On a unit with two RNs, two LPNs, and one UAP, which client should be assigned to the registered nurse?

• A. Client with stable hypertension
• B. Client diagnosed with attempted suicide requiring observation
• C. Client with metastatic bone cancer using a PCA pump
• D. Client with diabetic ketoacidosis requiring insulin

Answer: (B)

The key idea is that certain patients require the highest level of monitoring and rapid decision-making, which is within an RN’s scope. A client who has attempted suicide and requires observation needs constant safety monitoring, frequent mental-status checks, and the ability to intervene immediately if risk changes. This demands one-on-one oversight and the nuanced clinical judgment an RN provides to ensure safety and coordinate any needed crisis interventions.

The other patients involve serious conditions as well, but their needs are typically managed with established protocols and supervision by LPNs or UAPs under an RN’s direction. For example, taking care of a patient with stable hypertension is routine monitoring and medication administration; a patient using a PCA pump requires careful analgesia monitoring and assessment for adverse effects, and a patient with diabetic ketoacidosis needs timely insulin therapy and fluid management, both of which require RN involvement, but the immediate safety risk driving priority here is the suicide observation. Therefore, the RN should be assigned to the client requiring suicide observation.