Actual ATI RN Leadership 2026 (Latest 2027 Version)
Proctored Exam with NGN 70 Questions and A+
Verified Answer Key | Actual Detailed RN ATI
Leadership Exam with NGN!
1 of 70
Question: A nurse manager is reviewing the principles of delegation with a new charge nurse. Which of
the following statements by the new charge nurse indicates an understanding of the five rights of
delegation?
Correct Answer: “I must ensure the right task, right circumstance, right person, right
direction/communication, and right supervision.”
Rationale: The five rights of delegation are foundational to safe and effective delegation. They ensure
the task is appropriate, the patient is stable, the delegatee is competent, instructions are clear, and the
delegator supervises appropriately.
2 of 70
Question: A charge nurse on a medical-surgical unit is planning care for a patient with a new diagnosis
of diabetes mellitus. Which task should the charge nurse assign to an LPN/VN?
Correct Answer: Administering subcutaneous insulin to a stable patient according to a sliding scale
Rationale: LPNs can administer subcutaneous insulin to stable patients with predictable outcomes.
Teaching about insulin administration (A) requires RN scope. Adjusting insulin based on complex trends
(C) is an RN responsibility. Drawing up two types of insulin (D) may be done by LPN but administration to
an unstable patient is not appropriate.
3 of 70 (NGN – Highlight)
Question: A nurse manager is observing a new graduate RN caring for a patient with a chest tube. Which
actions by the new graduate would cause the manager to intervene? (Select all that apply)
Correct Answer: Clamping the chest tube during patient transport and Emptying the drainage system
without wearing gloves
Rationale: Chest tubes should never be clamped during transport unless specifically ordered, as this can
lead to tension pneumothorax. Emptying the drainage system requires sterile technique or at minimum
clean gloves to prevent infection. Placing the drainage system below the chest level and reporting
increased bubbling are correct actions.
4 of 70
Question: A charge nurse observes a staff nurse administering a blood transfusion without obtaining
written informed consent. The client is conscious and alert. Which action should the charge nurse take
first?
Correct Answer: B. Stop the transfusion immediately
Rationale: Client safety is the priority. Administering blood without informed consent is a violation of
,patient rights and could lead to legal consequences. The transfusion must be stopped first to prevent
further risk. After stopping, the charge nurse can notify the provider, complete an incident report, and
ensure consent is obtained if the transfusion is still indicated.
5 of 70
Question: A nurse manager is reviewing disaster triage tags after a mass casualty event. Which client
should receive a black tag (expectant)?
Correct Answer: C. A client with agonal breathing and no palpable carotid pulse
Rationale: Black tag is for expectant/deceased – those who are unlikely to survive given available
resources. Agonal breathing with no palpable pulse indicates impending or actual death. The other
options (partial thickness burn, open femur fracture with pulse, sucking chest wound with stridor) are
potentially salvageable (red or yellow tags).
6 of 70 (NGN – Drag and Drop)
Question: A nurse manager reviews fall data: 80% of falls on night shift in rooms 210–215 (far from
nurses’ station). Hourly rounding implemented; falls decreased 50% in 3 weeks. Drag and drop the two
most appropriate actions.
Correct Answer: B. Present the data at the next unit council meeting and E. Evaluate the fall rate again
in one month
Rationale: Sharing success with the unit council promotes transparency and staff engagement.
Re-evaluating in one month ensures the improvement is sustained. Discontinuing rounding (A) is
premature. Requesting more staff (C) may not be necessary if hourly rounding works. Motion sensor
mats (D) are costly and not yet indicated given current improvement.
7 of 70
Question: A nurse is delegating tasks to an LPN/VN and an AP. Which of the following tasks should the
nurse delegate to the LPN/VN? (Select all that apply)
Correct Answer: A, C, E (A. Reinforcing teaching about a low-sodium diet, C. Suctioning a stable
tracheostomy, E. Changing a sterile wound dressing on a stage 3 pressure injury)
Rationale: LPNs can reinforce teaching, suction stable tracheostomies, and perform sterile dressing
changes for chronic stable wounds. Clean catch urine (B) can be delegated to AP. IV push morphine (D) is
beyond LPN scope in most states.
8 of 70
Question: A charge nurse is leading a team of four RNs, one LPN, and two APs. The unit census is 28
patients. Which patient should be assigned to the LPN?
Correct Answer: A stable patient with a Foley catheter requiring routine care and I&O monitoring
Rationale: LPNs can care for stable patients with predictable outcomes, perform catheter care, monitor
I&O, and administer some medications. Unstable, newly post-op, or complex assessment patients
should be assigned to RNs.
9 of 70
Question: A nurse manager notices increased conflict between two staff nurses. The manager meets
with them together. One nurse says, “She always criticizes my charting in front of others.” The other
says, “He never completes his assigned tasks.” Which conflict resolution strategy should the manager
use first?
Correct Answer: Facilitate collaborative problem-solving (interest-based negotiation)
Rationale: The manager should first bring them together to identify underlying issues, use active
listening, and guide them to a mutually acceptable solution. Avoidance or forcing would not resolve the
root cause.
, 10 of 70
Question: An RN on a medical floor is floating to the ICU for the first time. The ICU charge nurse notes
the RN is hesitant to care for a patient on a ventilator. What is the charge nurse’s best action?
Correct Answer: Assign the RN to a stable patient who is ready for transfer to a step-down unit
Rationale: Floating to a higher acuity area requires appropriate assignment. The charge nurse should
Proctored Exam with NGN 70 Questions and A+
Verified Answer Key | Actual Detailed RN ATI
Leadership Exam with NGN!
1 of 70
Question: A nurse manager is reviewing the principles of delegation with a new charge nurse. Which of
the following statements by the new charge nurse indicates an understanding of the five rights of
delegation?
Correct Answer: “I must ensure the right task, right circumstance, right person, right
direction/communication, and right supervision.”
Rationale: The five rights of delegation are foundational to safe and effective delegation. They ensure
the task is appropriate, the patient is stable, the delegatee is competent, instructions are clear, and the
delegator supervises appropriately.
2 of 70
Question: A charge nurse on a medical-surgical unit is planning care for a patient with a new diagnosis
of diabetes mellitus. Which task should the charge nurse assign to an LPN/VN?
Correct Answer: Administering subcutaneous insulin to a stable patient according to a sliding scale
Rationale: LPNs can administer subcutaneous insulin to stable patients with predictable outcomes.
Teaching about insulin administration (A) requires RN scope. Adjusting insulin based on complex trends
(C) is an RN responsibility. Drawing up two types of insulin (D) may be done by LPN but administration to
an unstable patient is not appropriate.
3 of 70 (NGN – Highlight)
Question: A nurse manager is observing a new graduate RN caring for a patient with a chest tube. Which
actions by the new graduate would cause the manager to intervene? (Select all that apply)
Correct Answer: Clamping the chest tube during patient transport and Emptying the drainage system
without wearing gloves
Rationale: Chest tubes should never be clamped during transport unless specifically ordered, as this can
lead to tension pneumothorax. Emptying the drainage system requires sterile technique or at minimum
clean gloves to prevent infection. Placing the drainage system below the chest level and reporting
increased bubbling are correct actions.
4 of 70
Question: A charge nurse observes a staff nurse administering a blood transfusion without obtaining
written informed consent. The client is conscious and alert. Which action should the charge nurse take
first?
Correct Answer: B. Stop the transfusion immediately
Rationale: Client safety is the priority. Administering blood without informed consent is a violation of
,patient rights and could lead to legal consequences. The transfusion must be stopped first to prevent
further risk. After stopping, the charge nurse can notify the provider, complete an incident report, and
ensure consent is obtained if the transfusion is still indicated.
5 of 70
Question: A nurse manager is reviewing disaster triage tags after a mass casualty event. Which client
should receive a black tag (expectant)?
Correct Answer: C. A client with agonal breathing and no palpable carotid pulse
Rationale: Black tag is for expectant/deceased – those who are unlikely to survive given available
resources. Agonal breathing with no palpable pulse indicates impending or actual death. The other
options (partial thickness burn, open femur fracture with pulse, sucking chest wound with stridor) are
potentially salvageable (red or yellow tags).
6 of 70 (NGN – Drag and Drop)
Question: A nurse manager reviews fall data: 80% of falls on night shift in rooms 210–215 (far from
nurses’ station). Hourly rounding implemented; falls decreased 50% in 3 weeks. Drag and drop the two
most appropriate actions.
Correct Answer: B. Present the data at the next unit council meeting and E. Evaluate the fall rate again
in one month
Rationale: Sharing success with the unit council promotes transparency and staff engagement.
Re-evaluating in one month ensures the improvement is sustained. Discontinuing rounding (A) is
premature. Requesting more staff (C) may not be necessary if hourly rounding works. Motion sensor
mats (D) are costly and not yet indicated given current improvement.
7 of 70
Question: A nurse is delegating tasks to an LPN/VN and an AP. Which of the following tasks should the
nurse delegate to the LPN/VN? (Select all that apply)
Correct Answer: A, C, E (A. Reinforcing teaching about a low-sodium diet, C. Suctioning a stable
tracheostomy, E. Changing a sterile wound dressing on a stage 3 pressure injury)
Rationale: LPNs can reinforce teaching, suction stable tracheostomies, and perform sterile dressing
changes for chronic stable wounds. Clean catch urine (B) can be delegated to AP. IV push morphine (D) is
beyond LPN scope in most states.
8 of 70
Question: A charge nurse is leading a team of four RNs, one LPN, and two APs. The unit census is 28
patients. Which patient should be assigned to the LPN?
Correct Answer: A stable patient with a Foley catheter requiring routine care and I&O monitoring
Rationale: LPNs can care for stable patients with predictable outcomes, perform catheter care, monitor
I&O, and administer some medications. Unstable, newly post-op, or complex assessment patients
should be assigned to RNs.
9 of 70
Question: A nurse manager notices increased conflict between two staff nurses. The manager meets
with them together. One nurse says, “She always criticizes my charting in front of others.” The other
says, “He never completes his assigned tasks.” Which conflict resolution strategy should the manager
use first?
Correct Answer: Facilitate collaborative problem-solving (interest-based negotiation)
Rationale: The manager should first bring them together to identify underlying issues, use active
listening, and guide them to a mutually acceptable solution. Avoidance or forcing would not resolve the
root cause.
, 10 of 70
Question: An RN on a medical floor is floating to the ICU for the first time. The ICU charge nurse notes
the RN is hesitant to care for a patient on a ventilator. What is the charge nurse’s best action?
Correct Answer: Assign the RN to a stable patient who is ready for transfer to a step-down unit
Rationale: Floating to a higher acuity area requires appropriate assignment. The charge nurse should
