Which client should the charge nurse assign to the most experienced RN?

A. A client with diabetic ketoacidosis on an insulin infusion with hourly glucose checks
B. A client with stable chronic kidney disease awaiting discharge
C. A client 3 days after a hip replacement who is walking with a walker
D. A client with a urinary tract infection on oral antibiotics

Show answer and rationale

Correct answer: A

The most complex, unstable client with high-alert medications and frequent titration needs the most experienced nurse. The other clients are stable with predictable needs.

Source: ADA. Standards of Care in Diabetes (DKA management)

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This question is one of 193 Management of Care items in NCLEXSim. On the NCLEX-RN, this category makes up 15–21% of the exam.

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Study tip

Work every 'who first' item through the same ladder: airway, breathing, circulation; then unstable before stable, acute before chronic, actual before potential.
Delegation: the RN keeps initial assessment, care planning, teaching, evaluation, and any unstable client. LPNs take stable, predictable clients. Assistive personnel take routine tasks such as vital signs on stable clients, hygiene, feeding without swallowing risk, and ambulation.

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Which client should the charge nurse assign to the most experienced RN?

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