ATI LEADERSHIP PROCTORED EXAM 2023 NEWEST ACTUAL EXAM 3
VERSIONS EACH VERSION WITH 70 QUESTIONS WITH DETAILED
VERIFIED ANSWERS / ALREADY GRADED A+
Question 1
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) Tell the client that refusal will be reported to law enforcement.
B) Obtain a court order to force the client to provide the specimen.
C) Document the client’s refusal in the chart.
D) Explain the procedure again and tell the client he must comply.
E) Ask the provider to obtain a straight catheter specimen.
Correct Answer: C) Document the client’s refusal in the chart.
Rationale: Clients have the legal right to refuse treatment or procedures, even if refusal is
against medical advice or for legal purposes. The nurse must respect the client's autonomy
and document the refusal thoroughly.
Question 2
A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to
assign to a licensed practical nurse (LPN)?
A) Develop the initial plan of care for a newly admitted client.
B) Administer a nasogastric tube feeding.
C) Complete the initial admission assessment.
D) Provide IV push narcotics to a client with unstable pain.
E) Evaluate the effectiveness of a client's pain medication.
Correct Answer: B) Administer a nasogastric tube feeding.
Rationale: Administering a tube feeding is a technical skill performed on a stable client,
which falls within the scope of practice for a licensed practical nurse (LPN). Initial
assessment, developing the care plan, and complex evaluation are the responsibility of the
Registered Nurse (RN).
Question 3
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?
A) Opens the sterile pack by first unfolding the bottom flap away from her body.
B) Holds sterile items in his hand until the provider is ready to use them.
C) Turns his back to the sterile field to retrieve a dropped item.
D) Opens the sterile pack by first unfolding the top flap away from her body.
E) Places the sterile drape on the edge of the sterile field for later use.
Correct Answer: D) Opens the sterile pack by first unfolding the top flap away from her
body.
Rationale: The first flap of a sterile package must be unfolded away from the nurse's body
to prevent the unsterile sleeve/arm from reaching over or across the sterile field, thereby
maintaining asepsis.
Question 4
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) Auscultate the client’s lungs.
B) Stop the infusion of IV fluid immediately.
C) Complete an incident report.
D) Notify the healthcare provider.
E) Check the client’s blood pressure and heart rate.
Correct Answer: A) Auscultate the client’s lungs.
Rationale: The priority using the nursing process (Assessment/Data Collection) and the
ABC framework is to assess the client for harm. Auscultating the lungs first will detect
signs of acute fluid volume overload (pulmonary edema/crackles), a life-threatening
complication.
Question 5
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) Provide initial teaching on a new diagnosis of chronic obstructive pulmonary disease
,(COPD).
B) Perform the admission assessment on a client with a femur fracture.
C) Reinforcing teaching with a client who is learning to self-administer insulin.
D) Change the dressing on a pressure injury with purulent drainage.
E) Evaluate a client's understanding of discharge medications.
Correct Answer: C) Reinforcing teaching with a client who is learning to self-administer
insulin.
Rationale: LPNs can perform routine procedures and reinforce teaching that was initially
provided by the RN. Providing initial teaching, performing initial assessments, and
complex evaluations are the domain of the RN.
Question 6
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 places their hands below their waist level briefly.
B) The nurse adjusts their glasses using a gloved hand.
C) The nurse holds her hands above her waist.
D) The nurse turns their back to the sterile field to retrieve a suture kit.
E) The nurse places a sterile item within the 1-inch border of the sterile field.
Correct Answer: C) The nurse holds her hands above her waist.
Rationale: Once sterile attire is donned, only the area from the chest to the waist (or table
height) is considered sterile. Therefore, the nurse must keep their hands above waist level
to ensure they remain within the sterile field and prevent contamination.
Question 7
A nurse who is caring for a group of clients delegates collection of vital signs (VS) to an assistive
personnel (AP). Which of the following actions should the nurse take to evaluate the delegated
task?
A) Ask the AP if they felt comfortable performing the task.
B) Compare the client's current VS to the expected norms for that age group.
C) Provide the AP with positive feedback on their time management skills.
, D) Recheck vital signs that are outside the expected reference range.
E) Review the VS only at the end of the shift.
Correct Answer: D) Recheck vital signs that are outside the expected reference range.
Rationale: The RN retains accountability for supervision and evaluation of delegated tasks.
The priority for the RN is to validate and assess any findings that could indicate a change
in the client's status or require immediate intervention.
Question 8
A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive
personnel (AP)?
A) Performing range-of-motion exercises on a client with a new hip replacement.
B) Obtaining a stool sample from a client who has renal failure.
C) Providing a client with information about a low-sodium diet.
D) Checking a client's peripheral intravenous infusion site for phlebitis.
E) Changing the dressing on a central venous catheter insertion site.
Correct Answer: B) Obtaining a stool sample from a client who has renal failure.
Rationale: Collecting specimens (non-sterile and non-invasive) is a basic, routine procedure
that is appropriate to delegate to an AP for a stable client. The other options involve
assessment, specialized teaching, or sterile technique, which are outside the AP's scope.
Question 9
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 with a fractured tibia and severe bleeding.
B) A client who has two open chest wounds with a left tracheal deviation.
C) A client with an open head injury and exposed brain matter.
D) A client with a closed fracture of the ulna.
E) A client with first-degree burns over 25% of his body.
Correct Answer: B) A client who has two open chest wounds with a left tracheal deviation.
Rationale: Tracheal deviation in the context of chest trauma is a sign of a tension
pneumothorax, which compromises breathing and circulation and is immediately life-
threatening. This client is a "Red" (Immediate) priority in the disaster triage system.
VERSIONS EACH VERSION WITH 70 QUESTIONS WITH DETAILED
VERIFIED ANSWERS / ALREADY GRADED A+
Question 1
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) Tell the client that refusal will be reported to law enforcement.
B) Obtain a court order to force the client to provide the specimen.
C) Document the client’s refusal in the chart.
D) Explain the procedure again and tell the client he must comply.
E) Ask the provider to obtain a straight catheter specimen.
Correct Answer: C) Document the client’s refusal in the chart.
Rationale: Clients have the legal right to refuse treatment or procedures, even if refusal is
against medical advice or for legal purposes. The nurse must respect the client's autonomy
and document the refusal thoroughly.
Question 2
A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to
assign to a licensed practical nurse (LPN)?
A) Develop the initial plan of care for a newly admitted client.
B) Administer a nasogastric tube feeding.
C) Complete the initial admission assessment.
D) Provide IV push narcotics to a client with unstable pain.
E) Evaluate the effectiveness of a client's pain medication.
Correct Answer: B) Administer a nasogastric tube feeding.
Rationale: Administering a tube feeding is a technical skill performed on a stable client,
which falls within the scope of practice for a licensed practical nurse (LPN). Initial
assessment, developing the care plan, and complex evaluation are the responsibility of the
Registered Nurse (RN).
Question 3
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?
A) Opens the sterile pack by first unfolding the bottom flap away from her body.
B) Holds sterile items in his hand until the provider is ready to use them.
C) Turns his back to the sterile field to retrieve a dropped item.
D) Opens the sterile pack by first unfolding the top flap away from her body.
E) Places the sterile drape on the edge of the sterile field for later use.
Correct Answer: D) Opens the sterile pack by first unfolding the top flap away from her
body.
Rationale: The first flap of a sterile package must be unfolded away from the nurse's body
to prevent the unsterile sleeve/arm from reaching over or across the sterile field, thereby
maintaining asepsis.
Question 4
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) Auscultate the client’s lungs.
B) Stop the infusion of IV fluid immediately.
C) Complete an incident report.
D) Notify the healthcare provider.
E) Check the client’s blood pressure and heart rate.
Correct Answer: A) Auscultate the client’s lungs.
Rationale: The priority using the nursing process (Assessment/Data Collection) and the
ABC framework is to assess the client for harm. Auscultating the lungs first will detect
signs of acute fluid volume overload (pulmonary edema/crackles), a life-threatening
complication.
Question 5
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) Provide initial teaching on a new diagnosis of chronic obstructive pulmonary disease
,(COPD).
B) Perform the admission assessment on a client with a femur fracture.
C) Reinforcing teaching with a client who is learning to self-administer insulin.
D) Change the dressing on a pressure injury with purulent drainage.
E) Evaluate a client's understanding of discharge medications.
Correct Answer: C) Reinforcing teaching with a client who is learning to self-administer
insulin.
Rationale: LPNs can perform routine procedures and reinforce teaching that was initially
provided by the RN. Providing initial teaching, performing initial assessments, and
complex evaluations are the domain of the RN.
Question 6
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 places their hands below their waist level briefly.
B) The nurse adjusts their glasses using a gloved hand.
C) The nurse holds her hands above her waist.
D) The nurse turns their back to the sterile field to retrieve a suture kit.
E) The nurse places a sterile item within the 1-inch border of the sterile field.
Correct Answer: C) The nurse holds her hands above her waist.
Rationale: Once sterile attire is donned, only the area from the chest to the waist (or table
height) is considered sterile. Therefore, the nurse must keep their hands above waist level
to ensure they remain within the sterile field and prevent contamination.
Question 7
A nurse who is caring for a group of clients delegates collection of vital signs (VS) to an assistive
personnel (AP). Which of the following actions should the nurse take to evaluate the delegated
task?
A) Ask the AP if they felt comfortable performing the task.
B) Compare the client's current VS to the expected norms for that age group.
C) Provide the AP with positive feedback on their time management skills.
, D) Recheck vital signs that are outside the expected reference range.
E) Review the VS only at the end of the shift.
Correct Answer: D) Recheck vital signs that are outside the expected reference range.
Rationale: The RN retains accountability for supervision and evaluation of delegated tasks.
The priority for the RN is to validate and assess any findings that could indicate a change
in the client's status or require immediate intervention.
Question 8
A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive
personnel (AP)?
A) Performing range-of-motion exercises on a client with a new hip replacement.
B) Obtaining a stool sample from a client who has renal failure.
C) Providing a client with information about a low-sodium diet.
D) Checking a client's peripheral intravenous infusion site for phlebitis.
E) Changing the dressing on a central venous catheter insertion site.
Correct Answer: B) Obtaining a stool sample from a client who has renal failure.
Rationale: Collecting specimens (non-sterile and non-invasive) is a basic, routine procedure
that is appropriate to delegate to an AP for a stable client. The other options involve
assessment, specialized teaching, or sterile technique, which are outside the AP's scope.
Question 9
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 with a fractured tibia and severe bleeding.
B) A client who has two open chest wounds with a left tracheal deviation.
C) A client with an open head injury and exposed brain matter.
D) A client with a closed fracture of the ulna.
E) A client with first-degree burns over 25% of his body.
Correct Answer: B) A client who has two open chest wounds with a left tracheal deviation.
Rationale: Tracheal deviation in the context of chest trauma is a sign of a tension
pneumothorax, which compromises breathing and circulation and is immediately life-
threatening. This client is a "Red" (Immediate) priority in the disaster triage system.
