ATI Leadership| NURS 420 | Latest Exam 2026
2026 VERSION
1. A nurse is assessing pressure ulcers on four clients to evaluate the effectiveness of a
change in the wound care procedure. Which of the following findings indicate wound
healing?
a. Erythema on the skin surrounding a client's wound
b. Deep red color on the center of the clients wound
c. Inflammation noted on the tissue edges of a client's wound
d. Increase in serosanguineous exudate from the clients wound
Rationale: Leadership 7.0 pg 329: Red indicates healthy regeneration of tissue. Yellow
suggests purulent drainage and slough; black indicates eschar. Inflammation and exudate
are signs of inflammation or infection.
2. A nurse received change of shift report at 0700 for four clients. Which of the
following actions should the nurse perform first?
a. Obtain a breakfast tray for a client who received a morning dose of insulin aspart
b. Administer pain medication to a client who has rheumatoid arthritis and received the last
dose at 0400
c. Restart an infiltrated IV for a client whose IV antibiotic is scheduled for 0900
d. Replace a client's enteral nutrition feeding solution that has been hanging for 24 hours
Rationale: Insulin aspart is fast-acting (onset 15 min); the client needs food immediately to
prevent hypoglycemia. This is the priority.
3. A nurse is orienting a newly licensed nurse on the neurological unit. Which of the
following clients should the nurse assign to the newly licensed nurse?
a. A client who has multiple sclerosis and ataxia
, b. A client who has brain tumor and is admitted for chemotherapy
c. A client who has Guillain-Barré syndrome and a tracheostomy
d. A client who sustained a concussion and is being monitored for complications
Rationale: The client with MS and ataxia is the most stable. Newly licensed nurses should
be assigned stable clients with predictable outcomes.
4. A nurse is providing teaching to a client about advance directives. Which of the
following statements by the client indicates an understanding of the teaching?
a. “Once I sign my living will, a family member must co-sign it”
b. “I will wait until I have a serious health problems to sign my advance directives”
c. “My doctor will need to provide approval for the decisions outlines in my living will”
d. “My durable power of attorney for health care is part of my advance directives”
Rationale: Leadership 7.0 page 38: Durable power of attorney for health care and living will
are both components of advance directives.
5. A nurse is chairing a committee about preventing infant abduction in a new birth care
center. Which of the following quality control tasks should the nurse assign to be
completed first?
a. Identify the industry standards for infant safety
b. Evaluate the selected infant safety system
c. Choose an infant safety system
d. Establish measurement criteria for infant safety systems
Rationale: Quality improvement begins with identifying standards before evaluating,
choosing, or measuring systems.
6. A nurse notes that a client is eating about half of the food on his plate and coughs
frequently during meals. The nurse plans to perform dysphagia screening to
determine the client's need for a referral to which of the following providers?
a. Physical therapist
b. Respiratory therapist
, c. Speech therapist
d. Occupational therapist
Rationale: Speech-language pathologists specialize in swallowing disorders (dysphagia).
7. A home health nurse is assessing the home environment during an initial visit to a
client who has a history of falls. Which of the following findings should the nurse
identify as increasing the client's risk for falls? (Select all that apply)
A wheeled office chair at the client’s computer desk
A raised vinyl seat on the toilet in the bathroom
A throw rug covering some cracked vinyl flooring in the kitchen
A folding chair without arm rests
A two-wheeled walker used to assist the client with ambulation
Rationale: Wheeled chairs, throw rugs, and chairs without armrests increase fall risk. Raised
toilet seats and two-wheeled walkers are safety aids.
8. A nurse manager is planning to assign care for four clients on a medical surgical unit.
Which of the following clients should the nurse assign to a LPN?
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputation and requires a dressing
change
c. A young adult client who is postoperative, receiving morphine via epidural, and reports
pruritus
d. An adolescent who is newly diagnosed with DM and requires teaching regarding insulin
administration
Rationale: LPNs can perform stable, routine tasks like dressing changes. Unstable clients,
epidural pain management, and new teaching require RN.
9. While auditing the medical records of clients currently on an oncology unit, the nurse
manager finds that six of the 15 records lack documentation regarding advance
directives. Which of the following is the priority for the nurse to take?
, a. Remind nurses to obtain this information during the admission process.
b. Reinforce the potential consequences of not having this information on record to the
nursing staff.
c. Meet with nursing staff to review the policy regarding advance directive.
d. Ask nurses who are caring for clients without this information in the medical record
to obtain it.
Rationale: The priority is to correct the immediate deficit for current clients.
10. A nurse is caring for a group of clients. Which of the following should the nurse see
first?
a. A client who is postoperative and has a fever.
b. A client whose pressure ulcer has serosanguineous drainage on the dressing.
c. A client who has diabetes mellitus and is diaphoretic.
d. A client who has a fractured hip and reports a pain level of 7 on a scale from 0 to 10.
Rationale: Diaphoresis in a diabetic client indicates hypoglycemia, which can lead to
seizures, coma, or death if untreated.
11. A nurse is receiving change-of-shift report for four clients. Which of the following
clients should the nurse care for first?
a. A client who is 4 hr post-operative following a hernia repair and has pitting edema
of the right leg.
b. A client who is scheduled for an intermittent enteral feeding in 2 hr and reports diarrhea.
c. A client who has pneumonia and requires a tracheostomy dressing change.
d. A client who has a new colostomy and requires discharge teaching.
Rationale: Pitting edema post-op may indicate DVT, which is a life-threatening
complication.
12. A nurse manager discovers there is a conflict between nurses working the day shift
and nurses working on the night shift. Which of the following actions should the
nurse manager take first?
2026 VERSION
1. A nurse is assessing pressure ulcers on four clients to evaluate the effectiveness of a
change in the wound care procedure. Which of the following findings indicate wound
healing?
a. Erythema on the skin surrounding a client's wound
b. Deep red color on the center of the clients wound
c. Inflammation noted on the tissue edges of a client's wound
d. Increase in serosanguineous exudate from the clients wound
Rationale: Leadership 7.0 pg 329: Red indicates healthy regeneration of tissue. Yellow
suggests purulent drainage and slough; black indicates eschar. Inflammation and exudate
are signs of inflammation or infection.
2. A nurse received change of shift report at 0700 for four clients. Which of the
following actions should the nurse perform first?
a. Obtain a breakfast tray for a client who received a morning dose of insulin aspart
b. Administer pain medication to a client who has rheumatoid arthritis and received the last
dose at 0400
c. Restart an infiltrated IV for a client whose IV antibiotic is scheduled for 0900
d. Replace a client's enteral nutrition feeding solution that has been hanging for 24 hours
Rationale: Insulin aspart is fast-acting (onset 15 min); the client needs food immediately to
prevent hypoglycemia. This is the priority.
3. A nurse is orienting a newly licensed nurse on the neurological unit. Which of the
following clients should the nurse assign to the newly licensed nurse?
a. A client who has multiple sclerosis and ataxia
, b. A client who has brain tumor and is admitted for chemotherapy
c. A client who has Guillain-Barré syndrome and a tracheostomy
d. A client who sustained a concussion and is being monitored for complications
Rationale: The client with MS and ataxia is the most stable. Newly licensed nurses should
be assigned stable clients with predictable outcomes.
4. A nurse is providing teaching to a client about advance directives. Which of the
following statements by the client indicates an understanding of the teaching?
a. “Once I sign my living will, a family member must co-sign it”
b. “I will wait until I have a serious health problems to sign my advance directives”
c. “My doctor will need to provide approval for the decisions outlines in my living will”
d. “My durable power of attorney for health care is part of my advance directives”
Rationale: Leadership 7.0 page 38: Durable power of attorney for health care and living will
are both components of advance directives.
5. A nurse is chairing a committee about preventing infant abduction in a new birth care
center. Which of the following quality control tasks should the nurse assign to be
completed first?
a. Identify the industry standards for infant safety
b. Evaluate the selected infant safety system
c. Choose an infant safety system
d. Establish measurement criteria for infant safety systems
Rationale: Quality improvement begins with identifying standards before evaluating,
choosing, or measuring systems.
6. A nurse notes that a client is eating about half of the food on his plate and coughs
frequently during meals. The nurse plans to perform dysphagia screening to
determine the client's need for a referral to which of the following providers?
a. Physical therapist
b. Respiratory therapist
, c. Speech therapist
d. Occupational therapist
Rationale: Speech-language pathologists specialize in swallowing disorders (dysphagia).
7. A home health nurse is assessing the home environment during an initial visit to a
client who has a history of falls. Which of the following findings should the nurse
identify as increasing the client's risk for falls? (Select all that apply)
A wheeled office chair at the client’s computer desk
A raised vinyl seat on the toilet in the bathroom
A throw rug covering some cracked vinyl flooring in the kitchen
A folding chair without arm rests
A two-wheeled walker used to assist the client with ambulation
Rationale: Wheeled chairs, throw rugs, and chairs without armrests increase fall risk. Raised
toilet seats and two-wheeled walkers are safety aids.
8. A nurse manager is planning to assign care for four clients on a medical surgical unit.
Which of the following clients should the nurse assign to a LPN?
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputation and requires a dressing
change
c. A young adult client who is postoperative, receiving morphine via epidural, and reports
pruritus
d. An adolescent who is newly diagnosed with DM and requires teaching regarding insulin
administration
Rationale: LPNs can perform stable, routine tasks like dressing changes. Unstable clients,
epidural pain management, and new teaching require RN.
9. While auditing the medical records of clients currently on an oncology unit, the nurse
manager finds that six of the 15 records lack documentation regarding advance
directives. Which of the following is the priority for the nurse to take?
, a. Remind nurses to obtain this information during the admission process.
b. Reinforce the potential consequences of not having this information on record to the
nursing staff.
c. Meet with nursing staff to review the policy regarding advance directive.
d. Ask nurses who are caring for clients without this information in the medical record
to obtain it.
Rationale: The priority is to correct the immediate deficit for current clients.
10. A nurse is caring for a group of clients. Which of the following should the nurse see
first?
a. A client who is postoperative and has a fever.
b. A client whose pressure ulcer has serosanguineous drainage on the dressing.
c. A client who has diabetes mellitus and is diaphoretic.
d. A client who has a fractured hip and reports a pain level of 7 on a scale from 0 to 10.
Rationale: Diaphoresis in a diabetic client indicates hypoglycemia, which can lead to
seizures, coma, or death if untreated.
11. A nurse is receiving change-of-shift report for four clients. Which of the following
clients should the nurse care for first?
a. A client who is 4 hr post-operative following a hernia repair and has pitting edema
of the right leg.
b. A client who is scheduled for an intermittent enteral feeding in 2 hr and reports diarrhea.
c. A client who has pneumonia and requires a tracheostomy dressing change.
d. A client who has a new colostomy and requires discharge teaching.
Rationale: Pitting edema post-op may indicate DVT, which is a life-threatening
complication.
12. A nurse manager discovers there is a conflict between nurses working the day shift
and nurses working on the night shift. Which of the following actions should the
nurse manager take first?
