A charge nurse is working with a team that includes two registered nurses (RNs), one licensed practical nurse (LPN), and two unlicensed assistive personnel (UAPs). The charge nurse must assign care for four patients: a post-operative patient requiring pain assessment and medication administration, a stable diabetic patient needing blood glucose monitoring, a patient with a new tracheostomy requiring suctioning, and a patient needing assistance with activities of daily living. Which task assignment demonstrates the most appropriate delegation based on scope of practice and patient safety?
1Assign the LPN to perform tracheostomy suctioning for the patient with a new tracheostomy
2Delegate blood glucose monitoring of the stable diabetic patient to the UAP
3Assign the RN to assess pain and administer medications to the post-operative patient✓ 정답
4Have the UAP assist with tracheostomy care and suctioning procedures
해설
Proper delegation matches tasks to scope of practice. Option 3 assigns pain assessment and medication to an RN, which is within their scope. Other options delegate tasks like tracheostomy suctioning or blood glucose monitoring to LPN or UAP, which may exceed their scope or require RN-level assessment.
Clinical Judgment
This question assesses core judgment regarding Delegation and Scope of Practice. You must understand the legal and educational limits of each team member (RN, LPN, UAP) and choose the safest task assignment considering the patient's condition (stable vs. unstable, new vs. chronic). The core principles are "patient safety" and "appropriate skill level." Option 3 assigns complex assessment (pain) and medication administration to the RN, which perfectly aligns with the RN's core scope of practice, making it the most appropriate choice.
Memory Tip:
Remember the 5 Rights of Delegation: Right Task, Right Circumstance, Right Person, Right Direction/Communication, Right Supervision/Evaluation. This question specifically focuses on Right Task and Right Person.
KR vs US:
In Korea, the roles and legal responsibilities of nursing assistants or nurse aides may differ from those of UAPs/LPNs in the US. In the NGN, questions are based on standardized US Delegation Principles. Remember that the RN always retains ultimate accountability for delegation, and complex assessments, unstable patients, and new/high-risk procedures must be performed directly by the RN.
Clinical Practice Guide
RN duties: Comprehensive assessment, nursing diagnosis, care plan development/evaluation, intravenous medication administration, management of unstable or complex patients.
LPN duties: Routine care for stable patients under RN supervision (vital signs, oral/subcutaneous medication administration, basic dressings), assisting with routine procedures they are already familiar with.
UAP duties: Basic assistance with daily living under RN direction and supervision (bathing, eating, mobility), non-clinical tasks (bed making, transporting supplies), never! perform assessment, evaluation, medication administration, or sterile/high-risk procedures.
Caution:
In SATA (Select All That Apply) questions asking for the "most appropriate delegation," you must evaluate each option individually through two lenses: "Is it safe?" and "Is it within the scope of practice?" A statement like "The UAP measures blood glucose" can be a trap, as it is not permitted in most U.S. states or requires strict conditions.
Delegation — Delegation. The RN assigns specific patient care tasks to other qualified personnel (LPN, UAP), while retaining responsibility and supervisory authority over those tasks.
Scope of Practice — Scope of practice. The range of clinical activities legally permitted and trained for according to each nursing license or certification (LVN/LPN, RN).
Unlicensed Assistive Personnel — Unlicensed assistive personnel. Personnel who do not have a nursing license but are trained to perform basic patient care tasks (e.g., nursing assistants, nurse aides).
Licensed Practical Nurse (LPN) / Licensed Vocational Nurse — Licensed Practical Nurse. A nurse who has completed 1-2 years of education and obtained a license, providing a limited scope of nursing care under the supervision of an RN.
Patient Acuity — Patient acuity. An indicator representing the patient's condition and the complexity and intensity of nursing care required. A key factor to consider when delegating (e.g., stable vs. unstable).