ATI RN Leadership Proctored Exam Study Guide |
100% Verified Q&As with Rationales | Latest 2026/2027
Version (Level 3 Assured)
A charge nurse is planning care for a medical-surgical unit. Which of the
following tasks should the nurse delegate to an assistive personnel (AP)?
A. Assessing a patient’s surgical incision for signs of infection.
B. Transporting a stable patient who is being discharged home.
C. Re-evaluating a patient’s pain level 30 minutes after medication administration.
D. Teaching a patient how to use an incentive spirometer.
Correct Answer: B
Rationale:
B is correct: Transporting a stable, discharged patient is a routine task within the scope
of practice for an AP. It does not require clinical judgment or nursing assessment.
A is incorrect: Assessment of a surgical wound requires clinical observation and data
synthesis, which must be performed by a registered nurse (RN).
C is incorrect: Evaluating the outcome of an intervention (such as pain relief) is part of
the nursing process and cannot be delegated to an AP.
D is incorrect: Patient teaching requires the knowledge and skill of an RN. While an
LPN or AP can reinforce teaching, the initial education must be completed by the RN.
, Question 2: Patient Prioritization Framework
A nurse is reviewing the shift report for four clients. Which of the following
clients should the nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) with an SpO2 of 89% on
2 L/min of oxygen.
B. A client who is 2 days postoperative following a total hip arthroplasty and reports pain
as 7 on a scale of 0 to 10.
C. A client with diabetes mellitus whose morning blood glucose is 210 mg/dL.
D. A client who had an abdominal aortic aneurysm repair 4 hours ago and has a blood
pressure of 88/54 mmHg.
Correct Answer: D
Rationale:
D is correct: Applying the ABC (Airway-Breathing-Circulation) and Acute vs.
Chronic frameworks, this client is at high risk for hemorrhage or graft failure following a
major vascular surgery, as evidenced by hypotension (Circulation issue). This requires
immediate assessment and intervention.
A is incorrect: An SpO2 of 89% is an expected finding for a client with chronic COPD;
this client is stable.
B is incorrect: While a pain level of 7 requires management, it is not life-threatening
and does not take priority over cardiovascular instability.
C is incorrect: A blood glucose of 210 mg/dL is elevated but expected in a diabetic
patient post-meal or during stress, and it does not represent an immediate acute
emergency.
Question 3: Leadership Styles
A nurse manager is responding to a sudden, unexpected fire on the unit. The
manager gives direct, non-negotiable commands to staff to ensure patient
evacuation. Which leadership style is the nurse manager displaying?
, A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
Correct Answer: C
Rationale:
C is correct: Autocratic (or authoritative) leadership involves making quick decisions
and giving direct orders with little to no input from others. This style is highly effective
and appropriate during a crisis or emergency situation where safety depends on
immediate compliance.
A is incorrect: Democratic leadership involves group discussion and voting, which
wastes critical time during an active emergency.
B is incorrect: Laissez-faire leadership is passive and leaves the group to guide
themselves, which would lead to chaos in a crisis.
D is incorrect: Transformational leadership focuses on long-term vision,
empowerment, and building relationships, which is not the priority during an immediate
physical hazard.
Question 4: Legal & Ethical / Informed Consent
A nurse is preparing a client for an elective colonoscopy. The client states, "I
signed the consent form, but I'm still not really sure what the doctor is going to
do." Which of the following actions should the nurse take?
A. Explain the risks, benefits, and alternatives of the procedure to the client.
B. Notify the provider that the client has questions about the procedure.
C. Reassure the client that the provider is highly skilled and there is nothing to worry
about.
D. Document that the client understands the procedure since the form is signed.
Correct Answer: B
Rationale:
B is correct: The nurse's role in informed consent is to witness the client's signature
and verify that they appear competent. If the client expresses a lack of understanding
regarding the procedure itself, the nurse must advocate for the client by notifying the
provider, who carries the legal responsibility to explain the procedure.
A is incorrect: It is outside the nurse's legal scope of practice to provide the initial
explanation of the risks, benefits, and alternatives of a medical procedure.
C is incorrect: This response offers false reassurance and ignores the client's explicit
statement of misunderstanding.
, D is incorrect: Documenting that the client understands when they just stated they do
not is a violation of professional standards and negligence.
Question 5: Conflict Resolution Strategies
Two staff nurses are in a disagreement regarding the holiday shift schedule. The
charge nurse steps in and convinces both nurses to give up a preferred day off
so that they can both work a partial shift, resulting in a compromise where neither
gets exactly what they wanted, but the unit is covered. Which conflict resolution
strategy was used?
A. Collaborating
B. Compromising
C. Accommodating
D. Avoiding
Correct Answer: B
Rationale:
B is correct: Compromising involves a "lose-lose" scenario where both parties give up
something of value to reach a middle ground.
A is incorrect: Collaborating is a "win-win" strategy where both parties work together to
find a completely new solution that satisfies all needs without sacrificing priorities.
C is incorrect: Accommodating occurs when one party completely sacrifices their own
desires to satisfy the other party ("win-lose").
D is incorrect: Avoiding involves walking away from or ignoring the conflict entirely,
leaving it unresolved.
Question 6: Quality Improvement (QI) Process
A hospital unit is experiencing an increase in patient falls. Which of the following
actions should the nursing quality improvement committee take first?
A. Implement a new hourly rounding protocol on the unit.
B. Conduct a root-cause analysis by auditing the charts of patients who fell.
C. Mandate that all nursing staff attend a mandatory class on fall prevention.
D. Reprimand the staff members who were on duty during the falls.
Correct Answer: B
Rationale:
100% Verified Q&As with Rationales | Latest 2026/2027
Version (Level 3 Assured)
A charge nurse is planning care for a medical-surgical unit. Which of the
following tasks should the nurse delegate to an assistive personnel (AP)?
A. Assessing a patient’s surgical incision for signs of infection.
B. Transporting a stable patient who is being discharged home.
C. Re-evaluating a patient’s pain level 30 minutes after medication administration.
D. Teaching a patient how to use an incentive spirometer.
Correct Answer: B
Rationale:
B is correct: Transporting a stable, discharged patient is a routine task within the scope
of practice for an AP. It does not require clinical judgment or nursing assessment.
A is incorrect: Assessment of a surgical wound requires clinical observation and data
synthesis, which must be performed by a registered nurse (RN).
C is incorrect: Evaluating the outcome of an intervention (such as pain relief) is part of
the nursing process and cannot be delegated to an AP.
D is incorrect: Patient teaching requires the knowledge and skill of an RN. While an
LPN or AP can reinforce teaching, the initial education must be completed by the RN.
, Question 2: Patient Prioritization Framework
A nurse is reviewing the shift report for four clients. Which of the following
clients should the nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) with an SpO2 of 89% on
2 L/min of oxygen.
B. A client who is 2 days postoperative following a total hip arthroplasty and reports pain
as 7 on a scale of 0 to 10.
C. A client with diabetes mellitus whose morning blood glucose is 210 mg/dL.
D. A client who had an abdominal aortic aneurysm repair 4 hours ago and has a blood
pressure of 88/54 mmHg.
Correct Answer: D
Rationale:
D is correct: Applying the ABC (Airway-Breathing-Circulation) and Acute vs.
Chronic frameworks, this client is at high risk for hemorrhage or graft failure following a
major vascular surgery, as evidenced by hypotension (Circulation issue). This requires
immediate assessment and intervention.
A is incorrect: An SpO2 of 89% is an expected finding for a client with chronic COPD;
this client is stable.
B is incorrect: While a pain level of 7 requires management, it is not life-threatening
and does not take priority over cardiovascular instability.
C is incorrect: A blood glucose of 210 mg/dL is elevated but expected in a diabetic
patient post-meal or during stress, and it does not represent an immediate acute
emergency.
Question 3: Leadership Styles
A nurse manager is responding to a sudden, unexpected fire on the unit. The
manager gives direct, non-negotiable commands to staff to ensure patient
evacuation. Which leadership style is the nurse manager displaying?
, A. Democratic
B. Laissez-faire
C. Autocratic
D. Transformational
Correct Answer: C
Rationale:
C is correct: Autocratic (or authoritative) leadership involves making quick decisions
and giving direct orders with little to no input from others. This style is highly effective
and appropriate during a crisis or emergency situation where safety depends on
immediate compliance.
A is incorrect: Democratic leadership involves group discussion and voting, which
wastes critical time during an active emergency.
B is incorrect: Laissez-faire leadership is passive and leaves the group to guide
themselves, which would lead to chaos in a crisis.
D is incorrect: Transformational leadership focuses on long-term vision,
empowerment, and building relationships, which is not the priority during an immediate
physical hazard.
Question 4: Legal & Ethical / Informed Consent
A nurse is preparing a client for an elective colonoscopy. The client states, "I
signed the consent form, but I'm still not really sure what the doctor is going to
do." Which of the following actions should the nurse take?
A. Explain the risks, benefits, and alternatives of the procedure to the client.
B. Notify the provider that the client has questions about the procedure.
C. Reassure the client that the provider is highly skilled and there is nothing to worry
about.
D. Document that the client understands the procedure since the form is signed.
Correct Answer: B
Rationale:
B is correct: The nurse's role in informed consent is to witness the client's signature
and verify that they appear competent. If the client expresses a lack of understanding
regarding the procedure itself, the nurse must advocate for the client by notifying the
provider, who carries the legal responsibility to explain the procedure.
A is incorrect: It is outside the nurse's legal scope of practice to provide the initial
explanation of the risks, benefits, and alternatives of a medical procedure.
C is incorrect: This response offers false reassurance and ignores the client's explicit
statement of misunderstanding.
, D is incorrect: Documenting that the client understands when they just stated they do
not is a violation of professional standards and negligence.
Question 5: Conflict Resolution Strategies
Two staff nurses are in a disagreement regarding the holiday shift schedule. The
charge nurse steps in and convinces both nurses to give up a preferred day off
so that they can both work a partial shift, resulting in a compromise where neither
gets exactly what they wanted, but the unit is covered. Which conflict resolution
strategy was used?
A. Collaborating
B. Compromising
C. Accommodating
D. Avoiding
Correct Answer: B
Rationale:
B is correct: Compromising involves a "lose-lose" scenario where both parties give up
something of value to reach a middle ground.
A is incorrect: Collaborating is a "win-win" strategy where both parties work together to
find a completely new solution that satisfies all needs without sacrificing priorities.
C is incorrect: Accommodating occurs when one party completely sacrifices their own
desires to satisfy the other party ("win-lose").
D is incorrect: Avoiding involves walking away from or ignoring the conflict entirely,
leaving it unresolved.
Question 6: Quality Improvement (QI) Process
A hospital unit is experiencing an increase in patient falls. Which of the following
actions should the nursing quality improvement committee take first?
A. Implement a new hourly rounding protocol on the unit.
B. Conduct a root-cause analysis by auditing the charts of patients who fell.
C. Mandate that all nursing staff attend a mandatory class on fall prevention.
D. Reprimand the staff members who were on duty during the falls.
Correct Answer: B
Rationale:
