兒科病房護理師正在接班。護理長應將下列哪位新入院兒科病人指派給從成人腫瘤病房支援的浮動護理師？
An RN on a pediatric unit is receiving shift report. Which newly admitted pediatric client should the charge nurse assign to a float RN reassigned from the adult oncology floor?
- AA 6-year-old with severe asthma exacerbation showing intercostal retractions and requiring complex nebulizer titration.一名患有嚴重氣喘惡化、出現肋間肌凹陷且需要複雜霧化治療調整的6歲兒童。
- BA 2-month-old lethargic infant with a high-pitched cry indicating worsening bacterial meningitis.一名嗜睡、哭聲尖銳提示細菌性腦膜炎惡化的2個月大嬰兒。
- CA 14-year-old with intractable nausea and vomiting from chemotherapy receiving IV fluids and antiemetics through a central line.✓ 正解一名因化療而難治性噁心嘔吐、透過中心導管接受靜脈輸液和抗吐藥物的14歲青少年。
- DA 4-year-old newly diagnosed with Kawasaki disease requiring IV immunoglobulin infusion.一名新診斷為川崎病且需要靜脈注射免疫球蛋白輸注的4歲兒童。
跨科支援護理師指派原則：交派最能利用其既有專長、且病情相對穩定的病人。 選項 C 正確：14 歲化療相關噁心嘔吐病人，雖在兒科卻是「腫瘤照護」核心情境——成人腫瘤護理師熟悉化療副作用管理、IV 輸液幫浦、中心靜脈導管、止吐處置，這些核心技能適用於各年齡層。 選項 B 錯誤：2 個月大細菌性腦膜炎需新生兒/兒科專科評估、神經學監測。 選項 A 錯誤：嚴重氣喘小兒需兒科呼吸專業（小兒氣道與成人不同）。 選項 D 錯誤：川崎病屬兒科特有疾病，IVIG 處置與小兒劑量需兒科專業。
Float nurse assignment principle: assign the client whose care best matches the float nurse's existing competencies and is most clinically stable. C is correct: A 14-year-old with chemo-related nausea/vomiting requires oncology core skills (chemo side-effect management, IV pumps, central line, antiemetic protocols)—skills the adult oncology nurse already possesses. B is incorrect: Bacterial meningitis in a 2-month-old requires neonatal/pediatric-specific neurologic monitoring. A is incorrect: Severe pediatric asthma requires pediatric respiratory expertise (pediatric airways differ from adult). D is incorrect: Kawasaki disease and pediatric IVIG dosing require pediatric specialty knowledge.
台美皆強烈規定：跨科調動 (Floating) 的護理師只能接受「常規、穩定或與其原本專長相符的病患」。這題利用 Oncology 的專長 (TPN) 作為共通橋樑，是國考出題萬年神招。