2023 RN LEADERSHIP ATI PROCTORED FORM A & B, EXAM & 2023 NGN RN ATI LEADERSHIP PROCTORED EXAM AND 2023 RETAKE EXAM WITH NGN QUESTIONS AND ANSWERS, 100% VERIFIED NEWEST VERSION UPDATE(2026- 2027)

Scenario: A client is brought to the emergency department following a motor-vehicle crash. Drug use is suspected in the crash, and a voided urine specimen is ordered. The client repeatedly refuses to provide the specimen. Which of the following is the appropriate action by the nurse? A) Notify security to enforce specimen collection B) Document the client's refusal in the chart C) Restrain the client to obtain the specimen D) Ask the client's family to convince them Correct Answer: B Rationale: A client has the right to refuse any medical treatment or procedure. The nurse should respect the client's autonomy, document the refusal in the medical record, and notify the provider. Forcing a specimen would be assault and a violation of client rights. Question 2 Scenario: A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a licensed practical nurse? A) Perform a comprehensive admission assessment B) Administer a nasogastric tube feeding C) Develop the plan of care for a complex client D) Evaluate client outcomes after teaching Correct Answer: B Rationale: LPNs can administer NG tube feedings as this is within their scope of practice. Comprehensive assessments, care plan development, and outcome evaluation are responsibilities of the registered nurse. Question 3 Scenario: A nurse preceptor is evaluating a newly licensed nurse's competency in assisting with a sterile procedure. Which of the following actions indicates the newly licensed nurse is maintaining sterile technique? (Select All That Apply) A) Opens the sterile pack by unfolding the top flap toward her body B) Opens the sterile pack by first unfolding the top flap away from her body C) Places sterile items on the back half of the sterile field D) Removes the outside packaging of a sterile instrument before dropping it onto the sterile field Correct Answers: B and D Rationale: • B: The top flap should be opened away from the body to prevent contamination from reaching over the sterile field. • D: Outside packaging is considered contaminated; it should be removed before dropping the sterile instrument onto the field. • A is incorrect: Opening toward the body risks contamination. • C is incorrect: Only the center of the sterile field (not the back half) is considered sterile; the 1-inch border is non-sterile. Question 4 Scenario: A nurse enters a client's room and identifies that the client is receiving too much IV fluid because the IV pump is not working properly. Which of the following actions should the nurse take first? A) Stop the IV infusion B) Notify the provider C) Auscultate the client's lungs D) Complete an incident report Correct Answer: C Rationale: The nurse should first assess the client for signs of fluid overload (such as crackles in the lungs) to determine the client's current status. Assessment always precedes intervention. Stopping the infusion would be immediate but auscultation assesses the consequence. Question 5 Scenario: A nurse is planning care for a group of clients and can delegate care to a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following tasks should the nurse assign to the LPN? A) Bathe a client who is on bed rest B) Feed a client who requires assistance C) Reinforcing teaching with a client who is learning to self-administer insulin D) Ambulate a client who is post-operative Correct Answer: C Rationale: LPNs can reinforce teaching that has already been initiated by the RN. Bathing, feeding, and ambulating are appropriate tasks for APs. Question 6 Scenario: A nurse is supervising a newly licensed nurse who is performing surgical asepsis. After donning a sterile gown and gloves, which of the following actions by the newly licensed nurse demonstrates correct aseptic technique? A) The nurse holds her hands above her waist B) The nurse folds her hands together resting them on her lap C) The nurse clasps her hands behind her back D) The nurse places her hands at her sides Correct Answer: A Rationale: Sterile hands and arms must be kept above the waist and within the line of sight to maintain sterility. Hands below the waist are considered contaminated. Question 7 Scenario: A nurse who is caring for a group of clients delegates collection of vital signs to an assistive personnel (AP). Which of the following actions should the nurse take to evaluate the delegated task? A) Assume the AP collected accurate data B) Recheck vital signs that are outside the expected reference range C) Ask the AP to document vital signs immediately D) Compare vital signs to previous shifts' data Correct Answer: B Rationale: The nurse retains accountability for delegated tasks. Rechecking abnormal vital signs ensures accuracy and allows the nurse to assess the client personally for any concerning findings. Question 8 Scenario: A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel? A) Assessing a client's surgical incision B) Administering a medication C) Obtaining a stool sample from a client who has renal failure D) Teaching a client about diet modifications Correct Answer: C Rationale: Obtaining a stool sample is a non-invasive collection task appropriate for APs. Assessment, medication administration, and teaching are beyond the scope of AP practice. Question 9 Scenario: A nurse is triaging a group of clients following a disaster. Which of the following clients should the nurse recommend for treatment first? A) A client who has a fractured femur with a visible bone fragment B) A client who has two open chest wounds with a left tracheal deviation C) A client who has superficial burns to the face and neck D) A client who has a closed head injury with a Glasgow Coma Scale score of 13 Correct Answer: B Rationale: Two open chest wounds with tracheal deviation indicates tension pneumothorax, a life-threatening condition requiring immediate intervention. This is a red tag (immediate) in disaster triage. Question 10 Scenario: A nurse manager is reviewing guidelines for informed consent with the nursing staff. Which of the following statements by a staff nurse indicates that the teaching was effective? A) "The provider is responsible for obtaining informed consent." B) "Consent can be given by a durable power of attorney." C) "Witnessing consent means verifying the client understands the procedure." D) "Consent must be obtained after sedation is given." Correct Answer: B Rationale: A durable power of attorney for healthcare can provide consent if the client is unable to do so. The nurse witnesses signature but does not obtain consent; consent must be obtained before sedation. Question 11 Scenario: A nurse is caring for four clients. For which of the following clients should the nurse collaborate with the facility ethics committee? A) A client who refuses a blood transfusion due to religious beliefs B) An adolescent client whose parents refuse a blood transfusion for religious reasons C) A client who requests a do-not-resuscitate order D) A client who wants to leave against medical advice Correct Answer: B Rationale: Ethical dilemmas arise when there is conflict between parental rights, adolescent autonomy, and beneficence. This situation requires ethical consultation. Adults have the right to refuse treatment; competent adults can request DNR or leave AMA without ethics committee involvement. Question 12 Scenario: A nurse in an ambulatory care setting is orienting a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth? A) Replacing in-person visits entirely B) Establishing communication between providers C) Reducing the need for electronic medical records D) Eliminating follow-up care Correct Answer: B Rationale: Telehealth facilitates communication between healthcare providers and clients, as well as between providers. It supplements rather than replaces in-person care. Question 13 Scenario: A nurse is providing discharge teaching to a client who has a new diagnosis of diabetes. The client expresses concern about the cost of blood-glucose monitoring supplies. Which of the following actions should the nurse take? A) Tell the client to purchase supplies online B) Refer the client to the social services department C) Suggest the client skip testing to save money D) Provide the client with free samples from the facility Correct Answer: B Rationale: Social services can help identify resources such as insurance coverage, assistance programs, or low-cost supply options. The nurse should not give medical advice about purchasing or suggest skipping testing. Question 14 Scenario: A charge nurse is receiving change-of-shift report. Which of the following situations should the charge nurse address first? A) A client is requesting pain medication B) The emergency department nurse is waiting to give report on a new admission C) A staff nurse is behind on documentation D) A family member is asking to speak with the provider Correct Answer: B Rationale: Patient safety and continuity of care require that new admissions receive timely assessment and care. The ED nurse waiting to give report delays care for the incoming client. Question 15 Scenario: A nurse who is precepting a newly licensed nurse is discussing the client assignment for the shift. Which of the following actions should the nurse preceptor take first to demonstrate appropriate time management? A) Delegate tasks to assistive personnel B) Determine client care goals C) Begin providing care immediately D) Document the plan of care Correct Answer: B Rationale: Time management begins with planning. Determining client care goals and priorities allows the nurse to organize tasks effectively before implementing care. Question 16 Scenario: A charge nurse is reviewing information about HIPAA with a group of staff nurses. Which of the following statements by a staff nurse indicates understanding? A) "HIPAA allows healthcare providers to share information without client consent." B) "HIPAA prevents clients from accessing their own medical records." C) "HIPAA allows clients to request a review of their own medical records." D) "HIPAA requires all medical records to be stored in paper format." Correct Answer: C Rationale: HIPAA grants clients the right to access, review, and request amendments to their medical records. Clients have rights to their own health information. Question 17 Scenario: A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the client's partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery will be done? A) The partner's wishes as the primary caregiver B) The provider's recommendation C) Whether the client understands the risk of refusing the procedure D) The nurse's assessment of the client's mental status Correct Answer: C Rationale: A competent adult has the right to refuse treatment. The key is determining if the client is competent and understands the risks and benefits. Informed refusal is a valid legal concept. Question 18 Scenario: A charge nurse is planning the care of four newborns. An assistive personnel (AP) and licensed practical nurse (LPN) are available for staffing. Which of the following tasks should the nurse assign to a licensed practical nurse? A) Bathe a newborn B) Feed a newborn C) Administer a hepatitis B vaccine D) Change a newborn's diaper Correct Answer: C Rationale: LPNs can administer medications, including immunizations, under the supervision of an RN. Bathing, feeding, and diapering are appropriate for APs.