ATI Capstone Leadership Exam |
Questions and Verified Answers|
2026/2027 Update
Delegation, Supervision & Staff Management
Q1: The charge nurse on a medical-surgical unit is making assignments for the shift.
One of the patients is a stable client with a chronic tracheostomy who requires
tracheostomy suctioning every 4 hours. Which staff member is most appropriate to
assign to this patient?
A. The licensed practical nurse (LPN)
B. The unlicensed assistive personnel (UAP)
C. The registered nurse (RN) who is floating from the ICU
D. A graduate nurse currently in their orientation period
A. The licensed practical nurse (LPN) [CORRECT]
B. The unlicensed assistive personnel (UAP)
C. The registered nurse (RN) who is floating from the ICU
D. A graduate nurse currently in their orientation period
Correct Answer: A
Rationale: Suctioning a stable, established tracheostomy is within the scope of practice
for an LPN in most states, provided the patient is stable, making this the best use of
resources while the RN handles more complex care.
Q2: A nurse is delegating tasks to a UAP. Which of the following instructions should the
nurse include to ensure effective delegation according to the Five Rights of Delegation?
A. "Please measure the patient's intake and output, and if you have time, check their
blood pressure."
B. "Let me know if the patient complains of any pain while you are assisting them to the
bathroom."
C. "Measure the patient's vital signs every 4 hours and report any readings above
140/90 immediately."
D. "Perform the patient's morning bath and make sure they eat a good breakfast."
C. "Measure the patient's vital signs every 4 hours and report any readings above
140/90 immediately." [CORRECT]
,A. "Please measure the patient's intake and output, and if you have time, check their
blood pressure."
B. "Let me know if the patient complains of any pain while you are assisting them to the
bathroom."
D. "Perform the patient's morning bath and make sure they eat a good breakfast."
Correct Answer: C
Rationale: This response clearly defines the right task (vital signs), the right
circumstance (every 4 hours), the right direction/communication (specific parameters to
report), and the right supervision/feedback, which ensures clarity and safety.
Q3: The nurse manager overhears a staff nurse speaking harshly to a UAP about a
delayed task in the hallway. Which action demonstrates the best approach to resolving
this situation?
A. Immediately intervene in the conversation to reprimand the staff nurse in front of the
UAP.
B. Wait until the shift ends and send a group email to the entire unit about professional
conduct.
C. Schedule a private meeting with the staff nurse to discuss the incident and explore
alternative communication strategies.
D. Document the incident in the UAP's personnel file as a witness to a hostile work
environment.
C. Schedule a private meeting with the staff nurse to discuss the incident and explore
alternative communication strategies. [CORRECT]
A. Immediately intervene in the conversation to reprimand the staff nurse in front of the
UAP.
B. Wait until the shift ends and send a group email to the entire unit about professional
conduct.
D. Document the incident in the UAP's personnel file as a witness to a hostile work
environment.
Correct Answer: C
Rationale: Addressing the behavior privately respects the staff nurse's dignity while
allowing the manager to coach them on appropriate professional communication and
conflict resolution, which is more effective than public correction.
Q4: A newly hired RN is assigned to care for a client who is receiving continuous IV
heparin infusion. The RN has never managed a heparin infusion before. What is the
charge nurse's best action?
A. Reassign the client to another RN and provide the new RN with a different, less
complex patient load.
B. Tell the new RN to review the policy and procedure manual and administer the
medication as ordered.
, C. Ask the new RN to shadow another nurse for this task but leave them responsible for
the client.
D. Contact the nursing supervisor to report that the new hire is incompetent.
A. Reassign the client to another RN and provide the new RN with a different, less
complex patient load. [CORRECT]
B. Tell the new RN to review the policy and procedure manual and administer the
medication as ordered.
C. Ask the new RN to shadow another nurse for this task but leave them responsible for
the client.
D. Contact the nursing supervisor to report that the new hire is incompetent.
Correct Answer: A
Rationale: The charge nurse must ensure patient safety; since the RN lacks the
competency for this high-risk medication, the appropriate action is to reassign the
patient to a qualified nurse and give the new RN a suitable assignment.
Q5: Which of the following tasks is most appropriate for the charge nurse to delegate to
a UAP working on a busy telemetry unit?
A. Administering a nebulizer treatment to a client with COPD.
B. Obtaining a daily weight on a client with heart failure.
C. Performing the initial admission assessment for a new stable patient.
D. Evaluating the effectiveness of pain medication for a post-op client.
B. Obtaining a daily weight on a client with heart failure. [CORRECT]
A. Administering a nebulizer treatment to a client with COPD.
C. Performing the initial admission assessment for a new stable patient.
D. Evaluating the effectiveness of pain medication for a post-op client.
Correct Answer: B
Rationale: Obtaining a daily weight is a standardized, non-invasive task that falls within
the UAP's scope of practice and does not require assessment or clinical judgment.
Q6: The nurse is caring for a client who is on contact precautions for Clostridioides
difficile (C. diff). Which task can be delegated to the UAP?
A. Teaching the client about the importance of hand hygiene.
B. Administering oral metronidazole as scheduled.
C. Assisting the client with a bed bath while wearing appropriate PPE.
D. Monitoring the client for signs of dehydration.
C. Assisting the client with a bed bath while wearing appropriate PPE. [CORRECT]
A. Teaching the client about the importance of hand hygiene.
B. Administering oral metronidazole as scheduled.
D. Monitoring the client for signs of dehydration.
Correct Answer: C
Questions and Verified Answers|
2026/2027 Update
Delegation, Supervision & Staff Management
Q1: The charge nurse on a medical-surgical unit is making assignments for the shift.
One of the patients is a stable client with a chronic tracheostomy who requires
tracheostomy suctioning every 4 hours. Which staff member is most appropriate to
assign to this patient?
A. The licensed practical nurse (LPN)
B. The unlicensed assistive personnel (UAP)
C. The registered nurse (RN) who is floating from the ICU
D. A graduate nurse currently in their orientation period
A. The licensed practical nurse (LPN) [CORRECT]
B. The unlicensed assistive personnel (UAP)
C. The registered nurse (RN) who is floating from the ICU
D. A graduate nurse currently in their orientation period
Correct Answer: A
Rationale: Suctioning a stable, established tracheostomy is within the scope of practice
for an LPN in most states, provided the patient is stable, making this the best use of
resources while the RN handles more complex care.
Q2: A nurse is delegating tasks to a UAP. Which of the following instructions should the
nurse include to ensure effective delegation according to the Five Rights of Delegation?
A. "Please measure the patient's intake and output, and if you have time, check their
blood pressure."
B. "Let me know if the patient complains of any pain while you are assisting them to the
bathroom."
C. "Measure the patient's vital signs every 4 hours and report any readings above
140/90 immediately."
D. "Perform the patient's morning bath and make sure they eat a good breakfast."
C. "Measure the patient's vital signs every 4 hours and report any readings above
140/90 immediately." [CORRECT]
,A. "Please measure the patient's intake and output, and if you have time, check their
blood pressure."
B. "Let me know if the patient complains of any pain while you are assisting them to the
bathroom."
D. "Perform the patient's morning bath and make sure they eat a good breakfast."
Correct Answer: C
Rationale: This response clearly defines the right task (vital signs), the right
circumstance (every 4 hours), the right direction/communication (specific parameters to
report), and the right supervision/feedback, which ensures clarity and safety.
Q3: The nurse manager overhears a staff nurse speaking harshly to a UAP about a
delayed task in the hallway. Which action demonstrates the best approach to resolving
this situation?
A. Immediately intervene in the conversation to reprimand the staff nurse in front of the
UAP.
B. Wait until the shift ends and send a group email to the entire unit about professional
conduct.
C. Schedule a private meeting with the staff nurse to discuss the incident and explore
alternative communication strategies.
D. Document the incident in the UAP's personnel file as a witness to a hostile work
environment.
C. Schedule a private meeting with the staff nurse to discuss the incident and explore
alternative communication strategies. [CORRECT]
A. Immediately intervene in the conversation to reprimand the staff nurse in front of the
UAP.
B. Wait until the shift ends and send a group email to the entire unit about professional
conduct.
D. Document the incident in the UAP's personnel file as a witness to a hostile work
environment.
Correct Answer: C
Rationale: Addressing the behavior privately respects the staff nurse's dignity while
allowing the manager to coach them on appropriate professional communication and
conflict resolution, which is more effective than public correction.
Q4: A newly hired RN is assigned to care for a client who is receiving continuous IV
heparin infusion. The RN has never managed a heparin infusion before. What is the
charge nurse's best action?
A. Reassign the client to another RN and provide the new RN with a different, less
complex patient load.
B. Tell the new RN to review the policy and procedure manual and administer the
medication as ordered.
, C. Ask the new RN to shadow another nurse for this task but leave them responsible for
the client.
D. Contact the nursing supervisor to report that the new hire is incompetent.
A. Reassign the client to another RN and provide the new RN with a different, less
complex patient load. [CORRECT]
B. Tell the new RN to review the policy and procedure manual and administer the
medication as ordered.
C. Ask the new RN to shadow another nurse for this task but leave them responsible for
the client.
D. Contact the nursing supervisor to report that the new hire is incompetent.
Correct Answer: A
Rationale: The charge nurse must ensure patient safety; since the RN lacks the
competency for this high-risk medication, the appropriate action is to reassign the
patient to a qualified nurse and give the new RN a suitable assignment.
Q5: Which of the following tasks is most appropriate for the charge nurse to delegate to
a UAP working on a busy telemetry unit?
A. Administering a nebulizer treatment to a client with COPD.
B. Obtaining a daily weight on a client with heart failure.
C. Performing the initial admission assessment for a new stable patient.
D. Evaluating the effectiveness of pain medication for a post-op client.
B. Obtaining a daily weight on a client with heart failure. [CORRECT]
A. Administering a nebulizer treatment to a client with COPD.
C. Performing the initial admission assessment for a new stable patient.
D. Evaluating the effectiveness of pain medication for a post-op client.
Correct Answer: B
Rationale: Obtaining a daily weight is a standardized, non-invasive task that falls within
the UAP's scope of practice and does not require assessment or clinical judgment.
Q6: The nurse is caring for a client who is on contact precautions for Clostridioides
difficile (C. diff). Which task can be delegated to the UAP?
A. Teaching the client about the importance of hand hygiene.
B. Administering oral metronidazole as scheduled.
C. Assisting the client with a bed bath while wearing appropriate PPE.
D. Monitoring the client for signs of dehydration.
C. Assisting the client with a bed bath while wearing appropriate PPE. [CORRECT]
A. Teaching the client about the importance of hand hygiene.
B. Administering oral metronidazole as scheduled.
D. Monitoring the client for signs of dehydration.
Correct Answer: C
