負責護理師（Charge nurse）正在分配下一班的工作。下列哪些病人應分配給註冊護理師（RN）？（選所有適合的）
The charge nurse is making assignments for the upcoming shift. Which clients should be assigned to the Registered Nurse (RN)? (Select all that apply.)
- AA client who underwent a total hip replacement 4 hours ago✓ 正解四小時前接受全髖關節置換術的病人
- BA client with chronic obstructive pulmonary disease (COPD) requiring routine suctioning需要常規抽吸之慢性阻塞性肺疾病（COPD）病人
- CA client scheduled for discharge teaching later today✓ 正解預計今日稍後進行出院衛教的病人
- DA client newly admitted with suspected bacterial meningitis✓ 正解新入院且懷疑患有細菌性腦膜炎的病人
- EA client with stable heart failure receiving daily oral diuretics病情穩定且接受每日口服利尿劑治療之心衰竭病人
護理分配的核心在於評估病人的穩定度、複雜度與預測性。RN 必須照護最不穩定、最複雜且需要高度判斷力的病人。選項 A 的髖關節置換術後 4 小時病人正處於術後急性期，有出血、神經血管損傷或栓塞的風險，需要頻繁的評估與監測。選項 C 涉及出院教學（Discharge Teaching），這是 RN 的專屬核心職責，不能由 LPN 或 UAP 獨立完成。選項 D 的疑似腦膜炎新病人情況不明且具傳染風險，其神經學評估與急性治療需要 RN 的高度判斷力。選項 B 的常規抽痰（Routine suctioning）可由 LPN 執行，因為這是一個相對穩定且可預測的程序。選項 E 的穩定心衰竭病人僅需口服藥物，亦屬 LPN 的範圍。護理師在分配時應遵循『安全性與範疇一致性』，確保每位病人的需求都能由具備相應能力的專業人員滿足。
The core of assignment is evaluating a client's stability, complexity, and predictability. The RN must care for the most unstable and complex clients who require advanced clinical judgment. Option A — the post-hip-replacement client 4 hours postop — is in the acute postoperative phase with risks of bleeding, neurovascular injury, or embolism, requiring frequent assessment and monitoring. Option C involves discharge teaching, which is a core RN responsibility and cannot be performed independently by an LPN or UAP. Option D — a newly admitted client with suspected meningitis — has an uncertain status with infection risk, and neurologic assessment and acute treatment require the RN's advanced judgment. Option B — routine suctioning of a stable client — can be performed by an LPN because it is a relatively stable and predictable procedure. Option E — a stable heart failure client receiving oral medications only — also falls within the LPN's scope. Assignment should follow 'safety and scope consistency,' ensuring that each client's needs are met by a professional with the appropriate competencies.
在美國 NCLEX 考試中，RN 與 LPN 的分工邊界非常嚴格，RN 絕不可委派評估與初始衛教；在台灣臨床實務中，由於病房護生或初級護理師較多，雖然也有資深與資淺之分，但法定職責差異在實務操作上不如美國法律界定得那樣涇渭分明，且出院衛教有時會由專科護理師或個管師協助。