護理師在內科病房照護一組病人。下列哪位病人最適合委派給執業護理師（LPN/LVN）？
A nurse is caring for a group of clients on a medical unit. Which client is the most appropriate to delegate to a Licensed Practical Nurse (LPN)?
- AA stable client with a stage 3 pressure injury who requires a dressing change✓ 正解一位患有第三期壓瘡且需要換藥的穩定病人
- BA client with a new onset of atrial fibrillation with a heart rate of 140 bpm一位新發心房顫動且心跳速率為每分鐘 140 次的病人
- CA client who just returned from surgery and requires vital signs every 15 minutes一位剛從手術返回且需要每 15 分鐘測量生命徵象的病人
- DA client who was admitted with dehydration and needs oral rehydration education一位因脫水入院且需要口服補液衛教的病人
委派給 LPN 的原則是選擇「穩定、具備預測性、常規護理」的病人。LPN 的職責範圍包括給藥（視州法規而定，通常不包含 IV push）、執行常規技術性操作（如換藥、導尿）。選項 A 的病人病況穩定且傷口換藥屬於 LPN 的核心技能，非常適合委派。選項 D 涉及「教育」（Education），雖然 LPN 可以強化（Reinforce）衛教，但初步教育應由 RN 負責。選項 C 為「術後即刻」，病人處於不穩定高峰期，需 RN 密切評估。選項 B 是「新發病」且生命徵象不穩（心搏過速），必須由 RN 親自處理與判斷。透過排除不穩定與需複雜判斷的案例，A 是最安全且合適的委派選擇。
The principle for delegating to an LPN is to choose a client who is stable, predictable, and requires routine care. The LPN's scope of practice includes medication administration (depending on state regulations, generally excluding IV push) and performance of routine technical procedures (such as dressing changes and catheterization). Option A's client is stable and the wound dressing change falls within the LPN's core skills, making this a very appropriate delegation. Option D involves education; although the LPN can reinforce teaching, initial education should be done by the RN. Option C is immediately postoperative, when the client is at peak instability and requires close RN assessment. Option B is a newly diagnosed client with unstable vital signs (tachycardia), which must be handled and judged personally by the RN. By eliminating unstable cases and those requiring complex judgment, A is the safest and most appropriate delegation choice.
美國護理體系中 RN 與 LPN 的職責劃分非常明確（LPN 需考國家執照）；台灣目前護理體系主要為護理師（RN），雖然早期有護士（LPN）職等，但目前多數醫療機構已全面提升為護理師，臨床上較少出現這種角色間的委派爭議，但在考題中仍是核心概念。