ATI RN Leadership Proctored
Assessment 2023/2026 with NGN,
including 60 real screenshot questions
with 100% verified correct answers.
1. A charge nurse is assigning tasks to a licensed practical nurse
(LPN) and an assistive personnel (AP). Which task should the
charge nurse assign to the LPN?
Answer: Administer a scheduled oral medication to a stable
patient.
Rationale: LPNs can administer oral, IM, and subcut
medications to stable patients. APs cannot administer any
medications. Delegation must follow state Nurse Practice Act
and facility policy.
2. A nurse on a medical-surgical unit has four patients. Which
patient should the nurse see first?
Answer: A patient with diabetes who has a blood glucose of
48 mg/dL and is diaphoretic.
Rationale: Hypoglycemia (＜70 mg/dL) with diaphoresis is a
life-threatening emergency requiring immediate intervention
(oral or IV glucose). Safety and unstable physiological needs
come first.
,3. A nurse manager is implementing a new electronic health
record (EHR). Which approach best facilitates staff adoption?
Answer: Involve frontline nurses in the planning and training
process.
Rationale: Participative decision-making increases buy-in
and reduces resistance to change. Top-down mandates
without staff input often fail.
4. A registered nurse (RN) is delegating a sterile dressing change
for a stage 2 pressure injury. Which team member is most
appropriate?
Answer: LPN with validated competency in sterile technique.
Rationale: LPNs can perform sterile dressing changes for
stable wounds if the state Nurse Practice Act and facility
policy allow. RN retains accountability.
5. A charge nurse notes that a staff member frequently takes
longer breaks than allowed. What is the first action?
Answer: Discuss the observation privately with the staff
member.
Rationale: The initial step in conflict or performance
management is to address the issue directly and respectfully
with the individual, not immediately escalate or ignore.
6. A nurse suspects a coworker is impaired due to smelling
alcohol on their breath. What should the nurse do?
Answer: Report the observation to the nurse manager
immediately.
, Rationale: Impaired practice is a patient safety risk.
Reporting is mandatory and ethical; the manager can initiate
fitness-for-duty testing.
7. A nurse is prioritizing morning care. Which patient requires
assessment first?
Answer: A patient who had a tracheostomy 2 hours ago and
has oxygen saturation of 88%.
Rationale: Hypoxemia (SpO2 <90%) after a new airway
procedure indicates possible obstruction or displacement – a
critical airway issue.
8. A patient refuses a blood transfusion due to religious beliefs
(Jehovah’s Witness). The surgeon insists the transfusion is
life-saving. What should the nurse do?
Answer: Respect the patient’s refusal and inform the surgeon
of the patient’s decision.
Rationale: Autonomous, informed adults have the right to
refuse treatment. The nurse advocates for the patient’s
wishes, not the physician’s preference.
9. An RN receives a handoff report on four patients. Which patient
should the RN see first?
Answer: Post-operative patient who received morphine 30
minutes ago and has a respiratory rate of 8 breaths/min.
Rationale: Respiratory depression (RR 8) is an immediate life
threat. Airway/breathing take priority over other concerns.
, 10. A nurse manager is reviewing cause and effect of medication
errors on a unit. Which strategy is the most effective for
prevention?
Answer: Implement a non-punitive reporting system to
identify system failures.
Rationale: Most errors stem from faulty processes, not
individual recklessness. Blame-free reporting uncovers root
causes (e.g., similar drug names, interruptions).
11. A charge nurse is making shift assignments. Which patient
should be assigned to the most experienced RN?
Answer: A patient with a chest tube that has 200 mL of
bloody drainage in the past hour.
Rationale: Active bleeding via chest tube is unstable and
requires expert assessment and intervention.
12. An LPN reports to the charge nurse that an AP did not
ambulate a patient as assigned. What is the charge nurse’s best
action?
Answer: Speak with the AP to determine the reason for
non-completion.
Rationale: The charge nurse must first gather information
directly from the AP (e.g., patient refusal, time constraints)
before coaching or corrective action.
13. A nurse is preparing to discharge a patient who speaks limited
English. What is the required action?
Assessment 2023/2026 with NGN,
including 60 real screenshot questions
with 100% verified correct answers.
1. A charge nurse is assigning tasks to a licensed practical nurse
(LPN) and an assistive personnel (AP). Which task should the
charge nurse assign to the LPN?
Answer: Administer a scheduled oral medication to a stable
patient.
Rationale: LPNs can administer oral, IM, and subcut
medications to stable patients. APs cannot administer any
medications. Delegation must follow state Nurse Practice Act
and facility policy.
2. A nurse on a medical-surgical unit has four patients. Which
patient should the nurse see first?
Answer: A patient with diabetes who has a blood glucose of
48 mg/dL and is diaphoretic.
Rationale: Hypoglycemia (＜70 mg/dL) with diaphoresis is a
life-threatening emergency requiring immediate intervention
(oral or IV glucose). Safety and unstable physiological needs
come first.
,3. A nurse manager is implementing a new electronic health
record (EHR). Which approach best facilitates staff adoption?
Answer: Involve frontline nurses in the planning and training
process.
Rationale: Participative decision-making increases buy-in
and reduces resistance to change. Top-down mandates
without staff input often fail.
4. A registered nurse (RN) is delegating a sterile dressing change
for a stage 2 pressure injury. Which team member is most
appropriate?
Answer: LPN with validated competency in sterile technique.
Rationale: LPNs can perform sterile dressing changes for
stable wounds if the state Nurse Practice Act and facility
policy allow. RN retains accountability.
5. A charge nurse notes that a staff member frequently takes
longer breaks than allowed. What is the first action?
Answer: Discuss the observation privately with the staff
member.
Rationale: The initial step in conflict or performance
management is to address the issue directly and respectfully
with the individual, not immediately escalate or ignore.
6. A nurse suspects a coworker is impaired due to smelling
alcohol on their breath. What should the nurse do?
Answer: Report the observation to the nurse manager
immediately.
, Rationale: Impaired practice is a patient safety risk.
Reporting is mandatory and ethical; the manager can initiate
fitness-for-duty testing.
7. A nurse is prioritizing morning care. Which patient requires
assessment first?
Answer: A patient who had a tracheostomy 2 hours ago and
has oxygen saturation of 88%.
Rationale: Hypoxemia (SpO2 <90%) after a new airway
procedure indicates possible obstruction or displacement – a
critical airway issue.
8. A patient refuses a blood transfusion due to religious beliefs
(Jehovah’s Witness). The surgeon insists the transfusion is
life-saving. What should the nurse do?
Answer: Respect the patient’s refusal and inform the surgeon
of the patient’s decision.
Rationale: Autonomous, informed adults have the right to
refuse treatment. The nurse advocates for the patient’s
wishes, not the physician’s preference.
9. An RN receives a handoff report on four patients. Which patient
should the RN see first?
Answer: Post-operative patient who received morphine 30
minutes ago and has a respiratory rate of 8 breaths/min.
Rationale: Respiratory depression (RR 8) is an immediate life
threat. Airway/breathing take priority over other concerns.
, 10. A nurse manager is reviewing cause and effect of medication
errors on a unit. Which strategy is the most effective for
prevention?
Answer: Implement a non-punitive reporting system to
identify system failures.
Rationale: Most errors stem from faulty processes, not
individual recklessness. Blame-free reporting uncovers root
causes (e.g., similar drug names, interruptions).
11. A charge nurse is making shift assignments. Which patient
should be assigned to the most experienced RN?
Answer: A patient with a chest tube that has 200 mL of
bloody drainage in the past hour.
Rationale: Active bleeding via chest tube is unstable and
requires expert assessment and intervention.
12. An LPN reports to the charge nurse that an AP did not
ambulate a patient as assigned. What is the charge nurse’s best
action?
Answer: Speak with the AP to determine the reason for
non-completion.
Rationale: The charge nurse must first gather information
directly from the AP (e.g., patient refusal, time constraints)
before coaching or corrective action.
13. A nurse is preparing to discharge a patient who speaks limited
English. What is the required action?
