護理師可以適當地將下列哪項工作委派給輔助人員（UAP）？

核心概念：護理輔助人員（Unlicensed Assistive Personnel, UAP）的職責與任務委派。 為什麼正確答案 B 對：測量並記錄留置導尿管的尿量（measuring and documenting the output of an indwelling urinary catheter）是屬於例行性的生理數據收集與記錄工作。這項任務不涉及複雜的臨床判斷、評估或教學，UAP 經過適當培訓後可以勝任，並將數據報告給註冊護理師（Registered Nurse, RN）。 為什麼其他選項錯： B. 教導病人如何進行自我導尿（teaching a client how to perform self-catheterization）屬於「教學」範疇，需要 RN 的專業知識、評估病人的學習能力，並示範操作技巧。這是 RN 的核心職責，不得委派。 C. 評估（evaluating）疼痛藥物給予的有效性，需要 RN 評估病人的疼痛程度、藥物反應、以及是否有其他影響因素，並據此調整照護計畫。這涉及到臨床判斷，是 RN 的職責。 D. 對於有頸椎脊髓損傷（cervical spinal cord injury）的病人進行翻身（re-positioning），需要特殊的技巧和對病人神經損傷程度的仔細評估，以避免加重損傷或引起併發症（如自主神經反射異常）。這項操作複雜且風險較高，應由 RN 執行或監督，不適合直接委派給 UAP。 臨床思路：此題考量的是「委派的安全性」與「職責區分」。RN 在委派任務給 UAP 時，必須遵循「不委派評估、教學、判斷」的原則，確保任務的性質適合 UAP 的能力範圍，並將潛在風險降至最低。

Core concept: scope of practice for unlicensed assistive personnel (UAP) and task delegation. Why option B is correct: measuring and documenting the output of an indwelling urinary catheter is a routine collection and recording of physiologic data. This task does not involve complex clinical judgment, assessment, or teaching, so a UAP with appropriate training can perform it and report the data to the registered nurse (RN). Why the other options are wrong: B. Teaching a client how to perform self-catheterization falls under teaching, which requires the RN's professional knowledge, assessment of the client's learning ability, and demonstration of the technique. This is a core RN responsibility and cannot be delegated. C. Evaluating the effectiveness of pain medication administration requires the RN to assess the client's pain level, drug response, and other contributing factors, and to adjust the plan of care accordingly. This involves clinical judgment and is an RN responsibility. D. Repositioning a client with a cervical spinal cord injury requires specialized technique and careful assessment of the neurologic injury to avoid worsening it or causing complications such as autonomic dysreflexia. This task is complex and high-risk and should be performed or supervised by the RN; it is not appropriate to delegate directly to the UAP. Clinical reasoning: this item addresses the safety of delegation and the division of responsibilities. When delegating to a UAP, the RN must follow the principle that assessment, teaching, and judgment are not delegated, ensuring that the task matches the UAP's scope of practice and that potential risk is minimized.