Which client is most appropriate to assign to an LPN/LVN?

Which client is most appropriate to assign to an LPN/LVN?

• A. Client with Cushing's syndrome who requires orthostatic vital signs assessments
• B. Client with diabetes mellitus who was admitted with a blood glucose of 45 mg/dL
• C. Client with exophthalmos who has many questions about endocrine function
• D. Client with possible pituitary adenoma who has just arrived on the nursing unit

Answer: (A)

The main idea is matching tasks to scope of practice and patient stability. An LPN/LVN is well suited for routine, ongoing monitoring on a stable patient, such as obtaining orthostatic vital signs to detect changes in volume status or autonomic response. The client with Cushing's syndrome who requires orthostatic vital signs assessments fits this: the task is a straightforward, repeatable monitoring activity that doesn’t require independent clinical decision-making. In contrast, the other scenarios involve situations that typically need a higher level of assessment, urgent intervention, or specialized education by an RN. A hypoglycemic event is a time-sensitive emergency where rapid evaluation and potential IV treatment or escalation are needed. A patient asking for detailed endocrine-function education involves more in-depth counseling and interpretation than a routine nursing task. A new admission with a suspected pituitary adenoma requires comprehensive admission assessment, history, and care planning, which are RN responsibilities.

The main idea is matching tasks to scope of practice and patient stability. An LPN/LVN is well suited for routine, ongoing monitoring on a stable patient, such as obtaining orthostatic vital signs to detect changes in volume status or autonomic response. The client with Cushing's syndrome who requires orthostatic vital signs assessments fits this: the task is a straightforward, repeatable monitoring activity that doesn’t require independent clinical decision-making.

In contrast, the other scenarios involve situations that typically need a higher level of assessment, urgent intervention, or specialized education by an RN. A hypoglycemic event is a time-sensitive emergency where rapid evaluation and potential IV treatment or escalation are needed. A patient asking for detailed endocrine-function education involves more in-depth counseling and interpretation than a routine nursing task. A new admission with a suspected pituitary adenoma requires comprehensive admission assessment, history, and care planning, which are RN responsibilities.