2026 Update ATI PN Leadership 2023 Proctored Exam: 180
Questions with Correct Answers and Detailed Rationales for
Success
ATI PN LEADERSHIP 2023 PROCTORED EXAM
Comprehensive Sample: 180Questions with Answers & Rationales
SECTION 1: PRIORITIZATION & ACUTE CARE (
Q1.
Q1. A nurse is caring for four clients. Which finding requires immediate
intervention?
• A. A client with a Foley catheter reporting burning sensation
• B. A client with a cast reporting itching under the cast
• C. A client post-surgery with a blood pressure of 88/50 mm Hg and heart
rate of 120/min
• D. A client with a wound vac reporting intermittent suctioning
☑Correct Answer-: C
Rationale: The client with hypotension (88/50) and tachycardia (120) may be
experiencing hypovolemic shock, possibly from postoperative bleeding. This is a
life-threatening emergency requiring immediate intervention. The other findings
are concerning but not immediately life-threatening.
Q2. A nurse on a medical-surgical unit receives report. Which client should the
nurse assess first?
, • A. A client with chronic kidney disease whose potassium level is 5.8 mEq/L
• B. A client with hypertension whose blood pressure is 148/90 mm Hg
• C. A client with diabetes whose blood glucose is 180 mg/dL
• D. A client with heart failure who has 1+ edema in bilateral lower
extremities
☑Correct Answer-: A
Rationale: A potassium level of 5.8 mEq/L indicates hyperkalemia, which can lead
to life-threatening cardiac dysrhythmias. This requires immediate assessment and
intervention. The other findings are abnormal but not immediately
lifethreatening.
Q3. A nurse is prioritizing care for four clients. Which client should be seen first?
• A. A client requesting discharge instructions
• B. A client needing a routine wound dressing change
• C. A client with a nasogastric tube who reports nausea and abdominal
distention
• D. A client who needs a routine medication
☑Correct Answer-: C
Rationale: Nausea and abdominal distention in a client with an NG tube may
indicate tube malfunction, obstruction, or displacement. This requires immediate
assessment to prevent complications such as vomiting, aspiration, or bowel
perforation.
Q4 A nurse is assessing clients in the emergency department. Which client
requires immediate intervention?
• A. A client with a fever of 101.2°F and productive cough
, • B. A client with chest pain radiating to the left arm and diaphoresis
• C. A client with a laceration requiring sutures
• D. A client with a sprained ankle requesting pain medication
☑Correct Answer-: B
Rationale: Chest pain radiating to the left arm with diaphoresis are classic signs of
myocardial infarction. This client is at immediate risk for cardiac arrest and
requires rapid assessment and intervention. Emergency department triage
prioritizes life-threatening conditions first.
Q8. A nurse is caring for four clients. Which client is at highest risk for falls?
• A. A client who is ambulatory with a walker
• B. A client who received morphine 2 hours ago for postoperative pain
• C. A client who is oriented to person, place, and time
• D. A client who has a urinary catheter
☑Correct Answer-: B
Rationale: The client who received morphine is at highest risk for falls due to
opioid-induced sedation, dizziness, and orthostatic hypotension. The peak effect
of morphine occurs within 1-2 hours, placing this client at increased risk during
this time frame.
Q9. A nurse is assessing a client who is 6 hours post-surgery. Which finding
requires immediate intervention?
• A. Temperature of 99.8°F
• B. Urine output of 30 mL over the past hour
• C. Blood pressure of 100/60 mm Hg
• D. Oxygen saturation of 88% on room air
, ☑Correct Answer-: D
Rationale: An oxygen saturation of 88% indicates hypoxemia and respiratory
compromise. This requires immediate intervention such as supplemental oxygen,
assessment of airway, and notification of the provider. Postoperative hypoxemia
can lead to serious complications including respiratory failure.
Q10. A charge nurse is making assignments. Which client should be assigned to a
float nurse from the postpartum unit?
• A. A client with pneumonia requiring IV antibiotics
• B. A client with a stable wound infection needing a dressing change
• C. A client newly diagnosed with cancer requiring chemotherapy teaching
• D. A client with a central line requiring a blood transfusion
☑Correct Answer-: B
Rationale: A stable client requiring a routine wound dressing change has
predictable care needs that are within the competency of a float nurse. Complex
tasks such as chemotherapy teaching, blood transfusion, or unstable respiratory
clients should be assigned to staff familiar with those specific care needs.
SECTION 2: DELEGATION & SUPERVISION (Questions 11-20)
Q11. A charge nurse is delegating tasks to an LPN. Which task is appropriate to
delegate?
• A. Perform the initial admission assessment on a new client
• B. Administer IV push morphine to a client with acute pain
• C. Perform a sterile dressing change for a client with a surgical wound
• D. Create the plan of care for a client with diabetes
Questions with Correct Answers and Detailed Rationales for
Success
ATI PN LEADERSHIP 2023 PROCTORED EXAM
Comprehensive Sample: 180Questions with Answers & Rationales
SECTION 1: PRIORITIZATION & ACUTE CARE (
Q1.
Q1. A nurse is caring for four clients. Which finding requires immediate
intervention?
• A. A client with a Foley catheter reporting burning sensation
• B. A client with a cast reporting itching under the cast
• C. A client post-surgery with a blood pressure of 88/50 mm Hg and heart
rate of 120/min
• D. A client with a wound vac reporting intermittent suctioning
☑Correct Answer-: C
Rationale: The client with hypotension (88/50) and tachycardia (120) may be
experiencing hypovolemic shock, possibly from postoperative bleeding. This is a
life-threatening emergency requiring immediate intervention. The other findings
are concerning but not immediately life-threatening.
Q2. A nurse on a medical-surgical unit receives report. Which client should the
nurse assess first?
, • A. A client with chronic kidney disease whose potassium level is 5.8 mEq/L
• B. A client with hypertension whose blood pressure is 148/90 mm Hg
• C. A client with diabetes whose blood glucose is 180 mg/dL
• D. A client with heart failure who has 1+ edema in bilateral lower
extremities
☑Correct Answer-: A
Rationale: A potassium level of 5.8 mEq/L indicates hyperkalemia, which can lead
to life-threatening cardiac dysrhythmias. This requires immediate assessment and
intervention. The other findings are abnormal but not immediately
lifethreatening.
Q3. A nurse is prioritizing care for four clients. Which client should be seen first?
• A. A client requesting discharge instructions
• B. A client needing a routine wound dressing change
• C. A client with a nasogastric tube who reports nausea and abdominal
distention
• D. A client who needs a routine medication
☑Correct Answer-: C
Rationale: Nausea and abdominal distention in a client with an NG tube may
indicate tube malfunction, obstruction, or displacement. This requires immediate
assessment to prevent complications such as vomiting, aspiration, or bowel
perforation.
Q4 A nurse is assessing clients in the emergency department. Which client
requires immediate intervention?
• A. A client with a fever of 101.2°F and productive cough
, • B. A client with chest pain radiating to the left arm and diaphoresis
• C. A client with a laceration requiring sutures
• D. A client with a sprained ankle requesting pain medication
☑Correct Answer-: B
Rationale: Chest pain radiating to the left arm with diaphoresis are classic signs of
myocardial infarction. This client is at immediate risk for cardiac arrest and
requires rapid assessment and intervention. Emergency department triage
prioritizes life-threatening conditions first.
Q8. A nurse is caring for four clients. Which client is at highest risk for falls?
• A. A client who is ambulatory with a walker
• B. A client who received morphine 2 hours ago for postoperative pain
• C. A client who is oriented to person, place, and time
• D. A client who has a urinary catheter
☑Correct Answer-: B
Rationale: The client who received morphine is at highest risk for falls due to
opioid-induced sedation, dizziness, and orthostatic hypotension. The peak effect
of morphine occurs within 1-2 hours, placing this client at increased risk during
this time frame.
Q9. A nurse is assessing a client who is 6 hours post-surgery. Which finding
requires immediate intervention?
• A. Temperature of 99.8°F
• B. Urine output of 30 mL over the past hour
• C. Blood pressure of 100/60 mm Hg
• D. Oxygen saturation of 88% on room air
, ☑Correct Answer-: D
Rationale: An oxygen saturation of 88% indicates hypoxemia and respiratory
compromise. This requires immediate intervention such as supplemental oxygen,
assessment of airway, and notification of the provider. Postoperative hypoxemia
can lead to serious complications including respiratory failure.
Q10. A charge nurse is making assignments. Which client should be assigned to a
float nurse from the postpartum unit?
• A. A client with pneumonia requiring IV antibiotics
• B. A client with a stable wound infection needing a dressing change
• C. A client newly diagnosed with cancer requiring chemotherapy teaching
• D. A client with a central line requiring a blood transfusion
☑Correct Answer-: B
Rationale: A stable client requiring a routine wound dressing change has
predictable care needs that are within the competency of a float nurse. Complex
tasks such as chemotherapy teaching, blood transfusion, or unstable respiratory
clients should be assigned to staff familiar with those specific care needs.
SECTION 2: DELEGATION & SUPERVISION (Questions 11-20)
Q11. A charge nurse is delegating tasks to an LPN. Which task is appropriate to
delegate?
• A. Perform the initial admission assessment on a new client
• B. Administer IV push morphine to a client with acute pain
• C. Perform a sterile dressing change for a client with a surgical wound
• D. Create the plan of care for a client with diabetes
