ATI Nursing Leadership and
Management Exam ACTUAL EXAM
2026/2027 | Complete Exam-Style
Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
Section A: Legal & Ethical Issues (10 questions)
Q1. A 42-year-old patient admitted for elective knee replacement tells the nurse, "I changed my mind. I
don't want the surgery anymore." The surgeon insists the patient sign the consent form, stating,We've
already scheduled the OR and prepped the site." What is the nurse's most appropriate action?
A. Hold the consent form and tell the patient they must sign or face legal consequences for breach of
contract
B. Notify the surgeon that the patient has withdrawn consent and document the patient's refusal in the
medical record [CORRECT]
C. Convince the patient to proceed by explaining the risks of delaying surgery
D. Call the patient's family to pressure them into consenting
Correct Answer: B
Rationale: Informed consent is a voluntary process that the patient can withdraw at any time before the
procedure begins, for any reason, without penalty. The nurse serves as the patient's advocate and must
immediately communicate the withdrawal to the surgeon and document it objectively. The surgeon's
insistence violates the ethical principle of autonomy.
Distractor A: Patients cannot be legally compelled to undergo elective surgery; "breach of contract" is
not applicable to informed consent withdrawal.
Distractor C: The nurse's role is to support autonomous decision-making, not to persuade the patient
against their stated wishes; this violates advocacy.
Distractor D: Family pressure constitutes coercion and violates the patient's right to self-determination;
consent must be free from undue influence.
Reference: ATI Nursing Leadership Module 2 (Legal/Ethical); NCLEX-RN Test Plan 2026 — Management
of Care (Safety & Infection Control, Legal Rights).
,Q2. A nurse on the medical-surgical unit observes a nursing assistant (NA) documenting patient vital
signs that were not actually obtained. The NA says, "I was running behind, so I estimated them based on
the previous shift." Which legal and ethical principles are most directly violated? (Select all that apply)
A. Falsification of medical records
B. Negligence
C. Beneficence
D. Malpractice
E. Scope of practice violation for the NA
Correct Answer: A, B, E [CORRECT]
Rationale: Falsification of medical records (A) is a serious legal violation that can result in criminal
charges and loss of licensure. Negligence (B) is established because the NA breached the duty of care by
fabricating data, which could lead to patient harm if clinical decisions are based on false information.
Scope of practice violation (E) occurs because accurate vital sign measurement and documentation are
core NA responsibilities; falsifying them exceeds unauthorized practice boundaries and violates
professional standards.
Distractor C: Beneficence (doing good) is not the primary violated principle here; the issue is falsification
and potential harm, not failure to benefit.
Distractor D: Malpractice requires four elements (duty, breach, causation, damages); while this could
lead to malpractice if harm occurs, the immediate violations are falsification and negligence, not
established malpractice.
Reference: ATI Nursing Leadership Module 2 (Documentation & Legal Issues); NCLEX-RN Test Plan 2026
— Legal Rights & Responsibilities.
Q3. A patient with end-stage COPD has a living will stating "no mechanical ventilation." The patient
develops acute respiratory failure and becomes unresponsive. The adult child demands the nurse "do
everything" and threatens to sue if the ventilator is withheld. What is the nurse's priority action?
A. Intubate the patient immediately to avoid legal liability
B. Honor the living will and notify the physician, risk management, and hospital ethics committee
[CORRECT]
C. Ask the family to reach consensus before proceeding
D. Transfer the patient to the ICU while awaiting legal clarification
Correct Answer: B
Rationale: A valid, properly executed advance directive (living will) is legally binding and must be
honored. The nurse must act as patient advocate by ensuring the documented wishes are respected,
notifying the physician for a DNR/comfort care order, and engaging risk management and the ethics
committee to mediate family conflict. Intubating against the patient's stated wishes constitutes battery
,(unauthorized touching) and violates autonomy.
Distractor A: Intubating against a valid living will exposes the nurse, physician, and hospital to battery
charges and ethical violations; liability protection comes from honoring advance directives, not ignoring
them.
Distractor C: Family consensus is not required when a valid advance directive exists; the patient's
autonomous wishes take precedence over family preferences.
Distractor D: Transferring the patient without addressing the advance directive delays appropriate care
and does not resolve the ethical-legal conflict.
Reference: ATI Nursing Leadership Module 2 (Advance Directives); NCLEX-RN Test Plan 2026 — Legal
Rights (Self-Determination/Advance Directives).
Q4. Which scenario represents a violation of the nurse's scope of practice?
A. An RN administers IV push morphine to a postoperative patient per physician order
B. An LPN/LVN monitors a patient receiving maintenance IV fluids and reports assessment findings to
the RN
C. An RN accepts a physician's verbal order for a new chemotherapy regimen without read-back
verification
D. An RN in a compact license state practices in another compact state without obtaining that state's
specific license [CORRECT]
Correct Answer: D
Rationale: The Nurse Licensure Compact (NLC) allows RNs to practice in other compact states only if
they declare that state as their primary state of residence and their license is in good standing.
Practicing in a compact state without proper multistate authorization violates state nurse practice acts
and constitutes practicing without a license—a criminal offense. Even within compact states, nurses
must comply with each state's specific laws and regulations.
Distractor A: RNs are authorized to administer IV push medications per physician order within their
scope; this is standard practice.
Distractor B: LPNs/LVNs can monitor patients with maintenance IV fluids in most states; this is within
their scope when delegated and supervised by an RN.
Distractor C: While accepting verbal orders without read-back is a safety violation (Joint Commission
National Patient Safety Goal), it is not a scope of practice violation; RNs are authorized to accept verbal
orders with proper verification.
Reference: ATI Nursing Leadership Module 2 (Scope of Practice); NCLEX-RN Test Plan 2026 — Legal
Rights & Responsibilities; Nurse Licensure Compact 2026.
Q5. A nurse administers the wrong medication to a patient. The patient suffers no apparent harm.
According to legal principles, which type of tort has occurred?
, A. Malpractice
B. Negligence [CORRECT]
C. Assault
D. Battery
Correct Answer: B
Rationale: Negligence is the failure to exercise the degree of care that a reasonably prudent nurse
would exercise under similar circumstances. The wrong medication administration constitutes a breach
of the standard of care (the "reasonable nurse" standard). While no harm occurred (damages are
absent), the negligent act itself is still a tort. Malpractice is a specialized form of negligence requiring
professional duty; however, in common nursing parlance, this scenario is classified as negligence
because damages are required for malpractice litigation, and no harm occurred.
Distractor A: Malpractice requires all four elements: duty, breach, causation, and damages. Without
harm, damages are absent, making malpractice incomplete; however, the act still constitutes
negligence.
Distractor C: Assault is the threat of harmful or offensive contact without actual contact; the patient
received the medication, so actual contact occurred.
Distractor D: Battery is unauthorized touching; the patient consented to medication administration
generally, but the specific wrong medication was not authorized—however, negligence more precisely
describes the professional standard breach.
Reference: ATI Nursing Leadership Module 2 (Torts & Liability); NCLEX-RN Test Plan 2026 — Legal Rights
& Responsibilities.
Q6. A nurse is caring for a 16-year-old who requests contraceptive information without parental
knowledge. In most states, which ethical and legal principle supports providing this care?
A. Paternalism
B. Minor emancipation statutes and mature minor doctrine [CORRECT]
C. Mandatory parental notification laws
D. Therapeutic privilege
Correct Answer: B
Rationale: Most states recognize the mature minor doctrine or have specific statutes allowing minors to
consent to reproductive health care, substance abuse treatment, and mental health services without
parental notification. This reflects the ethical principle of autonomy applied to adolescents with
decisional capacity, balanced against public health goals of reducing teen pregnancy and sexually
transmitted infections. The nurse must know state-specific laws but generally can provide contraceptive
counseling under these provisions.
Distractor A: Paternalism (overriding patient autonomy for their perceived benefit) contradicts the
minor's right to confidential reproductive care.
Distractor C: Mandatory parental notification would violate the minor's privacy and deter seeking care;
Management Exam ACTUAL EXAM
2026/2027 | Complete Exam-Style
Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
Section A: Legal & Ethical Issues (10 questions)
Q1. A 42-year-old patient admitted for elective knee replacement tells the nurse, "I changed my mind. I
don't want the surgery anymore." The surgeon insists the patient sign the consent form, stating,We've
already scheduled the OR and prepped the site." What is the nurse's most appropriate action?
A. Hold the consent form and tell the patient they must sign or face legal consequences for breach of
contract
B. Notify the surgeon that the patient has withdrawn consent and document the patient's refusal in the
medical record [CORRECT]
C. Convince the patient to proceed by explaining the risks of delaying surgery
D. Call the patient's family to pressure them into consenting
Correct Answer: B
Rationale: Informed consent is a voluntary process that the patient can withdraw at any time before the
procedure begins, for any reason, without penalty. The nurse serves as the patient's advocate and must
immediately communicate the withdrawal to the surgeon and document it objectively. The surgeon's
insistence violates the ethical principle of autonomy.
Distractor A: Patients cannot be legally compelled to undergo elective surgery; "breach of contract" is
not applicable to informed consent withdrawal.
Distractor C: The nurse's role is to support autonomous decision-making, not to persuade the patient
against their stated wishes; this violates advocacy.
Distractor D: Family pressure constitutes coercion and violates the patient's right to self-determination;
consent must be free from undue influence.
Reference: ATI Nursing Leadership Module 2 (Legal/Ethical); NCLEX-RN Test Plan 2026 — Management
of Care (Safety & Infection Control, Legal Rights).
,Q2. A nurse on the medical-surgical unit observes a nursing assistant (NA) documenting patient vital
signs that were not actually obtained. The NA says, "I was running behind, so I estimated them based on
the previous shift." Which legal and ethical principles are most directly violated? (Select all that apply)
A. Falsification of medical records
B. Negligence
C. Beneficence
D. Malpractice
E. Scope of practice violation for the NA
Correct Answer: A, B, E [CORRECT]
Rationale: Falsification of medical records (A) is a serious legal violation that can result in criminal
charges and loss of licensure. Negligence (B) is established because the NA breached the duty of care by
fabricating data, which could lead to patient harm if clinical decisions are based on false information.
Scope of practice violation (E) occurs because accurate vital sign measurement and documentation are
core NA responsibilities; falsifying them exceeds unauthorized practice boundaries and violates
professional standards.
Distractor C: Beneficence (doing good) is not the primary violated principle here; the issue is falsification
and potential harm, not failure to benefit.
Distractor D: Malpractice requires four elements (duty, breach, causation, damages); while this could
lead to malpractice if harm occurs, the immediate violations are falsification and negligence, not
established malpractice.
Reference: ATI Nursing Leadership Module 2 (Documentation & Legal Issues); NCLEX-RN Test Plan 2026
— Legal Rights & Responsibilities.
Q3. A patient with end-stage COPD has a living will stating "no mechanical ventilation." The patient
develops acute respiratory failure and becomes unresponsive. The adult child demands the nurse "do
everything" and threatens to sue if the ventilator is withheld. What is the nurse's priority action?
A. Intubate the patient immediately to avoid legal liability
B. Honor the living will and notify the physician, risk management, and hospital ethics committee
[CORRECT]
C. Ask the family to reach consensus before proceeding
D. Transfer the patient to the ICU while awaiting legal clarification
Correct Answer: B
Rationale: A valid, properly executed advance directive (living will) is legally binding and must be
honored. The nurse must act as patient advocate by ensuring the documented wishes are respected,
notifying the physician for a DNR/comfort care order, and engaging risk management and the ethics
committee to mediate family conflict. Intubating against the patient's stated wishes constitutes battery
,(unauthorized touching) and violates autonomy.
Distractor A: Intubating against a valid living will exposes the nurse, physician, and hospital to battery
charges and ethical violations; liability protection comes from honoring advance directives, not ignoring
them.
Distractor C: Family consensus is not required when a valid advance directive exists; the patient's
autonomous wishes take precedence over family preferences.
Distractor D: Transferring the patient without addressing the advance directive delays appropriate care
and does not resolve the ethical-legal conflict.
Reference: ATI Nursing Leadership Module 2 (Advance Directives); NCLEX-RN Test Plan 2026 — Legal
Rights (Self-Determination/Advance Directives).
Q4. Which scenario represents a violation of the nurse's scope of practice?
A. An RN administers IV push morphine to a postoperative patient per physician order
B. An LPN/LVN monitors a patient receiving maintenance IV fluids and reports assessment findings to
the RN
C. An RN accepts a physician's verbal order for a new chemotherapy regimen without read-back
verification
D. An RN in a compact license state practices in another compact state without obtaining that state's
specific license [CORRECT]
Correct Answer: D
Rationale: The Nurse Licensure Compact (NLC) allows RNs to practice in other compact states only if
they declare that state as their primary state of residence and their license is in good standing.
Practicing in a compact state without proper multistate authorization violates state nurse practice acts
and constitutes practicing without a license—a criminal offense. Even within compact states, nurses
must comply with each state's specific laws and regulations.
Distractor A: RNs are authorized to administer IV push medications per physician order within their
scope; this is standard practice.
Distractor B: LPNs/LVNs can monitor patients with maintenance IV fluids in most states; this is within
their scope when delegated and supervised by an RN.
Distractor C: While accepting verbal orders without read-back is a safety violation (Joint Commission
National Patient Safety Goal), it is not a scope of practice violation; RNs are authorized to accept verbal
orders with proper verification.
Reference: ATI Nursing Leadership Module 2 (Scope of Practice); NCLEX-RN Test Plan 2026 — Legal
Rights & Responsibilities; Nurse Licensure Compact 2026.
Q5. A nurse administers the wrong medication to a patient. The patient suffers no apparent harm.
According to legal principles, which type of tort has occurred?
, A. Malpractice
B. Negligence [CORRECT]
C. Assault
D. Battery
Correct Answer: B
Rationale: Negligence is the failure to exercise the degree of care that a reasonably prudent nurse
would exercise under similar circumstances. The wrong medication administration constitutes a breach
of the standard of care (the "reasonable nurse" standard). While no harm occurred (damages are
absent), the negligent act itself is still a tort. Malpractice is a specialized form of negligence requiring
professional duty; however, in common nursing parlance, this scenario is classified as negligence
because damages are required for malpractice litigation, and no harm occurred.
Distractor A: Malpractice requires all four elements: duty, breach, causation, and damages. Without
harm, damages are absent, making malpractice incomplete; however, the act still constitutes
negligence.
Distractor C: Assault is the threat of harmful or offensive contact without actual contact; the patient
received the medication, so actual contact occurred.
Distractor D: Battery is unauthorized touching; the patient consented to medication administration
generally, but the specific wrong medication was not authorized—however, negligence more precisely
describes the professional standard breach.
Reference: ATI Nursing Leadership Module 2 (Torts & Liability); NCLEX-RN Test Plan 2026 — Legal Rights
& Responsibilities.
Q6. A nurse is caring for a 16-year-old who requests contraceptive information without parental
knowledge. In most states, which ethical and legal principle supports providing this care?
A. Paternalism
B. Minor emancipation statutes and mature minor doctrine [CORRECT]
C. Mandatory parental notification laws
D. Therapeutic privilege
Correct Answer: B
Rationale: Most states recognize the mature minor doctrine or have specific statutes allowing minors to
consent to reproductive health care, substance abuse treatment, and mental health services without
parental notification. This reflects the ethical principle of autonomy applied to adolescents with
decisional capacity, balanced against public health goals of reducing teen pregnancy and sexually
transmitted infections. The nurse must know state-specific laws but generally can provide contraceptive
counseling under these provisions.
Distractor A: Paternalism (overriding patient autonomy for their perceived benefit) contradicts the
minor's right to confidential reproductive care.
Distractor C: Mandatory parental notification would violate the minor's privacy and deter seeking care;
