ATI RN Leadership Proctored
Assessment 2026 with NGN 60 Verified
Questions with Answers & Rationales
Section 1: Delegation & Assignment (Questions 1–10)
1. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which task should the charge nurse assign to the LPN?
A) Ambulate a stable post-operative patient
B) Bathe a patient who is incontinent
C) Administer a scheduled oral medication to a stable patient
D) Feed a patient who requires assistance
Correct Answer: C
Rationale: LPNs can administer oral, IM, and subcutaneous medications to stable patients. APs
cannot administer any medications. Delegation must follow state Nurse Practice Act and facility
policy.
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) Administer a nasogastric tube feeding
B) Perform the initial admission assessment on a new client
C) Develop the plan of care for a client with diabetes
D) Evaluate the effectiveness of a client's pain management
Correct Answer: A
Rationale: LPNs can administer enteral feedings, including NG tube feedings, as this is a stable,
routine procedure. Initial assessments, care plan development, and evaluation of outcomes are
the responsibility of the RN.
,3. A nurse on a medical-surgical unit has four patients. Which patient should the nurse see first?
A) A patient with diabetes who has a blood glucose of 48 mg/dL and is diaphoretic
B) A patient requesting pain medication for a 4/10 headache
C) A patient needing assistance with toileting
D) A patient ready for discharge teaching
Correct Answer: A
Rationale: Hypoglycemia (＜70 mg/dL) with diaphoresis is a life-threatening emergency
requiring immediate intervention (oral or IV glucose). Safety and unstable physiological needs
come first per Maslow's hierarchy.
4. A charge nurse is making shift assignments. Which patient should be assigned to the most
experienced RN?
A) A patient requiring routine morning medications
B) A patient with a chest tube that has 200 mL of bloody drainage in the past hour
C) A patient requesting discharge instructions
D) A patient who needs a dressing change for a stage 2 pressure injury
Correct Answer: B
Rationale: Active bleeding via chest tube is unstable and requires expert assessment and
intervention. The most experienced RN has the clinical judgment to recognize early signs of
hemorrhage or tension pneumothorax.
5. A registered nurse (RN) is delegating a sterile dressing change for a stage 2 pressure injury.
Which team member is most appropriate?
A) Assistive personnel (AP)
B) Licensed practical nurse (LPN) with validated competency in sterile technique
C) Another RN
D) A nursing student
Correct Answer: B
Rationale: LPNs can perform sterile dressing changes for stable wounds if the state Nurse
Practice Act and facility policy allow. The RN retains accountability for the delegation and must
verify competency.
, 6. An RN delegates vital sign measurement of a stable post-operative patient to an AP. The AP
reports a BP of 88/50. What should the RN do next?
A) Document the reading as reported
B) Ask the AP to recheck the blood pressure
C) Assess the patient personally to verify the reading and evaluate for shock
D) Ignore the reading if the patient appears comfortable
Correct Answer: C
Rationale: Unexpected findings delegated to an AP must be followed up by the RN with an
assessment. The RN cannot simply re-delegate or ignore abnormal findings.
7. A charge nurse is evaluating a new graduate's delegation skills. Which statement by the new
graduate indicates understanding?
A) "I can delegate any task I am too busy to complete myself."
B) "I can delegate a task to an AP if it doesn't require nursing judgment."
C) "Once I delegate a task, I am no longer responsible for the outcome."
D) "Delegation means I don't need to supervise the AP's work."
Correct Answer: B
Rationale: Delegation is transferring performance of a task that is within the delegatee's scope
and does not require RN assessment or critical thinking. The RN retains accountability and
supervision responsibility.
8. A charge nurse notes that a staff member frequently takes longer breaks than allowed. What
is the first action?
A) Report the staff member to the nurse manager immediately
B) Ignore the behavior to avoid conflict
C) Discuss the observation privately with the staff member
D) Post a memo reminding all staff about break policies
Correct Answer: C
Assessment 2026 with NGN 60 Verified
Questions with Answers & Rationales
Section 1: Delegation & Assignment (Questions 1–10)
1. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which task should the charge nurse assign to the LPN?
A) Ambulate a stable post-operative patient
B) Bathe a patient who is incontinent
C) Administer a scheduled oral medication to a stable patient
D) Feed a patient who requires assistance
Correct Answer: C
Rationale: LPNs can administer oral, IM, and subcutaneous medications to stable patients. APs
cannot administer any medications. Delegation must follow state Nurse Practice Act and facility
policy.
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) Administer a nasogastric tube feeding
B) Perform the initial admission assessment on a new client
C) Develop the plan of care for a client with diabetes
D) Evaluate the effectiveness of a client's pain management
Correct Answer: A
Rationale: LPNs can administer enteral feedings, including NG tube feedings, as this is a stable,
routine procedure. Initial assessments, care plan development, and evaluation of outcomes are
the responsibility of the RN.
,3. A nurse on a medical-surgical unit has four patients. Which patient should the nurse see first?
A) A patient with diabetes who has a blood glucose of 48 mg/dL and is diaphoretic
B) A patient requesting pain medication for a 4/10 headache
C) A patient needing assistance with toileting
D) A patient ready for discharge teaching
Correct Answer: A
Rationale: Hypoglycemia (＜70 mg/dL) with diaphoresis is a life-threatening emergency
requiring immediate intervention (oral or IV glucose). Safety and unstable physiological needs
come first per Maslow's hierarchy.
4. A charge nurse is making shift assignments. Which patient should be assigned to the most
experienced RN?
A) A patient requiring routine morning medications
B) A patient with a chest tube that has 200 mL of bloody drainage in the past hour
C) A patient requesting discharge instructions
D) A patient who needs a dressing change for a stage 2 pressure injury
Correct Answer: B
Rationale: Active bleeding via chest tube is unstable and requires expert assessment and
intervention. The most experienced RN has the clinical judgment to recognize early signs of
hemorrhage or tension pneumothorax.
5. A registered nurse (RN) is delegating a sterile dressing change for a stage 2 pressure injury.
Which team member is most appropriate?
A) Assistive personnel (AP)
B) Licensed practical nurse (LPN) with validated competency in sterile technique
C) Another RN
D) A nursing student
Correct Answer: B
Rationale: LPNs can perform sterile dressing changes for stable wounds if the state Nurse
Practice Act and facility policy allow. The RN retains accountability for the delegation and must
verify competency.
, 6. An RN delegates vital sign measurement of a stable post-operative patient to an AP. The AP
reports a BP of 88/50. What should the RN do next?
A) Document the reading as reported
B) Ask the AP to recheck the blood pressure
C) Assess the patient personally to verify the reading and evaluate for shock
D) Ignore the reading if the patient appears comfortable
Correct Answer: C
Rationale: Unexpected findings delegated to an AP must be followed up by the RN with an
assessment. The RN cannot simply re-delegate or ignore abnormal findings.
7. A charge nurse is evaluating a new graduate's delegation skills. Which statement by the new
graduate indicates understanding?
A) "I can delegate any task I am too busy to complete myself."
B) "I can delegate a task to an AP if it doesn't require nursing judgment."
C) "Once I delegate a task, I am no longer responsible for the outcome."
D) "Delegation means I don't need to supervise the AP's work."
Correct Answer: B
Rationale: Delegation is transferring performance of a task that is within the delegatee's scope
and does not require RN assessment or critical thinking. The RN retains accountability and
supervision responsibility.
8. A charge nurse notes that a staff member frequently takes longer breaks than allowed. What
is the first action?
A) Report the staff member to the nurse manager immediately
B) Ignore the behavior to avoid conflict
C) Discuss the observation privately with the staff member
D) Post a memo reminding all staff about break policies
Correct Answer: C
