ATI Leadership Final Exam Practice (NCLEX-RN Aligned) 2026
|Questions |Answers |Rationales
1. A nurse is delegating tasks to an assistive personnel (AP). Which of the
following tasks is appropriate for the nurse to delegate?
A. Performing a sterile dressing change on a central line
B. Evaluating a client’s response to pain medication
C. Teaching a client how to use an incentive spirometer
D. Assisting a stable client with post-operative ambulation
Answer: D
Rationale: The RN should delegate tasks that are repetitive, non-invasive, and do not
require clinical judgment. Assisting a stable client with ambulation falls within the AP
scope of practice.
2. A nurse is planning to assign tasks to a licensed practical nurse (LPN). Which
client should be assigned to the LPN?
A. A new admission with chest pain
B. A client who requires reinforcement of colostomy care teaching
C. A client who is post-operative and requires a blood transfusion
D. A client being discharged with complex home health needs
Answer: B
Rationale: LPNs can reinforce teaching that has already been initiated by the RN. New
admissions, blood transfusions, and complex discharge planning require RN assessment
and judgment.
,3. A nurse is using the SBAR communication tool to report a change in a client’s
condition to a provider. Which information should the nurse include in the ‘B’
section?
A. The client’s current vital signs
B. The nurse’s recommendation for a change in treatment
C. A description of the current problem
D. The client’s admitting diagnosis and medical history
Answer: D
Rationale: In SBAR, ‘B’ stands for Background, which includes historical data such as the
admitting diagnosis, medical history, and summary of treatment to date.
4. A charge nurse is managing a conflict between two staff nurses regarding the
holiday schedule. Which of the following conflict resolution strategies involves
both parties giving up something to reach a solution?
A. Collaborating
B. Compromising
C. Smoothing
D. Competing
Answer: B
Rationale: Compromising is a ‘lose-lose’ or ‘win-lose’ strategy where both parties give up
something to reach a mutually acceptable solution.
5. A nurse is triaging clients following a mass casualty event. Which client should
be assigned a red tag?
A. A client with a sucking chest wound and stable vitals
B. A client with an obstructed airway and agonal breaths
C. A client with a simple fracture of the arm
D. A client who is unresponsive with a high-level spinal cord injury and no pulse
Answer: A
, Rationale: Red tags are for clients with life-threatening injuries who have a high possibility
of survival if treated immediately, such as a sucking chest wound. Agonal breaths or no
pulse are usually tagged black (expectant).
6. A nurse is caring for a client who decides to refuse further chemotherapy
treatments. Which ethical principle is the nurse supporting by respecting this
decision?
A. Justice
B. Nonmaleficence
C. Autonomy
D. Fidelity
Answer: C
Rationale: Autonomy is the right of the client to make their own decisions about their
medical care, even if the healthcare team disagrees.
7. A nurse manager is preparing an annual performance appraisal for a staff
nurse. Which of the following sources of data should the manager use?
A. Opinions of the nurse’s friends on the unit
B. Anecdotal notes kept by the manager only for the last month
C. The nurse’s self-appraisal and peer review data
D. Patient satisfaction surveys from the nurse’s previous employer
Answer: C
Rationale: A comprehensive appraisal should include the nurse’s self-evaluation, peer
reviews, and objective data collected throughout the entire year.
|Questions |Answers |Rationales
1. A nurse is delegating tasks to an assistive personnel (AP). Which of the
following tasks is appropriate for the nurse to delegate?
A. Performing a sterile dressing change on a central line
B. Evaluating a client’s response to pain medication
C. Teaching a client how to use an incentive spirometer
D. Assisting a stable client with post-operative ambulation
Answer: D
Rationale: The RN should delegate tasks that are repetitive, non-invasive, and do not
require clinical judgment. Assisting a stable client with ambulation falls within the AP
scope of practice.
2. A nurse is planning to assign tasks to a licensed practical nurse (LPN). Which
client should be assigned to the LPN?
A. A new admission with chest pain
B. A client who requires reinforcement of colostomy care teaching
C. A client who is post-operative and requires a blood transfusion
D. A client being discharged with complex home health needs
Answer: B
Rationale: LPNs can reinforce teaching that has already been initiated by the RN. New
admissions, blood transfusions, and complex discharge planning require RN assessment
and judgment.
,3. A nurse is using the SBAR communication tool to report a change in a client’s
condition to a provider. Which information should the nurse include in the ‘B’
section?
A. The client’s current vital signs
B. The nurse’s recommendation for a change in treatment
C. A description of the current problem
D. The client’s admitting diagnosis and medical history
Answer: D
Rationale: In SBAR, ‘B’ stands for Background, which includes historical data such as the
admitting diagnosis, medical history, and summary of treatment to date.
4. A charge nurse is managing a conflict between two staff nurses regarding the
holiday schedule. Which of the following conflict resolution strategies involves
both parties giving up something to reach a solution?
A. Collaborating
B. Compromising
C. Smoothing
D. Competing
Answer: B
Rationale: Compromising is a ‘lose-lose’ or ‘win-lose’ strategy where both parties give up
something to reach a mutually acceptable solution.
5. A nurse is triaging clients following a mass casualty event. Which client should
be assigned a red tag?
A. A client with a sucking chest wound and stable vitals
B. A client with an obstructed airway and agonal breaths
C. A client with a simple fracture of the arm
D. A client who is unresponsive with a high-level spinal cord injury and no pulse
Answer: A
, Rationale: Red tags are for clients with life-threatening injuries who have a high possibility
of survival if treated immediately, such as a sucking chest wound. Agonal breaths or no
pulse are usually tagged black (expectant).
6. A nurse is caring for a client who decides to refuse further chemotherapy
treatments. Which ethical principle is the nurse supporting by respecting this
decision?
A. Justice
B. Nonmaleficence
C. Autonomy
D. Fidelity
Answer: C
Rationale: Autonomy is the right of the client to make their own decisions about their
medical care, even if the healthcare team disagrees.
7. A nurse manager is preparing an annual performance appraisal for a staff
nurse. Which of the following sources of data should the manager use?
A. Opinions of the nurse’s friends on the unit
B. Anecdotal notes kept by the manager only for the last month
C. The nurse’s self-appraisal and peer review data
D. Patient satisfaction surveys from the nurse’s previous employer
Answer: C
Rationale: A comprehensive appraisal should include the nurse’s self-evaluation, peer
reviews, and objective data collected throughout the entire year.
