ATI RN LEADERSHIP 2026/2027: COMPREHENSIVE STUDY GUIDE
1. A nurse is delegating tasks to a licensed practical nurse (LPN) and an unlicensed
assistive personnel (UAP). Which task is most appropriate to delegate to the UAP?
ANSWER: ✓ Assisting a stable post-operative client with ambulation to the bathroom.
2. A client with heart failure refuses to take their furosemide, stating, "It makes me
go to the bathroom too much." What is the nurse's best initial action?
ANSWER: ✓ Explore the client's concerns and educate on the purpose of the
medication.
3. During a code blue, which role is uniquely and primarily the responsibility of the
registered nurse (RN)?
ANSWER: ✓ Administering intravenous medications as prescribed by the protocol or
provider.
4. A charge nurse must resolve a conflict between two staff nurses who disagree
about fair assignment of patients. Which approach should the charge nurse use
first?
ANSWER: ✓ Facilitate a meeting where both nurses can express their viewpoints in a
non-confrontational setting.
5. What is the priority action for a nurse who discovers a medication error they
have made?
ANSWER: ✓ Assess and stabilize the client, then report the error to the charge nurse
and provider immediately.
6. A nurse manager is implementing a change in shift report procedure from taped
to bedside reporting. Which strategy best promotes staff buy-in?
ANSWER: ✓ Form a committee of staff nurses to help design and pilot the new process.
7. Which client should the charge nurse assign to the most experienced medical-
surgical RN?
ANSWER: ✓ A client transferred from ICU 2 hours ago with a tracheostomy and stable
ventilator settings.
8. A UAP reports to the RN that a client's blood pressure is 88/50. What should the
RN do first?
ANSWER: ✓ Assess the client personally, including mentation, pulse, and skin perfusion.
, 9. A nurse is precepting a new graduate. The new graduate asks when it's
necessary to call a provider. Which response by the preceptor is best?
ANSWER: ✓ "Call for any change in condition that represents a significant deviation
from baseline and requires a new order or intervention."
10. Which situation requires an incident report (variance report) to be filed?
ANSWER: ✓ A visitor slips on a wet floor that was not marked with a caution sign.
11. A client with dementia is repeatedly trying to pull out their indwelling urinary
catheter. What is the least restrictive intervention the nurse should try first?
ANSWER: ✓ Distract the client with a preferred activity or offering a beverage.
12. The principle of "fidelity" in nursing ethics is best demonstrated by which
action?
ANSWER: ✓ Following through on a promise to sit with an anxious client before
surgery.
13. A nurse overhears a colleague discussing confidential client information in the
hospital cafeteria. What is the nurse's ethical responsibility?
ANSWER: ✓ Remind the colleague privately about HIPAA regulations and the need for
confidentiality.
14. During a disaster, a nurse triages multiple victims. Which client should be
tagged as "Immediate" (Red tag)?
ANSWER: ✓ A client with a open chest wound who has audible but diminished breath
sounds.
15. What is the key difference between leadership and management?
ANSWER: ✓ Leadership focuses on inspiring and influencing others towards a vision,
while management focuses on coordinating resources and tasks.
16. A staff nurse consistently arrives 10-15 minutes late. After informal discussions
failed, what is the nurse manager's next step?
ANSWER: ✓ Conduct a formal, documented counseling session outlining consequences.
17. A client from a culture different from the nurse's refuses a treatment due to
religious beliefs. What is the nurse's best response?
ANSWER: ✓ Acknowledge and respect the client's beliefs, and collaborate to find an
acceptable alternative if possible.
1. A nurse is delegating tasks to a licensed practical nurse (LPN) and an unlicensed
assistive personnel (UAP). Which task is most appropriate to delegate to the UAP?
ANSWER: ✓ Assisting a stable post-operative client with ambulation to the bathroom.
2. A client with heart failure refuses to take their furosemide, stating, "It makes me
go to the bathroom too much." What is the nurse's best initial action?
ANSWER: ✓ Explore the client's concerns and educate on the purpose of the
medication.
3. During a code blue, which role is uniquely and primarily the responsibility of the
registered nurse (RN)?
ANSWER: ✓ Administering intravenous medications as prescribed by the protocol or
provider.
4. A charge nurse must resolve a conflict between two staff nurses who disagree
about fair assignment of patients. Which approach should the charge nurse use
first?
ANSWER: ✓ Facilitate a meeting where both nurses can express their viewpoints in a
non-confrontational setting.
5. What is the priority action for a nurse who discovers a medication error they
have made?
ANSWER: ✓ Assess and stabilize the client, then report the error to the charge nurse
and provider immediately.
6. A nurse manager is implementing a change in shift report procedure from taped
to bedside reporting. Which strategy best promotes staff buy-in?
ANSWER: ✓ Form a committee of staff nurses to help design and pilot the new process.
7. Which client should the charge nurse assign to the most experienced medical-
surgical RN?
ANSWER: ✓ A client transferred from ICU 2 hours ago with a tracheostomy and stable
ventilator settings.
8. A UAP reports to the RN that a client's blood pressure is 88/50. What should the
RN do first?
ANSWER: ✓ Assess the client personally, including mentation, pulse, and skin perfusion.
, 9. A nurse is precepting a new graduate. The new graduate asks when it's
necessary to call a provider. Which response by the preceptor is best?
ANSWER: ✓ "Call for any change in condition that represents a significant deviation
from baseline and requires a new order or intervention."
10. Which situation requires an incident report (variance report) to be filed?
ANSWER: ✓ A visitor slips on a wet floor that was not marked with a caution sign.
11. A client with dementia is repeatedly trying to pull out their indwelling urinary
catheter. What is the least restrictive intervention the nurse should try first?
ANSWER: ✓ Distract the client with a preferred activity or offering a beverage.
12. The principle of "fidelity" in nursing ethics is best demonstrated by which
action?
ANSWER: ✓ Following through on a promise to sit with an anxious client before
surgery.
13. A nurse overhears a colleague discussing confidential client information in the
hospital cafeteria. What is the nurse's ethical responsibility?
ANSWER: ✓ Remind the colleague privately about HIPAA regulations and the need for
confidentiality.
14. During a disaster, a nurse triages multiple victims. Which client should be
tagged as "Immediate" (Red tag)?
ANSWER: ✓ A client with a open chest wound who has audible but diminished breath
sounds.
15. What is the key difference between leadership and management?
ANSWER: ✓ Leadership focuses on inspiring and influencing others towards a vision,
while management focuses on coordinating resources and tasks.
16. A staff nurse consistently arrives 10-15 minutes late. After informal discussions
failed, what is the nurse manager's next step?
ANSWER: ✓ Conduct a formal, documented counseling session outlining consequences.
17. A client from a culture different from the nurse's refuses a treatment due to
religious beliefs. What is the nurse's best response?
ANSWER: ✓ Acknowledge and respect the client's beliefs, and collaborate to find an
acceptable alternative if possible.
