A nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing action is appropriate to assign to the PN?

• A. Administer a dose of insulin per sliding scale for a client with type 2 diabetes mellitus.
• B. Perform daily surgical dressing change for a client who had an abdominal hysterectomy.
• C. Obtain postoperative vital signs for a client one day following unilateral knee arthroplasty.
• D. Provide patient education about wound care after discharge.

Answer: (B)

Delegation and scope of practice guide what a practical nurse can safely handle. Tasks that are routine, stable, and require basic skills—like keeping a wound clean, applying dressings, and observing for obvious changes—fit well with a PN role. Dressing changes after surgery are a straightforward wound-care activity that uses sterile technique, involves monitoring the dressing and surrounding skin, and reporting any drainage or signs of infection to the RN. It does not require the higher level of assessment, interpretation, or decision-making that medications or complex postoperative status demand.

Administering insulin on a sliding scale is a high-risk medication task that requires careful dosing, ongoing monitoring for hypoglycemia, and adjustment based on the client’s response. This level of pharmacologic responsibility typically falls to an RN or requires close, facility-specific delegation, not routine PN practice.

Taking postoperative vital signs after major surgery like knee arthroplasty involves more than just numbers; it requires interpretation in the context of recent surgery, potential complications (bleeding, perfusion issues, pain control), and timely escalation if abnormalities appear. That broader assessment and decision-making are usually handled by an RN.

Providing discharge wound-care education is important, but discharge teaching is generally within the RN's responsibilities, with the PN possibly reinforcing instructions under direction. The key is ensuring the patient understands when to seek care and how to care for the wound, which is best overseen by the RN.

So, performing daily surgical dressing changes for the client who had an abdominal hysterectomy aligns with the PN role: it’s a routine, wound-care task that supports care continuity without requiring advanced assessment or pharmacologic decision-making.