ATI RN LEADERSHIP AND MANAGEMENT
PROCTORED EXAM Actual Questions and
Verified Answers (2026/2027) Level 3
Preparation
Domain 1: Management of Care — Delegation and Supervision
Q1: A charge nurse is delegating tasks to a UAP who has completed competency
training. Which task is appropriate to delegate?
A. Inserting a urinary catheter using sterile technique
B. Performing a fingerstick blood glucose check and reporting results to the RN
[CORRECT]
C. Assessing a patient's pain level after medication administration
D. Teaching a patient about discharge medication side effects
Correct Answer: B
Rationale: Performing fingerstick blood glucose monitoring is within the UAP scope of
practice when the UAP has been trained and competency has been validated; the UAP
must report results to the RN for interpretation and intervention. Inserting a urinary
catheter (A) requires sterile technique and nursing judgment, which exceeds UAP
scope. Assessment of pain (C) and patient teaching (D) are protected nursing
responsibilities that require RN licensure and cannot be delegated to UAPs.
Q2: An RN is supervising an LPN. Which action by the LPN requires immediate
intervention by the RN?
A. The LPN documents patient intake and output accurately
B. The LPN administers oral antibiotics to a stable patient
,C. The LPN develops the initial teaching plan for a newly diagnosed diabetic patient
[CORRECT]
D. The LPN performs routine wound care on a chronic wound
Correct Answer: C
Rationale: Developing the initial teaching plan requires nursing assessment,
identification of learning needs, and care planning, which are RN responsibilities per the
Nurse Practice Act; LPNs may reinforce teaching but cannot create the initial plan.
Administering oral medications (B) to stable patients and performing routine wound
care (D) are within the LPN scope in most jurisdictions. Documentation (A) is an
appropriate LPN function.
Q3: A UAP reports that a patient has fallen in the bathroom. What is the RN's priority
action after ensuring the scene is safe?
A. Complete an incident report immediately
B. Assess the patient for injuries and neurological changes [CORRECT]
C. Delegate the UAP to complete the incident report
D. Call the physician without personally assessing the patient
Correct Answer: B
Rationale: Assessment is an RN responsibility that cannot be delegated; the RN must
perform a thorough evaluation for injuries, neurological status changes, and
hemodynamic stability before any other interventions. While incident reports (A) are
necessary, they are not the priority over patient assessment. The RN cannot delegate
the incident report (C) as this requires the RN's involvement, and calling the physician
(D) without assessment violates the standard of care.
Q4: Which task is appropriate for the RN to delegate to an LPN caring for stable patients
on a medical-surgical unit?
A. Completing the admission assessment for a new patient
B. Developing the nursing care plan for a patient with pneumonia
C. Administering enteral feedings through a PEG tube to a stable patient [CORRECT]
D. Performing discharge teaching for a patient going home
,Correct Answer: C
Rationale: Administering enteral feedings to stable patients is within the LPN scope of
practice, provided the patient is not experiencing complications and the feeding is
routine. Admission assessments (A), care plan development (B), and discharge
teaching (D) require nursing judgment, critical thinking, and evaluation of learning
outcomes, which are RN-specific responsibilities that cannot be delegated to LPNs.
Q5: A nurse delegates vital signs to a UAP. Which finding must the UAP report
immediately to the RN?
A. Blood pressure 128/82 mmHg in a patient with hypertension
B. Heart rate 110 beats per minute in a patient with fever [CORRECT]
C. Respiratory rate 18 breaths per minute
D. Temperature 37.2°C (99.0°F) orally
Correct Answer: B
Rationale: A heart rate of 110 bpm represents tachycardia that may indicate sepsis,
dehydration, or cardiac compromise in a febrile patient and requires immediate RN
assessment to determine intervention. The other vital signs (A, C, D) are within or close
to normal limits and do not represent immediate physiological threats requiring urgent
RN intervention.
Q6: The charge nurse is planning assignments. Which patient is appropriate to assign to
an LPN?
A. A patient admitted 2 hours ago with chest pain requiring comprehensive assessment
B. A patient with new onset atrial fibrillation requiring continuous cardiac monitoring
C. A stable patient with osteomyelitis receiving IV antibiotics via established PICC line
[CORRECT]
D. A patient with a new colostomy requiring initial pouch change instruction
Correct Answer: C
Rationale: A stable patient with an established vascular access device receiving routine
IV antibiotics is within LPN scope, provided the LPN has IV certification and the patient
is not experiencing complications. New admissions (A), patients with new unstable
, arrhythmias (B), and patients requiring initial ostomy teaching (D) require RN
assessment, planning, and teaching capabilities.
Q7: A UAP is assisting with patient care. Which action by the UAP requires the RN to
provide immediate education?
A. Measuring and recording urinary output from a Foley catheter
B. Assisting a patient with a bed bath
C. Explaining the purpose of a newly prescribed medication to a patient [CORRECT]
D. Ambulating a patient using a gait belt
Correct Answer: C
Rationale: Explaining medication purposes constitutes patient education, which is
outside the UAP scope of practice and must be performed by licensed personnel; the
RN must immediately correct this action and provide education about role boundaries.
Measuring output (A), hygiene care (B), and ambulation assistance (D) are appropriate
UAP tasks that do not require nursing judgment or knowledge of pathophysiology.
Q8: An RN delegates ambulation of a patient to a UAP. Which statement demonstrates
appropriate supervision using the "Right Direction/Communication" and "Right
Supervision/Evaluation"?
A. "Let me know when you are done"
B. "The patient uses a walker and gets short of breath easily. Check oxygen saturation
before and after, and call me if it's below 92% or if the patient becomes dizzy"
[CORRECT]
C. "Be careful and don't drop the patient"
D. "Ask the LPN if you have any problems"
Correct Answer: B
Rationale: Effective delegation requires specific communication about patient
limitations, objective parameters to monitor, and clear expectations for when to seek RN
assistance; this ensures patient safety and appropriate supervision. Vague instructions
(A, C) or redirecting supervision to another nurse (D) violate the Five Rights of
Delegation and place the patient at risk.
PROCTORED EXAM Actual Questions and
Verified Answers (2026/2027) Level 3
Preparation
Domain 1: Management of Care — Delegation and Supervision
Q1: A charge nurse is delegating tasks to a UAP who has completed competency
training. Which task is appropriate to delegate?
A. Inserting a urinary catheter using sterile technique
B. Performing a fingerstick blood glucose check and reporting results to the RN
[CORRECT]
C. Assessing a patient's pain level after medication administration
D. Teaching a patient about discharge medication side effects
Correct Answer: B
Rationale: Performing fingerstick blood glucose monitoring is within the UAP scope of
practice when the UAP has been trained and competency has been validated; the UAP
must report results to the RN for interpretation and intervention. Inserting a urinary
catheter (A) requires sterile technique and nursing judgment, which exceeds UAP
scope. Assessment of pain (C) and patient teaching (D) are protected nursing
responsibilities that require RN licensure and cannot be delegated to UAPs.
Q2: An RN is supervising an LPN. Which action by the LPN requires immediate
intervention by the RN?
A. The LPN documents patient intake and output accurately
B. The LPN administers oral antibiotics to a stable patient
,C. The LPN develops the initial teaching plan for a newly diagnosed diabetic patient
[CORRECT]
D. The LPN performs routine wound care on a chronic wound
Correct Answer: C
Rationale: Developing the initial teaching plan requires nursing assessment,
identification of learning needs, and care planning, which are RN responsibilities per the
Nurse Practice Act; LPNs may reinforce teaching but cannot create the initial plan.
Administering oral medications (B) to stable patients and performing routine wound
care (D) are within the LPN scope in most jurisdictions. Documentation (A) is an
appropriate LPN function.
Q3: A UAP reports that a patient has fallen in the bathroom. What is the RN's priority
action after ensuring the scene is safe?
A. Complete an incident report immediately
B. Assess the patient for injuries and neurological changes [CORRECT]
C. Delegate the UAP to complete the incident report
D. Call the physician without personally assessing the patient
Correct Answer: B
Rationale: Assessment is an RN responsibility that cannot be delegated; the RN must
perform a thorough evaluation for injuries, neurological status changes, and
hemodynamic stability before any other interventions. While incident reports (A) are
necessary, they are not the priority over patient assessment. The RN cannot delegate
the incident report (C) as this requires the RN's involvement, and calling the physician
(D) without assessment violates the standard of care.
Q4: Which task is appropriate for the RN to delegate to an LPN caring for stable patients
on a medical-surgical unit?
A. Completing the admission assessment for a new patient
B. Developing the nursing care plan for a patient with pneumonia
C. Administering enteral feedings through a PEG tube to a stable patient [CORRECT]
D. Performing discharge teaching for a patient going home
,Correct Answer: C
Rationale: Administering enteral feedings to stable patients is within the LPN scope of
practice, provided the patient is not experiencing complications and the feeding is
routine. Admission assessments (A), care plan development (B), and discharge
teaching (D) require nursing judgment, critical thinking, and evaluation of learning
outcomes, which are RN-specific responsibilities that cannot be delegated to LPNs.
Q5: A nurse delegates vital signs to a UAP. Which finding must the UAP report
immediately to the RN?
A. Blood pressure 128/82 mmHg in a patient with hypertension
B. Heart rate 110 beats per minute in a patient with fever [CORRECT]
C. Respiratory rate 18 breaths per minute
D. Temperature 37.2°C (99.0°F) orally
Correct Answer: B
Rationale: A heart rate of 110 bpm represents tachycardia that may indicate sepsis,
dehydration, or cardiac compromise in a febrile patient and requires immediate RN
assessment to determine intervention. The other vital signs (A, C, D) are within or close
to normal limits and do not represent immediate physiological threats requiring urgent
RN intervention.
Q6: The charge nurse is planning assignments. Which patient is appropriate to assign to
an LPN?
A. A patient admitted 2 hours ago with chest pain requiring comprehensive assessment
B. A patient with new onset atrial fibrillation requiring continuous cardiac monitoring
C. A stable patient with osteomyelitis receiving IV antibiotics via established PICC line
[CORRECT]
D. A patient with a new colostomy requiring initial pouch change instruction
Correct Answer: C
Rationale: A stable patient with an established vascular access device receiving routine
IV antibiotics is within LPN scope, provided the LPN has IV certification and the patient
is not experiencing complications. New admissions (A), patients with new unstable
, arrhythmias (B), and patients requiring initial ostomy teaching (D) require RN
assessment, planning, and teaching capabilities.
Q7: A UAP is assisting with patient care. Which action by the UAP requires the RN to
provide immediate education?
A. Measuring and recording urinary output from a Foley catheter
B. Assisting a patient with a bed bath
C. Explaining the purpose of a newly prescribed medication to a patient [CORRECT]
D. Ambulating a patient using a gait belt
Correct Answer: C
Rationale: Explaining medication purposes constitutes patient education, which is
outside the UAP scope of practice and must be performed by licensed personnel; the
RN must immediately correct this action and provide education about role boundaries.
Measuring output (A), hygiene care (B), and ambulation assistance (D) are appropriate
UAP tasks that do not require nursing judgment or knowledge of pathophysiology.
Q8: An RN delegates ambulation of a patient to a UAP. Which statement demonstrates
appropriate supervision using the "Right Direction/Communication" and "Right
Supervision/Evaluation"?
A. "Let me know when you are done"
B. "The patient uses a walker and gets short of breath easily. Check oxygen saturation
before and after, and call me if it's below 92% or if the patient becomes dizzy"
[CORRECT]
C. "Be careful and don't drop the patient"
D. "Ask the LPN if you have any problems"
Correct Answer: B
Rationale: Effective delegation requires specific communication about patient
limitations, objective parameters to monitor, and clear expectations for when to seek RN
assistance; this ensures patient safety and appropriate supervision. Vague instructions
(A, C) or redirecting supervision to another nurse (D) violate the Five Rights of
Delegation and place the patient at risk.
