Which pediatric patient is most appropriate to assign to a newly graduated registered nurse?

• A. Adolescent with sickle cell disease on escalating PCA opioids
• B. Child requiring premedication before reduction of a fracture
• C. Child with end-of-life cancer on around-the-clock narcotics with decreasing alertness
• D. Child with chronic pain whose regimen was recently changed and mother is anxious

Answer: (B)

The main idea is that a newly graduated RN should be assigned to stable, predictable tasks that involve routine care and clear expectations, with supervision available. Administering premedication for a procedure like a fracture reduction fits this best because it’s a planned, straightforward nursing intervention. It involves standard analgesia before a procedure, requires monitoring for common, anticipated side effects, and can be carried out using established protocols with supervision.

The other scenarios involve higher risk or more complex needs: escalating PCA opioid use in an adolescent with sickle cell is unpredictable and demands close, expert assessment for potential respiratory and comfort issues; a child with end-of-life cancer on continuous narcotics and decreasing alertness requires critical-care level monitoring and decision-making; a child with chronic pain and a recently changed regimen plus parental anxiety can involve multifaceted assessment, education, and coordination that are better suited to a more experienced nurse.