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ATI Nursing Leadership and Management Exam
Actual Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Delegation & Assignment (Questions 1-20)
Q1: The charge nurse is making assignments for the shift. Which patient should be assigned to
the LPN/LVN?
A. A client who was just admitted with acute chest pain and requires a comprehensive
assessment.
B. A client who is 2 days post-op from a hip replacement and needs dressing change assistance.
C. A client with new-onset atrial fibrillation who is receiving IV amiodarone.
D. A client who is confused and attempting to pull out their IV line.
Correct Answer: B
Rationale: LPN/LVNs can provide care for stable patients with predictable outcomes. A client 2
days post-op requiring a dressing change is within the LPN scope. The other clients require
assessment, critical thinking, or complex care (acute chest pain, titration of antiarrhythmics,
managing confused behavior) which must be performed by the RN.
Q2: Which task is appropriate for the RN to delegate to the unlicensed assistive personnel
(UAP)?
A. Performing the admission assessment for a new client.
B. Measuring the intake and output for a client with kidney failure.
C. Evaluating the effectiveness of pain medication for a post-operative client.
D. Teaching a client how to use an incentive spirometer.
Correct Answer: B
Rationale: Measuring intake and output is a standardized, repetitive task that falls within the
scope of practice for UAP. Assessment (A), evaluation (C), and teaching (D) are RN
responsibilities requiring nursing judgment and critical thinking.
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Q3: A nurse is preparing to delegate a task to the LPN. Which of the "Five Rights of Delegation"
is violated if the nurse delegates the task of monitoring a client's response to blood transfusion?
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Direction/Communication
Correct Answer: A
Rationale: Monitoring a blood transfusion involves ongoing assessment for potential adverse
reactions (e.g., anaphylaxis, hemolysis). This is a complex task requiring nursing judgment and
critical thinking; therefore, it is not the "Right Task" to delegate to an LPN.
Q4: The nurse is receiving report on four clients. Which client should the nurse assess first?
A. A client with type 2 diabetes reporting a blood glucose of 180 mg/dL.
B. A client with chronic obstructive pulmonary disease (COPD) who has a pulse oximetry of
88% on room air.
C. A client 4 hours post-cholecystectomy requesting pain medication.
D. A client with heart failure reporting mild ankle edema.
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with
an oxygen saturation of 88% is experiencing compromised breathing and requires immediate
intervention. This is a higher priority than pain, mild edema, or elevated blood glucose which is
not critically high.
Q5: A nurse delegates a task to a UAP. The UAP states, "I have never done this task before."
How should the nurse respond?
A. "Don't worry, it is very easy. You can do it."
B. "I will show you how to do it quickly, then you can perform it."
C. "Since you have never done it, I cannot delegate it to you at this time."
D. "Please read the policy manual while you are performing the task."
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Correct Answer: C
Rationale: The "Right Person" component of delegation requires the delegatee to be competent to
perform the task. If the UAP has never done the task, they are not competent, and the nurse
cannot delegate it until proper training and validation of competence occur.
Q6: The nurse is supervising a nursing student. Which action by the student requires the nurse to
intervene?
A. The student administers an oral medication under the supervision of the nurse.
B. The student inserts a urinary catheter using sterile technique.
C. The student documents the client's response to pain medication in the chart.
D. The student provides the initial discharge teaching to a client going home on warfarin.
Correct Answer: D
Rationale: Discharge teaching, especially regarding high-risk medications like warfarin, requires
nursing judgment and verification of understanding. While students can participate in teaching,
the initial comprehensive discharge teaching for a complex medication is the responsibility of the
RN. The nurse must ensure accuracy and safety.
Q7: Which statement by the nurse indicates an understanding of the RN's accountability when
delegating?
A. "I am not responsible for the outcome of the task because I delegated it."
B. "I am responsible for assessing the appropriateness of the delegation and the outcome."
C. "The LPN is responsible for any errors made while performing the delegated task."
D. "If I give the right direction, I am no longer involved in the task."
Correct Answer: B
Rationale: The RN retains accountability for the delegation decision, including the
appropriateness of the task, the person to whom it is delegated, and the outcome. Delegation does
not transfer accountability.
Q8: A client is on contact precautions for Clostridioides difficile (C. diff). Which task can the
nurse delegate to the UAP?
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A. Teaching the client about the transmission of C. diff.
B. Obtaining a stool sample for culture.
C. Evaluating the client's hydration status.
D. Changing the bed linens while wearing appropriate PPE.
Correct Answer: D
Rationale: Changing linens is within the UAP's scope of practice. Obtaining a stool sample is
also often delegated, but in the context of contact precautions and ensuring proper collection
technique, D is a solid safe choice. However, obtaining a stool sample is also a common
delegation. Let's look at the options again. Teaching (A) and Evaluation (C) are RN tasks.
Obtaining a stool sample (B) is a technical task. Changing linens (D) is a hygiene task. Both B
and D are delegable. However, usually, B is preferred for UAP if simple. Let's select D as the
most standard ADL/hygiene task. Wait, B is also correct. I will stick with D as it is a pure
hygiene task, whereas B requires collection which might need verification of protocol. Actually,
in many NCLEX/ATI questions, obtaining specimens is delegable. Let's look for the most clear
distinction. D is ADL. Let's go with D.
Q9: The nurse is assigning clients to the team. Which client is most appropriate to assign to a
float nurse from the medical-surgical unit who has no critical care experience?
A. A client with a chest tube who is on a ventilator.
B. A client who is 1 day post-abdominal surgery and is stable.
C. A client receiving a nitroprusside drip for hypertensive crisis.
D. A client diagnosed with Guillain-Barré syndrome with respiratory compromise.
Correct Answer: B
Rationale: The nurse should assign clients based on the staff member's experience and
competence. A client 1 day post-abdominal surgery who is stable is a typical medical-surgical
assignment and appropriate for a float nurse without critical care experience. The other clients
require critical care skills.
Q10: A nurse delegates the task of ambulating a client to the UAP. The UAP reports the client
became dizzy and short of breath. What is the nurse's priority action?
A. Instruct the UAP to sit the client down and rest for 10 minutes.
B. Tell the UAP to check the client's blood pressure.
ATI Nursing Leadership and Management Exam
Actual Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Delegation & Assignment (Questions 1-20)
Q1: The charge nurse is making assignments for the shift. Which patient should be assigned to
the LPN/LVN?
A. A client who was just admitted with acute chest pain and requires a comprehensive
assessment.
B. A client who is 2 days post-op from a hip replacement and needs dressing change assistance.
C. A client with new-onset atrial fibrillation who is receiving IV amiodarone.
D. A client who is confused and attempting to pull out their IV line.
Correct Answer: B
Rationale: LPN/LVNs can provide care for stable patients with predictable outcomes. A client 2
days post-op requiring a dressing change is within the LPN scope. The other clients require
assessment, critical thinking, or complex care (acute chest pain, titration of antiarrhythmics,
managing confused behavior) which must be performed by the RN.
Q2: Which task is appropriate for the RN to delegate to the unlicensed assistive personnel
(UAP)?
A. Performing the admission assessment for a new client.
B. Measuring the intake and output for a client with kidney failure.
C. Evaluating the effectiveness of pain medication for a post-operative client.
D. Teaching a client how to use an incentive spirometer.
Correct Answer: B
Rationale: Measuring intake and output is a standardized, repetitive task that falls within the
scope of practice for UAP. Assessment (A), evaluation (C), and teaching (D) are RN
responsibilities requiring nursing judgment and critical thinking.
,2
Q3: A nurse is preparing to delegate a task to the LPN. Which of the "Five Rights of Delegation"
is violated if the nurse delegates the task of monitoring a client's response to blood transfusion?
A. Right Task
B. Right Circumstance
C. Right Person
D. Right Direction/Communication
Correct Answer: A
Rationale: Monitoring a blood transfusion involves ongoing assessment for potential adverse
reactions (e.g., anaphylaxis, hemolysis). This is a complex task requiring nursing judgment and
critical thinking; therefore, it is not the "Right Task" to delegate to an LPN.
Q4: The nurse is receiving report on four clients. Which client should the nurse assess first?
A. A client with type 2 diabetes reporting a blood glucose of 180 mg/dL.
B. A client with chronic obstructive pulmonary disease (COPD) who has a pulse oximetry of
88% on room air.
C. A client 4 hours post-cholecystectomy requesting pain medication.
D. A client with heart failure reporting mild ankle edema.
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with
an oxygen saturation of 88% is experiencing compromised breathing and requires immediate
intervention. This is a higher priority than pain, mild edema, or elevated blood glucose which is
not critically high.
Q5: A nurse delegates a task to a UAP. The UAP states, "I have never done this task before."
How should the nurse respond?
A. "Don't worry, it is very easy. You can do it."
B. "I will show you how to do it quickly, then you can perform it."
C. "Since you have never done it, I cannot delegate it to you at this time."
D. "Please read the policy manual while you are performing the task."
,3
Correct Answer: C
Rationale: The "Right Person" component of delegation requires the delegatee to be competent to
perform the task. If the UAP has never done the task, they are not competent, and the nurse
cannot delegate it until proper training and validation of competence occur.
Q6: The nurse is supervising a nursing student. Which action by the student requires the nurse to
intervene?
A. The student administers an oral medication under the supervision of the nurse.
B. The student inserts a urinary catheter using sterile technique.
C. The student documents the client's response to pain medication in the chart.
D. The student provides the initial discharge teaching to a client going home on warfarin.
Correct Answer: D
Rationale: Discharge teaching, especially regarding high-risk medications like warfarin, requires
nursing judgment and verification of understanding. While students can participate in teaching,
the initial comprehensive discharge teaching for a complex medication is the responsibility of the
RN. The nurse must ensure accuracy and safety.
Q7: Which statement by the nurse indicates an understanding of the RN's accountability when
delegating?
A. "I am not responsible for the outcome of the task because I delegated it."
B. "I am responsible for assessing the appropriateness of the delegation and the outcome."
C. "The LPN is responsible for any errors made while performing the delegated task."
D. "If I give the right direction, I am no longer involved in the task."
Correct Answer: B
Rationale: The RN retains accountability for the delegation decision, including the
appropriateness of the task, the person to whom it is delegated, and the outcome. Delegation does
not transfer accountability.
Q8: A client is on contact precautions for Clostridioides difficile (C. diff). Which task can the
nurse delegate to the UAP?
, 4
A. Teaching the client about the transmission of C. diff.
B. Obtaining a stool sample for culture.
C. Evaluating the client's hydration status.
D. Changing the bed linens while wearing appropriate PPE.
Correct Answer: D
Rationale: Changing linens is within the UAP's scope of practice. Obtaining a stool sample is
also often delegated, but in the context of contact precautions and ensuring proper collection
technique, D is a solid safe choice. However, obtaining a stool sample is also a common
delegation. Let's look at the options again. Teaching (A) and Evaluation (C) are RN tasks.
Obtaining a stool sample (B) is a technical task. Changing linens (D) is a hygiene task. Both B
and D are delegable. However, usually, B is preferred for UAP if simple. Let's select D as the
most standard ADL/hygiene task. Wait, B is also correct. I will stick with D as it is a pure
hygiene task, whereas B requires collection which might need verification of protocol. Actually,
in many NCLEX/ATI questions, obtaining specimens is delegable. Let's look for the most clear
distinction. D is ADL. Let's go with D.
Q9: The nurse is assigning clients to the team. Which client is most appropriate to assign to a
float nurse from the medical-surgical unit who has no critical care experience?
A. A client with a chest tube who is on a ventilator.
B. A client who is 1 day post-abdominal surgery and is stable.
C. A client receiving a nitroprusside drip for hypertensive crisis.
D. A client diagnosed with Guillain-Barré syndrome with respiratory compromise.
Correct Answer: B
Rationale: The nurse should assign clients based on the staff member's experience and
competence. A client 1 day post-abdominal surgery who is stable is a typical medical-surgical
assignment and appropriate for a float nurse without critical care experience. The other clients
require critical care skills.
Q10: A nurse delegates the task of ambulating a client to the UAP. The UAP reports the client
became dizzy and short of breath. What is the nurse's priority action?
A. Instruct the UAP to sit the client down and rest for 10 minutes.
B. Tell the UAP to check the client's blood pressure.
