ATI RN LEADERSHIP PROCTORED EXAM 2026/2027 |
Guaranteed Level 3 with Questions and 100% Correct
Verified Answers | Pass Guaranteed - A+ Graded
Management of Care: Delegation and Assignment
Q1: The charge nurse is making assignments for the day shift on a medical-surgical
unit. Which client should the charge nurse assign to the LPN/LVN rather than the UAP?
A. A client who is post-operative day 1 following a total knee replacement and needs to
use a bedside commode
B. A client with a nasogastric tube connected to low intermittent suction who requires
oral care every 2 hours
C. A client with a resolving stage II pressure injury who needs a hydrocolloid dressing
changed
D. A client who was just admitted with dehydration and needs an intake and output
sheet started
Correct Answer: C
Rationale: The LPN/LVN scope of practice includes performing wound care and
applying specific dressings (like hydrocolloids) for stable clients with predictable
outcomes. This falls under the "right task" and "right person" for LPN/LVN delegation.
Option A involves basic hygiene/toileting, which is appropriate for UAP. Option B
involves basic oral care, appropriate for UAP (the nurse manages the suction, but oral
hygiene itself is a UAP task). Option D involves basic data collection (I&O), which is
appropriate for UAP. Complex or initial assessments, and care planning, cannot be
delegated to UAP or LPN.
Q2: A nurse on a telemetry unit is delegating tasks to a UAP. Which action by the UAP
requires immediate intervention by the nurse?
A. The UAP applies anti-embolism stockings to a client who is on bed rest.
B. The UAP measures the intake and output for a client receiving continuous bladder
irrigation.
C. The UAP reminds a client to splint their abdominal incision while coughing.
D. The UAP obtains a clean-catch urine specimen from a client.
Correct Answer: C
Rationale: Reminding a client to splint an incision while coughing involves reinforcing
therapeutic teaching, which requires nursing judgment and is outside the scope of
practice for a UAP. The RN or LPN/LVN must delegate basic coughing and deep
breathing, but evaluating or instructing on splinting techniques requires clinical
,knowledge. Applying anti-embolism stockings (A), measuring I&O (B), and obtaining
clean-catch specimens (D) are all standard, predictable tasks that can be safely
delegated to a UAP with the right direction and supervision.
Q3: The charge nurse is assigning clients to an RN who has been pulled from the ICU
to work on the medical-surgical unit for the shift. Which client is the most appropriate
assignment for this float nurse?
A. A client newly diagnosed with type 2 diabetes mellitus who requires discharge
teaching regarding insulin administration
B. A client with a history of heart failure who is receiving IV furosemide and needs
hourly urine output monitoring
C. A client who is 12 hours post-cholecystectomy with a T-tube and is complaining of
severe abdominal pain
D. A client admitted with pneumonia who has a temperature of 101.2°F and requires
frequent vital sign checks
Correct Answer: C
Rationale: When floating a nurse to an unfamiliar unit, the charge nurse should assign
clients whose care is most similar to the nurse's specialty area. An ICU nurse is highly
skilled in managing acute pain, monitoring invasive tubes (like a T-tube), and assessing
for post-surgical complications. Options A, B, and D involve high-frequency monitoring
or extensive patient education typical of medical-surgical nursing, whereas option C
requires the acute assessment skills of an ICU nurse.
Q4: A nurse is caring for four clients. Which task can the nurse delegate to the
LPN/LVN?
A. Performing the initial admission assessment on a client transferred from the
emergency department
B. Evaluating the effectiveness of a new antiemetic medication prescribed for a client
C. Administering an oral antihypertensive medication to a client with stable vital signs
D. Developing a nursing care plan for a client newly diagnosed with chronic obstructive
pulmonary disease
Correct Answer: C
Rationale: Administering oral medications to stable clients with predictable outcomes is
within the scope of practice of an LPN/LVN under the supervision of an RN. The RN
cannot delegate initial assessments (A), evaluation of medication effectiveness (B), or
care plan development (D) because these require RN-level nursing judgment, critical
thinking, and educational preparation.
Q5: The nurse is reviewing the state Nurse Practice Act regarding delegation. Which
statement by the nurse indicates an accurate understanding of the "right
supervision/evaluation"?
,A. "I am only responsible for evaluating the UAP's performance during the initial
orientation period."
B. "I must provide clear directions and then assume the UAP will complete the task
safely without further oversight."
C. "I am ultimately responsible for the outcomes of the tasks I delegate to the UAP."
D. "I must directly observe every task I delegate to an LPN/LVN to ensure it is done
correctly."
Correct Answer: C
Rationale: According to the Five Rights of Delegation, the delegating RN maintains
ultimate accountability and responsibility for the outcomes of delegated tasks, even
when the task is assigned to another licensed or unlicensed personnel. The RN cannot
abdicate responsibility (B). Evaluation and supervision are ongoing processes, not
limited to orientation (A). Direct observation of every task (D) is impractical and implies
a lack of trust; supervision can be periodic based on the UAP's demonstrated
competency.
Q6: A nurse is preparing to delegate client care to an experienced LPN/LVN. Which
instruction provides the "right direction/communication"?
A. "Please take care of the client in room 304."
B. "Check the client's blood pressure in room 304 and let me know if it is high."
C. "Measure the blood pressure in room 304 at 0800 and 1200. Report any systolic
reading greater than 160 mmHg or less than 90 mmHg to me immediately."
D. "The client in 304 has hypertension; use your nursing judgment to decide what to
do."
Correct Answer: C
Rationale: The "right direction/communication" requires the RN to provide clear,
specific, and measurable instructions regarding the task, including the exact parameters
for reporting back to the RN. Option A lacks detail. Option B is vague ("high" is not
defined). Option D is inappropriate because it asks the LPN/LVN to exercise
independent nursing judgment regarding a change in condition, which remains the
responsibility of the RN.
Q7: The charge nurse is making shift assignments. Which client should be assigned to
the most experienced RN on the team?
A. A client who is 2 days post-appendectomy and is preparing for discharge
B. A client with end-stage renal disease receiving continuous ambulatory peritoneal
dialysis
C. A client with acute respiratory distress syndrome (ARDS) who was just intubated and
placed on mechanical ventilation
D. A client with a new diagnosis of hypertension who requires initiation of lifestyle
modification education
, Correct Answer: C
Rationale: Client acuity classification systems dictate that the most experienced nurse
should be assigned the most unstable client with the highest acuity level. A client with
ARDS who has just been intubated requires continuous, complex assessment,
ventilator management, and rapid response to hemodynamic changes. This exceeds
the scope of stable client management and requires high-level critical care nursing
judgment. The other clients are stable or require routine care/teaching.
Q8: A nurse is delegating the care of a client with a Jackson-Pratt (JP) drain to an
LPN/LVN. Which statement by the LPN/LVN indicates a need for further teaching?
A. "I will wash my hands before and after emptying the drain."
B. "I will measure and record the drainage amount on the intake and output sheet."
C. "I will notify the RN if the drainage output suddenly increases to 50 mL in an hour."
D. "I will strip the tubing forcefully to ensure it remains patent and draining well."
Correct Answer: D
Rationale: Stripping JP drain tubing forcefully is contraindicated because it can cause
excessive negative pressure, damaging tissue and increasing the risk of infection or
bleeding at the insertion site. Gentle compression or milking may be permitted per
facility policy, but "forcefully stripping" is incorrect and requires immediate correction.
Hand hygiene (A), measuring and recording I&O (B), and reporting significant changes
in output (C) are all appropriate actions within the LPN/LVN scope.
Q9: The nurse is planning care for a client who is on suicide precautions. Which task is
appropriate to delegate to the UAP?
A. Evaluating the client's mood and affect during the shift
B. Removing all potentially harmful objects from the client's room
C. Performing a continuous 1:1 observation of the client
D. Assessing the client's suicidal ideation using a validated screening tool
Correct Answer: C
Rationale: While maintaining a safe environment is a shared responsibility, UAPs can
be delegated the task of continuous 1:1 observation (sitting with the client to prevent
self-harm), provided they have been given specific instructions to never leave the client
alone and to call the RN immediately if the client attempts anything dangerous.
Evaluating mood/affect (A) and assessing suicidal ideation (D) are RN-level
assessments. Removing harmful objects (B) should ideally be done by or with the RN to
ensure a thorough environmental safety check, though UAPs can assist under direct RN
supervision. Continuous observation is the clearest, safest delegation for UAP in this
context.
Q10: A nurse receives report on four clients. Which client can the nurse safely delegate
to the LPN/LVN?
Guaranteed Level 3 with Questions and 100% Correct
Verified Answers | Pass Guaranteed - A+ Graded
Management of Care: Delegation and Assignment
Q1: The charge nurse is making assignments for the day shift on a medical-surgical
unit. Which client should the charge nurse assign to the LPN/LVN rather than the UAP?
A. A client who is post-operative day 1 following a total knee replacement and needs to
use a bedside commode
B. A client with a nasogastric tube connected to low intermittent suction who requires
oral care every 2 hours
C. A client with a resolving stage II pressure injury who needs a hydrocolloid dressing
changed
D. A client who was just admitted with dehydration and needs an intake and output
sheet started
Correct Answer: C
Rationale: The LPN/LVN scope of practice includes performing wound care and
applying specific dressings (like hydrocolloids) for stable clients with predictable
outcomes. This falls under the "right task" and "right person" for LPN/LVN delegation.
Option A involves basic hygiene/toileting, which is appropriate for UAP. Option B
involves basic oral care, appropriate for UAP (the nurse manages the suction, but oral
hygiene itself is a UAP task). Option D involves basic data collection (I&O), which is
appropriate for UAP. Complex or initial assessments, and care planning, cannot be
delegated to UAP or LPN.
Q2: A nurse on a telemetry unit is delegating tasks to a UAP. Which action by the UAP
requires immediate intervention by the nurse?
A. The UAP applies anti-embolism stockings to a client who is on bed rest.
B. The UAP measures the intake and output for a client receiving continuous bladder
irrigation.
C. The UAP reminds a client to splint their abdominal incision while coughing.
D. The UAP obtains a clean-catch urine specimen from a client.
Correct Answer: C
Rationale: Reminding a client to splint an incision while coughing involves reinforcing
therapeutic teaching, which requires nursing judgment and is outside the scope of
practice for a UAP. The RN or LPN/LVN must delegate basic coughing and deep
breathing, but evaluating or instructing on splinting techniques requires clinical
,knowledge. Applying anti-embolism stockings (A), measuring I&O (B), and obtaining
clean-catch specimens (D) are all standard, predictable tasks that can be safely
delegated to a UAP with the right direction and supervision.
Q3: The charge nurse is assigning clients to an RN who has been pulled from the ICU
to work on the medical-surgical unit for the shift. Which client is the most appropriate
assignment for this float nurse?
A. A client newly diagnosed with type 2 diabetes mellitus who requires discharge
teaching regarding insulin administration
B. A client with a history of heart failure who is receiving IV furosemide and needs
hourly urine output monitoring
C. A client who is 12 hours post-cholecystectomy with a T-tube and is complaining of
severe abdominal pain
D. A client admitted with pneumonia who has a temperature of 101.2°F and requires
frequent vital sign checks
Correct Answer: C
Rationale: When floating a nurse to an unfamiliar unit, the charge nurse should assign
clients whose care is most similar to the nurse's specialty area. An ICU nurse is highly
skilled in managing acute pain, monitoring invasive tubes (like a T-tube), and assessing
for post-surgical complications. Options A, B, and D involve high-frequency monitoring
or extensive patient education typical of medical-surgical nursing, whereas option C
requires the acute assessment skills of an ICU nurse.
Q4: A nurse is caring for four clients. Which task can the nurse delegate to the
LPN/LVN?
A. Performing the initial admission assessment on a client transferred from the
emergency department
B. Evaluating the effectiveness of a new antiemetic medication prescribed for a client
C. Administering an oral antihypertensive medication to a client with stable vital signs
D. Developing a nursing care plan for a client newly diagnosed with chronic obstructive
pulmonary disease
Correct Answer: C
Rationale: Administering oral medications to stable clients with predictable outcomes is
within the scope of practice of an LPN/LVN under the supervision of an RN. The RN
cannot delegate initial assessments (A), evaluation of medication effectiveness (B), or
care plan development (D) because these require RN-level nursing judgment, critical
thinking, and educational preparation.
Q5: The nurse is reviewing the state Nurse Practice Act regarding delegation. Which
statement by the nurse indicates an accurate understanding of the "right
supervision/evaluation"?
,A. "I am only responsible for evaluating the UAP's performance during the initial
orientation period."
B. "I must provide clear directions and then assume the UAP will complete the task
safely without further oversight."
C. "I am ultimately responsible for the outcomes of the tasks I delegate to the UAP."
D. "I must directly observe every task I delegate to an LPN/LVN to ensure it is done
correctly."
Correct Answer: C
Rationale: According to the Five Rights of Delegation, the delegating RN maintains
ultimate accountability and responsibility for the outcomes of delegated tasks, even
when the task is assigned to another licensed or unlicensed personnel. The RN cannot
abdicate responsibility (B). Evaluation and supervision are ongoing processes, not
limited to orientation (A). Direct observation of every task (D) is impractical and implies
a lack of trust; supervision can be periodic based on the UAP's demonstrated
competency.
Q6: A nurse is preparing to delegate client care to an experienced LPN/LVN. Which
instruction provides the "right direction/communication"?
A. "Please take care of the client in room 304."
B. "Check the client's blood pressure in room 304 and let me know if it is high."
C. "Measure the blood pressure in room 304 at 0800 and 1200. Report any systolic
reading greater than 160 mmHg or less than 90 mmHg to me immediately."
D. "The client in 304 has hypertension; use your nursing judgment to decide what to
do."
Correct Answer: C
Rationale: The "right direction/communication" requires the RN to provide clear,
specific, and measurable instructions regarding the task, including the exact parameters
for reporting back to the RN. Option A lacks detail. Option B is vague ("high" is not
defined). Option D is inappropriate because it asks the LPN/LVN to exercise
independent nursing judgment regarding a change in condition, which remains the
responsibility of the RN.
Q7: The charge nurse is making shift assignments. Which client should be assigned to
the most experienced RN on the team?
A. A client who is 2 days post-appendectomy and is preparing for discharge
B. A client with end-stage renal disease receiving continuous ambulatory peritoneal
dialysis
C. A client with acute respiratory distress syndrome (ARDS) who was just intubated and
placed on mechanical ventilation
D. A client with a new diagnosis of hypertension who requires initiation of lifestyle
modification education
, Correct Answer: C
Rationale: Client acuity classification systems dictate that the most experienced nurse
should be assigned the most unstable client with the highest acuity level. A client with
ARDS who has just been intubated requires continuous, complex assessment,
ventilator management, and rapid response to hemodynamic changes. This exceeds
the scope of stable client management and requires high-level critical care nursing
judgment. The other clients are stable or require routine care/teaching.
Q8: A nurse is delegating the care of a client with a Jackson-Pratt (JP) drain to an
LPN/LVN. Which statement by the LPN/LVN indicates a need for further teaching?
A. "I will wash my hands before and after emptying the drain."
B. "I will measure and record the drainage amount on the intake and output sheet."
C. "I will notify the RN if the drainage output suddenly increases to 50 mL in an hour."
D. "I will strip the tubing forcefully to ensure it remains patent and draining well."
Correct Answer: D
Rationale: Stripping JP drain tubing forcefully is contraindicated because it can cause
excessive negative pressure, damaging tissue and increasing the risk of infection or
bleeding at the insertion site. Gentle compression or milking may be permitted per
facility policy, but "forcefully stripping" is incorrect and requires immediate correction.
Hand hygiene (A), measuring and recording I&O (B), and reporting significant changes
in output (C) are all appropriate actions within the LPN/LVN scope.
Q9: The nurse is planning care for a client who is on suicide precautions. Which task is
appropriate to delegate to the UAP?
A. Evaluating the client's mood and affect during the shift
B. Removing all potentially harmful objects from the client's room
C. Performing a continuous 1:1 observation of the client
D. Assessing the client's suicidal ideation using a validated screening tool
Correct Answer: C
Rationale: While maintaining a safe environment is a shared responsibility, UAPs can
be delegated the task of continuous 1:1 observation (sitting with the client to prevent
self-harm), provided they have been given specific instructions to never leave the client
alone and to call the RN immediately if the client attempts anything dangerous.
Evaluating mood/affect (A) and assessing suicidal ideation (D) are RN-level
assessments. Removing harmful objects (B) should ideally be done by or with the RN to
ensure a thorough environmental safety check, though UAPs can assist under direct RN
supervision. Continuous observation is the clearest, safest delegation for UAP in this
context.
Q10: A nurse receives report on four clients. Which client can the nurse safely delegate
to the LPN/LVN?
