Two clients are admitted to the unit at the same time. One client is an older adult client with a possible overdose of acetaminophen who has a heart rate of 130 beats/minute and a blood pressure of 86/40 mm Hg. The other is an older adult client with a long history of chronic obstructed pulmonary disease (COPD) and a pulse oximeter reading of 80% oxygen saturation. Which assignment is the best use of available staff?

Choice A reason: Assigning the RN to admit the COPD client while the PN checks vital signs of the overdose client is unsafe. The overdose client is unstable, with tachycardia and hypotension, which requires immediate advanced assessment and interventions such as IV access, antidote administration, and hemodynamic monitoring. These are outside the PN’s scope of practice. Therefore, this option places the unstable client at risk. Choice B reason: The RN caring for both clients is the safest and most appropriate assignment. Both clients present with conditions requiring advanced nursing judgment. The overdose client is hemodynamically unstable, needing critical interventions, while the COPD client has severe hypoxemia (SpO₂ 80%), requiring titration of oxygen therapy and possible escalation of care. These interventions fall within the RN’s scope and require prioritization skills. Assigning the RN ensures both clients receive safe, appropriate care. Choice C reason: Assigning the PN to monitor the COPD client is inappropriate because the client’s oxygen saturation is critically low. Management requires advanced assessment, titration of oxygen, and evaluation for possible respiratory failure, which are RN responsibilities. The RN admitting the overdose client is appropriate, but leaving the COPD client to a PN compromises safety. Choice D reason: Assigning two PNs to admit both clients is unsafe. Both clients are unstable and require interventions beyond the PN’s scope of practice. Frequent vital signs alone are insufficient; advanced clinical judgment and interventions are needed. This option fails to provide safe care.