ATI LEADERSHIP MANAGEMENT
PROCTORED ACTUAL EXAM
2026/2027 | Content Mastery Series | 2
Versions with Rationales | Complete
Study Guide | Verified Q&A | Pass
Guaranteed - A+ Graded
VERSION 1: LEADERSHIP/MANAGEMENT
EXAM A
MODULE 1: MANAGING CLIENT CARE (20 QUESTIONS)
Q1: The charge nurse is making client assignments for the medical-surgical unit. Which client
should be assigned to the most experienced RN?
● A. A 45-year-old with diabetes requiring insulin administration and dietary teaching
● B. A 72-year-old 2 days post-hip replacement requiring pain management and ambulation
assistance
● C. A 60-year-old with new-onset atrial fibrillation on continuous cardiac monitoring and IV
amiodarone [CORRECT]
● D. A 55-year-old with pneumonia receiving IV antibiotics every 8 hours and oxygen at 2L/min
Rationale: The client with new-onset atrial fibrillation on cardiac monitoring and IV
amiodarone is unstable and requires advanced assessment skills, continuous monitoring,
and knowledge of antiarrhythmic medications and potential complications. This client should
be assigned to the most experienced RN. Options A, B, and D are stable clients with
predictable outcomes who could be assigned to less experienced RNs.
ATI Hint: When making assignments, consider client acuity, complexity, and predictability.
Unstable clients require experienced nurses.
,Q2: Which care delivery model is characterized by an RN assuming responsibility for the total
care of a group of clients throughout their hospitalization?
● A. Functional nursing
● B. Team nursing
● C. Primary nursing [CORRECT]
● D. Case management
Rationale: Primary nursing is a care delivery model where one RN assumes 24-hour
responsibility for planning and coordinating care for a specific group of clients from
admission through discharge. Functional nursing assigns tasks to specific staff members,
team nursing uses an RN leading a team of ancillary staff, and case management focuses on
coordinating care across the continuum for specific populations.
ATI Hint: Primary nursing emphasizes continuity and accountability; case management
focuses on resource utilization and outcomes across settings.
Q3: A nurse manager is implementing a new staffing pattern based on client acuity. Which
system best determines staffing needs?
● A. Fixed staffing patterns
● B. Client classification systems [CORRECT]
● C. Budget-based staffing
● D. Seniority-based assignments
Rationale: Client classification systems (acuity systems) categorize clients based on care
requirements, dependency levels, and interventions needed. This objective approach matches
staffing resources to actual client needs, ensuring safe care delivery while managing
resources effectively.
Q4: The charge nurse must float an RN from the pediatric unit to the adult medical-surgical
unit. Which principle guides this decision?
● A. Floating is only permitted within the same nursing specialty
● B. The nurse should be floated to an area with similar client acuity and skills required
[CORRECT]
● C. Nurses cannot be floated to units where they lack certification
● D. Floating decisions should be based solely on seniority
Rationale: Floating principles require assigning nurses to areas where their existing
competencies can be safely utilized. The pediatric RN has skills in medication
administration, assessment, and care planning that transfer to adult care. The nurse should
,receive orientation to unit-specific protocols and not be assigned the most acute clients
initially.
ATI Hint: Floating is legal and expected; nurses must be floated to areas where they can
practice safely with appropriate orientation.
Q5: Which scenario demonstrates effective case management?
● A. An RN administers medications to 8 clients on a medical unit
● B. An RN coordinates discharge planning, home health referrals, and follow-up care for a
client with complex needs [CORRECT]
● C. An LPN provides routine care under RN supervision
● D. A physician manages all aspects of a client's hospitalization
Rationale: Case management focuses on coordinating care across the continuum for clients
with complex needs, ensuring quality outcomes while controlling costs. The case manager
facilitates interdisciplinary collaboration, resource allocation, and transition planning.
Q6: A client is being transferred from ICU to the medical-surgical unit. Which action by the
receiving nurse demonstrates continuity of care?
● A. Reviewing the transfer summary and verifying orders before the client arrives [CORRECT]
● B. Waiting until the client arrives to review the chart
● C. Assigning the client to a float nurse
● D. Delaying assessment until the next shift
Rationale: Continuity of care requires proactive communication and preparation. Reviewing
transfer documentation before arrival ensures appropriate room setup, equipment availability,
and immediate care continuity. This prevents gaps in care during the vulnerable transfer
period.
Q7: Which is the primary purpose of critical pathways in client care?
● A. To increase nursing documentation requirements
● B. To standardize expected outcomes and interventions for specific diagnoses [CORRECT]
● C. To replace individualized care plans
● D. To determine nursing salaries
Rationale: Critical pathways (clinical pathways) are multidisciplinary care plans that outline
expected progress and interventions for specific diagnoses or procedures. They facilitate
coordination, reduce variation in care, and identify deviations from expected outcomes early.
They complement, not replace, individualized care planning.
, Q8: During interdisciplinary rounds, which nursing contribution is most valuable?
● A. Detailed documentation of all client visitors
● B. Updates on client progress, barriers to discharge, and anticipated needs [CORRECT]
● C. Critique of physician orders
● D. Discussion of staffing shortages
Rationale: Interdisciplinary rounds focus on collaborative care planning. Nursing input
regarding client status, response to treatment, functional abilities, and discharge planning
needs ensures comprehensive care coordination. This facilitates timely discharge and
prevents readmissions.
Q9: Which factor is most important when determining client assignments?
● A. Nurse preference for specific clients
● B. Client acuity and nurse competency [CORRECT]
● C. Geographic convenience only
● D. Equal distribution of tasks regardless of complexity
Rationale: Safe assignments match client acuity (stability, complexity, care requirements)
with nurse competency (experience, skills, knowledge). This ensures appropriate care
delivery while supporting nurse development and maintaining safety standards.
Q10: A nurse manager is analyzing staffing effectiveness. Which metric best evaluates
outcomes?
● A. Number of staff scheduled per shift
● B. Client satisfaction scores, fall rates, and medication errors [CORRECT]
● C. Budget variance reports only
● D. Employee attendance records
Rationale: Structure metrics (staffing numbers) must be evaluated against outcome metrics
(quality indicators, safety events, satisfaction) to determine staffing effectiveness. This
comprehensive evaluation links resource allocation to actual care outcomes.
Q11: Which statement about utilization review is correct?
● A. It is conducted only by physicians
● B. It evaluates the medical necessity and appropriateness of care [CORRECT]
● C. It focuses solely on nursing documentation
● D. It is performed only at discharge
PROCTORED ACTUAL EXAM
2026/2027 | Content Mastery Series | 2
Versions with Rationales | Complete
Study Guide | Verified Q&A | Pass
Guaranteed - A+ Graded
VERSION 1: LEADERSHIP/MANAGEMENT
EXAM A
MODULE 1: MANAGING CLIENT CARE (20 QUESTIONS)
Q1: The charge nurse is making client assignments for the medical-surgical unit. Which client
should be assigned to the most experienced RN?
● A. A 45-year-old with diabetes requiring insulin administration and dietary teaching
● B. A 72-year-old 2 days post-hip replacement requiring pain management and ambulation
assistance
● C. A 60-year-old with new-onset atrial fibrillation on continuous cardiac monitoring and IV
amiodarone [CORRECT]
● D. A 55-year-old with pneumonia receiving IV antibiotics every 8 hours and oxygen at 2L/min
Rationale: The client with new-onset atrial fibrillation on cardiac monitoring and IV
amiodarone is unstable and requires advanced assessment skills, continuous monitoring,
and knowledge of antiarrhythmic medications and potential complications. This client should
be assigned to the most experienced RN. Options A, B, and D are stable clients with
predictable outcomes who could be assigned to less experienced RNs.
ATI Hint: When making assignments, consider client acuity, complexity, and predictability.
Unstable clients require experienced nurses.
,Q2: Which care delivery model is characterized by an RN assuming responsibility for the total
care of a group of clients throughout their hospitalization?
● A. Functional nursing
● B. Team nursing
● C. Primary nursing [CORRECT]
● D. Case management
Rationale: Primary nursing is a care delivery model where one RN assumes 24-hour
responsibility for planning and coordinating care for a specific group of clients from
admission through discharge. Functional nursing assigns tasks to specific staff members,
team nursing uses an RN leading a team of ancillary staff, and case management focuses on
coordinating care across the continuum for specific populations.
ATI Hint: Primary nursing emphasizes continuity and accountability; case management
focuses on resource utilization and outcomes across settings.
Q3: A nurse manager is implementing a new staffing pattern based on client acuity. Which
system best determines staffing needs?
● A. Fixed staffing patterns
● B. Client classification systems [CORRECT]
● C. Budget-based staffing
● D. Seniority-based assignments
Rationale: Client classification systems (acuity systems) categorize clients based on care
requirements, dependency levels, and interventions needed. This objective approach matches
staffing resources to actual client needs, ensuring safe care delivery while managing
resources effectively.
Q4: The charge nurse must float an RN from the pediatric unit to the adult medical-surgical
unit. Which principle guides this decision?
● A. Floating is only permitted within the same nursing specialty
● B. The nurse should be floated to an area with similar client acuity and skills required
[CORRECT]
● C. Nurses cannot be floated to units where they lack certification
● D. Floating decisions should be based solely on seniority
Rationale: Floating principles require assigning nurses to areas where their existing
competencies can be safely utilized. The pediatric RN has skills in medication
administration, assessment, and care planning that transfer to adult care. The nurse should
,receive orientation to unit-specific protocols and not be assigned the most acute clients
initially.
ATI Hint: Floating is legal and expected; nurses must be floated to areas where they can
practice safely with appropriate orientation.
Q5: Which scenario demonstrates effective case management?
● A. An RN administers medications to 8 clients on a medical unit
● B. An RN coordinates discharge planning, home health referrals, and follow-up care for a
client with complex needs [CORRECT]
● C. An LPN provides routine care under RN supervision
● D. A physician manages all aspects of a client's hospitalization
Rationale: Case management focuses on coordinating care across the continuum for clients
with complex needs, ensuring quality outcomes while controlling costs. The case manager
facilitates interdisciplinary collaboration, resource allocation, and transition planning.
Q6: A client is being transferred from ICU to the medical-surgical unit. Which action by the
receiving nurse demonstrates continuity of care?
● A. Reviewing the transfer summary and verifying orders before the client arrives [CORRECT]
● B. Waiting until the client arrives to review the chart
● C. Assigning the client to a float nurse
● D. Delaying assessment until the next shift
Rationale: Continuity of care requires proactive communication and preparation. Reviewing
transfer documentation before arrival ensures appropriate room setup, equipment availability,
and immediate care continuity. This prevents gaps in care during the vulnerable transfer
period.
Q7: Which is the primary purpose of critical pathways in client care?
● A. To increase nursing documentation requirements
● B. To standardize expected outcomes and interventions for specific diagnoses [CORRECT]
● C. To replace individualized care plans
● D. To determine nursing salaries
Rationale: Critical pathways (clinical pathways) are multidisciplinary care plans that outline
expected progress and interventions for specific diagnoses or procedures. They facilitate
coordination, reduce variation in care, and identify deviations from expected outcomes early.
They complement, not replace, individualized care planning.
, Q8: During interdisciplinary rounds, which nursing contribution is most valuable?
● A. Detailed documentation of all client visitors
● B. Updates on client progress, barriers to discharge, and anticipated needs [CORRECT]
● C. Critique of physician orders
● D. Discussion of staffing shortages
Rationale: Interdisciplinary rounds focus on collaborative care planning. Nursing input
regarding client status, response to treatment, functional abilities, and discharge planning
needs ensures comprehensive care coordination. This facilitates timely discharge and
prevents readmissions.
Q9: Which factor is most important when determining client assignments?
● A. Nurse preference for specific clients
● B. Client acuity and nurse competency [CORRECT]
● C. Geographic convenience only
● D. Equal distribution of tasks regardless of complexity
Rationale: Safe assignments match client acuity (stability, complexity, care requirements)
with nurse competency (experience, skills, knowledge). This ensures appropriate care
delivery while supporting nurse development and maintaining safety standards.
Q10: A nurse manager is analyzing staffing effectiveness. Which metric best evaluates
outcomes?
● A. Number of staff scheduled per shift
● B. Client satisfaction scores, fall rates, and medication errors [CORRECT]
● C. Budget variance reports only
● D. Employee attendance records
Rationale: Structure metrics (staffing numbers) must be evaluated against outcome metrics
(quality indicators, safety events, satisfaction) to determine staffing effectiveness. This
comprehensive evaluation links resource allocation to actual care outcomes.
Q11: Which statement about utilization review is correct?
● A. It is conducted only by physicians
● B. It evaluates the medical necessity and appropriateness of care [CORRECT]
● C. It focuses solely on nursing documentation
● D. It is performed only at discharge
