# 一名內外科病房的護理師(RN)正將工作分派給LPN(licensed practical nurse,類似輔助護理人員)。下列何者為適合分派給LPN之工作?(複選)

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=363932&lang=zh-tw  
> language: zh-TW  
> subject: Assignment/Delegation/Supervision  
> category: MOC

## 題目

一名內外科病房的護理師(RN)正將工作分派給LPN(licensed practical nurse,類似輔助護理人員)。下列何者為適合分派給LPN之工作?(複選)

1

為即將返家之病人擬定出院衛教計畫

2

加強昨日由RN開始的傷口護理衛教

3

完成新到術後病人的入院評估

4

為新入院病人擬定護理計畫

5

為穩定病人投予例行口服降壓藥

## 解析

LPN業務範圍一般包含穩定病人之例行給藥與加強RN已開始之衛教。初次入院評估、護理計畫擬定、出院衛教計畫均屬RN之廣泛評估與臨床判斷工作。各州護理師法不同,NCLEX採最限制性解讀。

## 深入解析

臨床判斷
RN專屬: 初次評估、護理計畫擬定、評值、出院衛教。LPN: 穩定病人例行給藥、加強衛教、RN監督下集中評估。UAP: ADL、穩定病人之生命徵象、I/O、步行。

記憶口訣
RN = 評估+計畫+衛教+評值。LPN = 加強+例行。UAP = ADL+生命徵象(穩定)

韓 vs 美
美國各州Nurse Practice Act規定RN/LPN/UAP範圍。臺灣有護理師(RN)與護士(LPN)之區分。NCLEX以美國架構為準。

## 臨床情境

臨床指引
NCSBN分派5原則:
- 適合的工作
- 適合的情境: 病人穩定性與場域
- 適合的對象: 受指派者具勝任能力
- 適合的指示與溝通: 明確、具體、可衡量
- 適合的督導與評值: RN仍負最終責任

不可分派: 初次或不穩定情境之A-P-T-E(評估、計畫、衛教、評值)。

注意
即使工作可分派,RN仍負結果責任。先確認受指派者能力;若不確定即不分派。任務後再評估安全完成。

## 重要概念

- **分派5原則** — NCSBN架構: 正確工作、情境、對象、指示、督導。分派給LPN或UAP前必行。即使分派恰當,RN仍負責任。
- **護理過程** — ADPIE: 評估、診斷、計畫、執行、評值。初次評估、診斷、計畫、評值為RN專屬。執行可在範圍內分派。不穩定病人之再評估亦為RN專屬。
- **LPN業務範圍** — 依州別規定之LPN職能。一般包含穩定病人之例行給藥、加強衛教、聚焦性資料收集、換藥及基本技術。不含初次評估、護理計畫、高警訊靜脈推注或初次衛教。

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