The RN charge nurse of a 24-bed medical unit is making shift assignments for 2 experienced registered nurses (RN), 1 graduate registered nurse, 1 practical nurse (PN), and 2 unlicensed assistive personnel (UAP). Which client should the nurse assign to the most experienced RN?

A. The 28-year-old who is being prepared for a laparoscopic cholecystectomy this morning: A client preparing for a laparoscopic cholecystectomy is stable and undergoing routine preoperative preparation such as vital signs monitoring, preoperative teaching reinforcement, and checklist completion. These tasks could appropriately be assigned to a graduate RN. B. The 72-year-old admitted with urosepsis who is being transferred to a skilled unit today: Although urosepsis can be a serious condition, a client being transferred to a skilled unit indicates that the condition has stabilized enough to allow step-down care. The primary nursing needs at this stage do not necessarily require the highest level of clinical expertise. C. The 48-year-old with advanced cancer who has requested not to be resuscitated: Caring for a client with a do-not-resuscitate (DNR) order involves respecting end-of-life preferences, symptom management, and communication with the healthcare team. While this requires sensitivity and professionalism, the care needs may be relatively stable and predictable. D. The 36-year-old admitted with angina who has a history of coronary artery disease: A client with active angina and known coronary artery disease carries a significant risk for acute coronary syndrome, myocardial infarction, and sudden deterioration. Continuous assessment is essential. The potential for rapid clinical instability makes this client most appropriate for assignment to the most experienced RN.