| Course | NSG 233 Medical-Surgical Nursing III |
|---|---|
| Unit | Unit 5 |
| Paper type | Acuity ranking and assignment exercise |
| Length | About 720 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 233 Unit 5
Four Adults at 0700, One Registered Nurse, One Practical Nurse, One Assistant: An Acuity Ranking With Every Task Assigned and the Reason for Each
Student Name
Department of Nursing, Herzing University
NSG 233: Medical-Surgical Nursing III
Instructor Name
February 13, 2026
Four Adults at 0700, One Registered Nurse, One Practical Nurse, One Assistant: An Acuity Ranking With Every Task Assigned and the Reason for Each
The Four Adults
All four are composites on a medical-surgical floor at the start of a day shift.
A. The 79-year-old woman from Units 1 to 4, transferred back from step-down last evening after treatment of a hyperosmolar crisis and fluid overload. Glucose 180 to 220 on subcutaneous insulin; saturation 94% on 2 L; weight down 1.8 kg since the diuretic. Oriented to place, not to date.
B. A 58-year-old man, day 1 after laparoscopic gallbladder removal, pain 3 of 10, eating, walking, planned for discharge by noon if he voids.
C. A 66-year-old woman with a bowel obstruction treated without surgery, nasogastric tube to suction, potassium 3.2 this morning, abdomen more distended than last night per the night nurse.
D. An 88-year-old man with dementia admitted for a urinary infection, now afebrile for 24 hours, eating with help, awaiting a nursing-home bed.
The Ranking
Positions are earned by the finding that most threatens the patient in the next few hours.
| Rank | Patient | Finding that earned the position |
|---|---|---|
| 1 | C | A distending abdomen overnight with a potassium of 3.2: possible worsening obstruction, and low potassium slows the bowel and affects heart rhythm; both could change within hours |
| 2 | A | Recovering from two serious events in 48 hours; still on oxygen and insulin, and her mental state is the earliest sign of trouble in her |
| 3 | D | Stable, but at high risk of falls, aspiration while eating, and delirium; needs frequent contact, not complex assessment |
| 4 | B | Stable and improving; the main task is discharge teaching and confirming that he has voided |
The Work of the Shift, Line by Line
Each line names who does it and why that role, based on the national delegation guidelines, which allow tasks to be delegated when they are within the person's training and the patient's condition is stable and predictable, while assessment and evaluation stay with the registered nurse (National Council of State Boards of Nursing [NCSBN] & American Nurses Association, 2016).
C, assess the abdomen, nasogastric output, and potassium trend, and report to the provider by 0800: registered nurse. Assessment of a changing patient cannot be delegated.
C, administer intravenous potassium replacement as ordered: registered nurse, because C is not stable and the infusion requires ongoing assessment.
A, morning assessment including mental status against her baseline and lung sounds: registered nurse.
A, scheduled oral medications and subcutaneous insulin after the registered nurse's morning assessment: licensed practical nurse, since her condition has now been assessed as stable enough; Wisconsin's standards of practice, used by this program, describe practical nurses as performing acts in basic patient situations under the general supervision of a registered nurse (Wisconsin Board of Nursing, 2025).
A, glucose checks before meals and daily weight: nursing assistant, with instructions to report any glucose below 70 or above 300 and any weight change of more than 1 kg, since both are routine measurements in a stable patient.
D, feeding assistance at breakfast and lunch, with the swallowing precautions on the care plan: nursing assistant, trained and competent in these precautions; to report coughing or choking at once.
D, scheduled oral medications and a mid-morning check of his mental state against yesterday's note: licensed practical nurse, reporting any change to the registered nurse.
B, confirm voiding and complete vital signs: nursing assistant.
B, discharge teaching and final assessment: registered nurse, because teaching a patient to recognize complications at home and deciding he is ready to leave require the registered nurse's judgment.
All four, hourly rounding for comfort, toileting, and position: nursing assistant, with the registered nurse rounding on C and A as well.
The Registered Nurse's Hour-by-Hour Plan
The assignments above leave the registered nurse with four pieces of work that no one else can do, and their order follows the ranking: C's assessment and report by 0800, A's assessment by 0830, the potassium infusion started for C once ordered, and B's discharge teaching mid-morning. Everything delegated comes back to the registered nurse as a report, and the times for those reports are set at the start of the shift: the assistant reports A's pre-breakfast glucose and weight by 0745 and D's breakfast by 0830; the practical nurse reports D's mental-status check by 1030. Setting the report times in advance is what keeps delegation from becoming a hope that someone will mention a problem.
What Would Change the Ranking
If C's abdomen settles and potassium rises, A becomes first. If A becomes more confused or her oxygen need rises, she moves above C. If D coughs at breakfast, he rises above A for the next hour. The ranking is a starting point that is revisited at 1000 and at every change, as the course text describes for managing care of several patients (Hinkle et al., 2022).
References
Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth's textbook of medical-surgical nursing (15th ed.). Wolters Kluwer.
National Council of State Boards of Nursing & American Nurses Association. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3
Wisconsin Board of Nursing. (2025). Standards of practice for registered nurses and licensed practical nurses (Wis. Admin. Code ch. N 6). Wisconsin Legislature. https://docs.legis.wisconsin.gov/code/admin_code/n/6
Reading the NSG 233 Unit 5 instructions
Unit 5 asks you to rank several patients by acuity and assign tasks across a team. Expect to describe each patient, rank them by the finding that most threatens each soon, assign every task to the right role with a reason, plan the registered nurse's time and name what would change the ranking. Students often ask how to rank patients who are all unwell and how to split tasks between an LPN and an assistant. Rank by threat in the next few hours, not by diagnosis. Assessment and evaluation of unstable patients stay with the registered nurse. Practical nurses can give many routine medications within state scope. Assistants handle routine care with clear reporting triggers. An hour-by-hour plan shows the registered nurse can actually do what was kept. Name the change that would reorder the list.
How the NSG 233 Unit 5 example is put together
The exercise opens with four short patient pictures. The ranking section places each with the finding that earned its position. The task section lists every piece of work in the shift with the role assigned and the reason, such as glucose checks to the assistant with a reporting threshold. The registered nurse's plan maps her kept tasks onto the first hours, showing they fit. The final section names findings that would move patients up or down. Each assignment refers to delegation criteria, so the reader can check the reasoning. The exercise reads as a real start-of-shift plan rather than a textbook list.
Reading the NSG 233 Unit 5 rubric
Herzing's rubric for an acuity ranking exercise usually covers patient descriptions, the ranking and its reasons, task assignment, the registered nurse's plan and triggers for change. Rankings tied to the most threatening finding carry the most weight, since graders want position earned by data rather than by diagnosis or age. Patient points reward concise, relevant findings. Assignment criteria look for tasks matched to scope, with assessment kept by the registered nurse. Plan points go to an hour-by-hour schedule that fits. Triggers earn credit when specific. Reporting thresholds for delegated tasks are often credited. A clear table helps. The NCSBN and ANA delegation guidelines support the assignments.
Common NSG 233 Unit 5 mistakes, and how to avoid them
Acuity exercises in Unit 5 often slip by ranking patients by diagnosis rather than current findings. Another frequent problem is assigning assessment of an unstable patient to a practical nurse or assistant. Students often skip reporting thresholds for delegated tasks. The registered nurse keeps more work than one person could do in the first hours. Triggers for reranking are missing. Practical nurse scope is guessed rather than checked against state rules. Potassium and other labs are not used in the ranking. Breaks and admissions are ignored. Finally, show the registered nurse's hour-by-hour plan, because graders reward an exercise that proves the kept work fits the shift.
Get a NSG 233 Unit 5 example written to your instructions
Send the Unit 5 instructions and your NSG 233 rubric, together with the assignment sheet if the case provides one. The example returns with matched patient paragraphs, a ranking table carrying a finding per position, work split into assignable lines with reasons attached, and a reordering paragraph. First custom sample free, returned in 24 to 48 hours.
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- NSG 233 Unit 6: High acuity case file
- NSG 233 Unit 7: Urgent report script
- NSG 233 Unit 8: Unstable patient timeline
- NSG 122 Unit 5: Patient needs ordering brief
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- NSG 126 Unit 5: Citation and reference set
NSG 233 Unit 5 questions, answered
How do I know what each role can be given?
From material your section has covered and the state or facility sources your instructions point at, since the answer differs by state and by setting. Cite what you use and say which setting the exercise assumes. We write examples keeping that citation visible and leave the specific scope of practice for you to supply from your own course.
Should the sickest patient always rank first?
Rank by what needs attention soonest rather than by who is most unwell overall, and say which of those two you are using. A stable adult with a long-standing severe condition may need less of the next twenty minutes than someone whose picture has just moved. Naming your basis for the order is usually worth more than the order itself.
Can I use my own clinical assignment?
No. Invent four adults with the contrasts your ranking needs and note in a line that they were drawn up for the sheet. The group you actually looked after belongs to those people and that facility, and a built set lets you place the specific comparison the table needs rather than whatever the floor happened to give you.
Where can I find a free NSG 233 Unit 5 sample paper?
The full NSG 233 Unit 5 acuity ranking is free on this page, four patients ranked with every task assigned to a role. Your own patient group can be ranked the same way on request.
How do nurses rank patient acuity at the start of a shift?
By the finding that threatens each patient most in the next few hours, such as a distending abdomen with a rising heart rate. This sample ranks four patients that way and assigns tasks across a three-person team.