執業護理師（RN）正在規劃當班的病人分配。哪位病人應分配給有經驗的執照職業護士（LPN/LVN）？
An RN is planning the client assignments for the shift. Which client should be assigned to an experienced Licensed Practical Nurse (LPN)?
- AA client with a stable stage 3 pressure injury requiring a sterile dressing change.✓ 正解一位患有穩定的第三級壓瘡，需要無菌敷料更換的病人。
- BA client who is post-operative day 1 after a heart transplant and is unstable.一位心臟移植術後第一天且狀況不穩定的病人。
- CA newly admitted client with chest pain and suspected myocardial infarction.一位因胸痛新入院的病人，懷疑患有心肌梗塞。
- DA client who requires discharge teaching about a new insulin pump.一位需要關於新胰島素幫浦之出院衛教的病人。
護理委派（Delegation）的核心在於區分 RN 與 LPN 的職權範圍。RN 負責「EAT」：Evaluation（評估）、Assessment（初始評估）、Teaching（複雜衛教）。LPN 適合照顧狀態穩定（Stable）、預期性強（Predictable outcomes）的病人，並可執行特定技術性護理，如給藥（不含高危 IV）、傷口換藥及導尿。本題中，穩定的三級壓瘡換藥（A）屬於 LPN 的技能範疇，且病人狀態穩定。選項 C 需要初次評估與緊急處置，D 涉及複雜衛教，B 涉及不穩定的術後病人，這三者都必須由 RN 直接負責。臨床思路是將高風險與複雜判斷留給 RN，將常規技術留給 LPN。
The core of delegation is distinguishing the scope of practice between the RN and the LPN. The RN is responsible for 'EAT': Evaluation, Assessment (initial), and Teaching (complex). The LPN is appropriate for patients who are stable with predictable outcomes and may perform specific technical nursing tasks, such as medication administration (excluding high-risk IV medications), wound dressing changes, and urinary catheterization. In this question, a sterile dressing change for a stable stage 3 pressure injury (A) falls within the LPN's skill set, and the patient is stable. Option C requires initial assessment and emergency interventions; D involves complex teaching; B involves an unstable postoperative patient. These three must be managed directly by the RN. The clinical reasoning is to reserve high-risk and complex judgment for the RN while assigning routine technical tasks to the LPN.
美國護理體系有明確的 RN 與 LPN (Licensed Practical Nurse) 分級。LPN 有獨立執照，可負責穩定病人的換藥與給藥。台灣則多為 RN（護理師），雖然有輔助人力，但並無對等的 LPN 職位在病房執行醫療處置，通常所有臨床決策與給藥均由 RN 完成。