The charge nurse is assigning one practical nurse (PN) and three registered nurses (RN) to neurologically compromised clients. Which client change is best to assign to the PN?

• A. Viral meningitis whose temperature changed from 101°F (38.3°C) to 102°F (38.9°C).
• B. New onset acute delirium in another client.
• C. A client with uncontrolled seizures.
• D. A client requiring multiple continuous intravenous medications.

Answer: (A)

The key idea is assigning tasks based on patient stability and the level of nursing expertise required. A practical nurse is suited to perform routine monitoring and care for a neurologically compromised patient, while more acute changes or complex therapies demand an RN.

The most appropriate assignment is the viral meningitis patient whose temperature has risen from 101°F to 102°F. This indicates a trend that requires ongoing vital signs and neuro checks, but it does not represent an immediate, high-risk deterioration that demands complex assessment or intervention. It fits the PN role of routine monitoring with escalation to an RN if the status worsens.

The other scenarios signal higher risk or complexity: new acute delirium requires thorough assessment to determine cause and management; uncontrolled seizures require continuous monitoring, seizure precautions, and potential emergency interventions; a patient needing multiple continuous IV medications involves complex IV management and monitoring, which typically surpasses the PN scope.