A registered nurse from an ambulatory surgery unit is floating to a medical-surgical unit. After confirming the nurse's competency, which client should the charge nurse assign to the float nurse?
1A client admitted with diabetic ketoacidosis who is receiving a titrated insulin infusion
2A client with new crushing chest pain who is awaiting an initial electrocardiogram
3A client 2 hours after thyroid surgery who has increasing neck swelling and hoarseness
4A client 2 days after laparoscopic surgery who needs routine medications and ambulation✓ Correct answer
Explanation
Assign the float nurse a stable client whose care matches verified competencies. Titrated infusions, possible acute coronary syndrome, and an evolving postoperative airway complication require nurses familiar with the unit and higher-acuity care.
Quick answer Assign the stable postoperative client who needs routine medications and ambulation. The assignment matches familiar adult postoperative skills without transferring an unstable assessment or titration burden.
Why this is correct Safe assignment considers the client's stability, the predictability of care, and the nurse's demonstrated competency. The other clients have changing conditions or therapies that require rapid reassessment, unit-specific escalation, or titration, so they remain with nurses experienced in that setting.
Easy analogy or mental picture Think of assigning a licensed driver to a familiar road before asking that driver to navigate an unfamiliar emergency route. The license matters, but verified route-specific skill still matters; this picture does not replace the charge nurse's actual competency assessment.
Memory hook Match stability, predictability, and verified competency before matching the available staff member to the client.
NCLEX decision rule When a nurse floats to an unfamiliar unit, choose a stable client with predictable care that falls within verified competency. Keep unstable clients, new admissions requiring complex assessment, and titrated high-risk therapies with unit-experienced nurses.
Why the other choices are wrong The insulin infusion requires titration and close metabolic reassessment. New crushing chest pain may represent acute coronary syndrome, and neck swelling with hoarseness after thyroid surgery can signal an airway-threatening hematoma. Each requires higher-acuity, unit-familiar care.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
NCSBN: National Guidelines for Nursing DelegationNational Council of State Boards of Nursing