: Correct. Providing education sessions and involving staff in the implementation
process promotes buy-in and ownership of the change. When staff understand the evidence behind the
new protocol and have contributed to the implementation plan, they are more likely to adopt the
,change successfully. This approach aligns with Kotter's change management model and Lewin's change
theory.
Rationale for Option C: Incorrect. Implementing the protocol only on weekends would create
inconsistency in practice and confuse staff. Evidence-based practice changes require consistent
application across all shifts and days to be effective and to evaluate outcomes accurately.
Rationale for Option D: Incorrect. Delaying implementation until all staff request the change is not
practical or evidence-based. Change is often met with resistance, and waiting for universal acceptance
would significantly delay improvement in patient outcomes. The nurse manager should lead the change
while addressing concerns and providing support.
QUESTION 3
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP) on a busy medical-surgical
unit. Which task is appropriate for the nurse to delegate to the UAP?
A) Administering oral medications to a stable client
B) Assessing a client's surgical wound for signs of infection
C) Obtaining a client's daily weight
D) Teaching a client about diabetic foot care
ANSWER✔✨-: C
Rationale for Option A: Incorrect. Administering medications, even oral medications, is not within the
scope of practice for UAP. Medication administration requires nursing judgment and is a responsibility
that cannot be delegated to UAP.
, Rationale for Option B: Incorrect. Assessment of a wound for signs of infection requires nursing
knowledge and clinical judgment. Assessment is a nursing responsibility that cannot be delegated to
UAP as it involves interpretation of findings and decision-making.
Rationale for Option C: Correct. Obtaining a client's daily weight is a routine, non-invasive task that falls
within the scope of practice for UAP. The nurse is responsible for ensuring the UAP is competent to
perform the task and for interpreting the results.
Rationale for Option D: Incorrect. Teaching about diabetic foot care requires specialized knowledge and
assessment of the client's learning readiness. Client education is a nursing responsibility that cannot be
delegated to UAP.
QUESTION 4
A charge nurse observes a staff nurse administering an incorrect dose of medication to a client. The
client is stable and did not experience adverse effects. Which action should the charge nurse take first?
A) Complete an incident report
B) Notify the client's healthcare provider
C) Speak with the staff nurse privately about the error
D) Report the nurse to the state board of nursing
ANSWER✔✨-: C
Rationale for Option A: Incorrect. While completing an incident report is important, it should not be the
first action. The charge nurse should first address the situation with the staff nurse to understand what
occurred and ensure the client's immediate safety.
