The nurse is planning client assignments for the day and has a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP) on the nursing team.

The nurse most appropriately assigns which client to the licensed practical nurse?

Note the strategic words most appropriately. This question requires that you determine which client should most appropriately be assigned to the licensed practical nurse. No information in the question indicates the need to use agency policies, procedures, or position descriptions to determine the most appropriate assignment; therefore, use general guidelines such as the nurse practice act. As you read each option, think about and visualize the client’s needs. The client described in option 1 has needs that cannot be met by the UAP. Remember that the health care provider needs to be competent and skilled to perform the assigned task or client activity.

You will learn about the specific roles and responsibilities of various health care providers in your fundamentals of nursing course. You will also learn more specific content about these roles and responsibilities when you discuss leadership and management roles of the nurse. The important thing to remember is that the registered nurse is educationally prepared to assume the highest level of responsibility. The licensed practical or vocational nurse can assume some responsibilities that are invasive, and the unlicensed assistive personnel can assume responsibilities that are noninvasive. A tracheostomy is a surgically created opening into the neck that provides an airway for a client who is unable to breathe through the upper airway. A client with a tracheostomy requires suctioning, which involves, as needed, the insertion of a tube that provides suction to remove secretions to maintain a clear airway. This is an invasive procedure, and thus a licensed nurse needs to be assigned to this client. The collection of urine, ambulating a client, and turning and repositioning and range-of-motion exercises are noninvasive procedures and thus can be assigned to unlicensed assistive personnel.

The licensed nurse employed in a hospital is assigning client care activities to an unlicensed assistive personnel (UAP). The UAP is a first-semester senior nursing student and works at the hospital as a UAP part-time on weekends. The hospital position description for a nursing student who is employed as a UAP indicates that he or she may perform basic procedures learned in nursing school if supervised by a licensed nurse.

Based on the hospital’s position description, the licensed nurse assigns which most appropriate activity to this UAP?

In this question, information is provided that directs you to use the hospital’s position description to determine the most appropriate activity to assign to the UAP. The strategic words in the question are most appropriate. Based on the data provided in the question and in the options, it is best to select the least invasive activity. Also, recall that blood administration and medication administration must be performed by a licensed health care provider. Inserting an IV catheter into an infant is an invasive procedure that needs to be performed by a health care provider specially trained to perform it. Remember that the health care provider needs to be competent and skilled to perform the assigned task or client activity.

When answering assignment making questions, remember to focus on who the task is being assigned to and remember to select the least invasive task if the health care provider is not licensed. Hanging red blood cells means that the client will receive blood by the IV route, and this is a highly invasive procedure. Inserting an IV catheter and administering digoxin (a cardiac medication) intravenously are also highly invasive procedures that need to be performed by licensed personnel. Changing a sterile dressing is also invasive to some degree and requires education in its performance to maintain sterility.