Adult Leadership 2026 Proctored Assessment

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Sample questions from Adult Leadership 2026 Proctored Assessment

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, which task is appropriate for the RN to delegate to experienced assistive personnel?

   • A.Teach a client how to use an incentive spirometer
   • B.Evaluate dizziness after a client's first antihypertensive dose
   • C.Measure urine output for a stable client receiving oral diuretics
   • D.Determine whether a newly admitted client can swallow safely

   Rationale: Measuring and reporting urine output is a routine task that assistive personnel can perform for a stable client. Swallowing assessment and evaluation of dizziness require nursing judgment, and initial teaching is an RN responsibility. Delegation transfers task performance, not accountability for assessment and evaluation.

2. 2.Before signing a surgical consent form, a client states, 'I still do not understand why this operation is necessary.' Which action should the RN take?

   • A.Witness the signature because the procedure is scheduled
   • B.Notify the surgeon that the client needs further explanation
   • C.Explain the surgical alternatives and obtain the signature
   • D.Ask a family member to sign instead

   Rationale: The surgeon must explain the procedure, benefits, risks, and alternatives so the client can make an informed decision. The RN may reinforce information but should not replace the surgeon's disclosure or witness consent when understanding is unresolved. A capable adult's family cannot substitute its consent merely because the client has questions.

3. 3.Refer to the client's chart. Which actions should the charge nurse take immediately? Select all that apply.

   • A.Delay escalation until the next scheduled laboratory draw
   • B.Activate the rapid response system
   • C.Assign assistive personnel to evaluate the client's perfusion
   • D.Prepare for urgent provider evaluation and ordered fluid resuscitation
   • E.Have another RN remain with the client and initiate protocol-based support

   Rationale: The BP decline to 84/48 mm Hg, new confusion, and lactate of 4.2 mmol/L indicate acute deterioration requiring rapid response activation and urgent evaluation. Another RN should remain with the client to provide immediate protocol-based support while preparations for ordered resuscitation occur. Evaluating perfusion cannot be delegated to assistive personnel because it requires nursing judgment. Waiting for routine laboratory testing would delay treatment of possible shock.

4. 4.An experienced outpatient RN floats to a telemetry unit. Which assignment is most appropriate?

   • A.A stable client awaiting discharge after uncomplicated treatment for dehydration
   • B.A client with new second-degree heart block and dizziness
   • C.A client with recurrent chest pain receiving a titrated nitroglycerin infusion
   • D.A client requiring initial teaching about a newly implanted defibrillator

   Answer and rationale are in the full material.

5. 5.During discharge planning, a client recovering from a stroke cannot afford medications and has difficulty transferring into a vehicle. Which referral best coordinates solutions to both barriers?

   • A.The hospital ethics committee
   • B.Speech-language pathology
   • C.Infection prevention
   • D.Case management

   Answer and rationale are in the full material.