Patient Prioritization Practice Questions & NCLEX Review (2024)

Prioritization of client care is a crucial skill for nurses. Once you have the knowledge and skills necessary to take care of clients (patients), you need to know how to prioritize who needs the care most and first.

Patient Prioritization Practice Questions with Answers and Practice Questions

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    Introduction to Prioritization in Nursing

    Client prioritization for nurses is a complex, multi-step process that involves an in-depth analysis of each individual’s needs and goals. Assessment is key in determining each client’s current state, as well as their future goals and potential outcomes.

    Nurses (and other staff) are often tasked with prioritizing clients in their care, from the most to least urgent. Prioritization helps utilize limited time and resources to provide the best possible care for clients.

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    ABC’s of Patient Prioritization

    ABC stands for Airway, Breathing, and Circulation. As a nurse, your first job is to remember that these ABCs are the highest priority.

    Maslow’s hierarchy of needs is another tool to help guide the nursing process. Maslow’s is a pyramid of needs. For example, a client with physiologic needs takes priority over love and belonging.

    Maslow’s guides nurses to prioritize client care using an organized approach:

    • Physiological needs
    • Safety needs
    • Love and belonging needs
    • Esteem needs
    • Self-actualization

    Here are some helpful guidelines to assist with the prioritization of clients:

    Airway = blockage

    • Stridor “squeak” – Postoperative Thyroid / Parathyroid
    • Anaphylaxis: throat swelling – Epipen 1st!
    • Ruptured esophageal varices – Turn to side-lying position

    Breathing = RR & Oxygenation

    • Low PaO2 (Norm: 80 – 100)
      • 60 or less = HypOXemic Respiratory failure
    • High CO2
      • 50 or MORE = HyperCapnic Respiratory failure
    • Hypoxia
      • Change LOC: Level of consciousness
      • Mental changes: Restless, agitation
      • Skin: Pale, dusky, cool & clammy
    • SpO2% (Norm: 95 – 100%)
      • COPD – Low 90% is normal]

    Circulation

    • Bleeding:
      • Internal:
        • Hypotension “Low BP”
        • Hard stiff “board-like” abdomen
        • Skin: Pale, dusky, cool & clammy
      • Coagulation:
        • Platelets (norm: 150k – 400k)
          • Less than 150k – Thrombocytopenia
          • Less than 50k – VERY RISKY!
        • Heparin: PTT 46 – 70
        • Warfarin: INR 2 – 3
          • 3 x MAX range

    Signs of Infection:

    • Fever (this is sometimes the only sign of an infection).
    • Chills and sweats.
    • Cough
    • Sore throat
    • Difficulty breathing
    • Nasal congestion
    • Redness, or swelling in any area, including surgical wounds and IV access
    • Burning or pain with urination
    • Unusual vagin*l discharge or irritation
    • New onset of pain
    • WBC over 10,000 or less than 1,500

    Clients at Increased Risk of Infection:

    • Neutropenic clients
    • Clients receiving Chemotherapy, Immunosuppressants

    Pain

    Pain is on the lower end of the prioritization list since it is not always fatal. As a nurse, you must understand that prioritization is always based on choosing the client with a higher chance of dying. Pain can be managed, and the discomfort can be tolerated for a certain period of time.

    Memory Trick – Lose life or limb

    • Chest Pain = number one priority
    • Cast or broken limb pain = pain unrelieved with pain meds

    Labs in Patient Prioritization

    • Low glucose
        • Less than 70 “Hypoglycemia”
        • Hypogly = Brain will DIE!
    • Kidney complications
        • Creatinine OVER 1.3 = Bad kidney!
        • Urine output 30 ml/hr or less = Kidneys in distress
        • CT contrast
        • Antibiotics: Vancomycin & Gentamicin
    • Toxic lab levels
      • Lithium 1.5 +
      • Digoxin 2.0 +
      • Theophylline 20 +
      • Phenytoin 20 +

    In prioritizing client care, things to consider are:

    • How will this affect the client if they are not taken care of immediately?
    • Are there tasks that can be delegated safely?
    • What can I do alone without the help of other staff?

    Client safety and nursing judgment go hand in hand with making key prioritization decisions.

    Patient Prioritization Practice Questions & NCLEX Review (2)

    Amy Stricklen

    Patient Prioritization Practice Questions & NCLEX Review (3)

    During my exam, I could literally see and hear him going over different areas as I was answering my questions.

    This past Friday I retook my Maternity Hesi and this time, I decided for my last week of Holiday break to just watch all of his OB videos. I am proud to say that with Mike’s help I received a score of 928 on my Maternity Hesi!

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    Patient Prioritization Practice Questions & NCLEX Review (4)

    Amy Stricklen

    Prioritization in Nursing Conclusion

    Patient prioritization is a multi-step process involving a complicated analysis of each client’s needs and goals. Nurses need to assess each client’s current state and future goals in order to figure out which clients are most likely to benefit from additional attention.

    The ABCs of patient prioritization are Airway, Breathing, and Circulation, which are the three things that must be addressed in any medical situation.

    Sources

    https://online.marymount.edu/blog/abcs-nursing-prioritization

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    Patient Prioritization Practice Questions & NCLEX Review (11)

    Patient Prioritization Practice Questions & NCLEX Review (2024)

    FAQs

    Is prioritization a hard question in NCLEX? ›

    Priority and delegation tend to be higher level questions because (for the most part) it assumes by a certain point that you have enough knowledge to answer them. Of course, you have to get them right, not just get them ?

    How to prioritize patients in NCLEX? ›

    Nurses need to assess each client's current state and future goals in order to figure out which clients are most likely to benefit from additional attention. The ABCs of patient prioritization are Airway, Breathing, and Circulation, which are the three things that must be addressed in any medical situation.

    What is an example of patient prioritization? ›

    For example, if the nurse enters the patient's room and discovers the patient is experiencing increased shortness of breath, nursing interventions to improve the patient's respiratory status receive top priority before attempting to get the patient to ambulate.

    Can you fail the NCLEX in 89 questions? ›

    You must get at least 85 questions correct, or achieve a 95% confidence level, to pass the NCLEX.

    What is the hardest part of the NCLEX? ›

    The hardest questions on the NCLEX often require a deep understanding of nursing theory, pharmacology, pathophysiology, and nursing interventions. They may present complex clinical scenarios involving multiple patients or require you to identify the best course of action when faced with conflicting information.

    What kind of questions are considered hard on NCLEX? ›

    Higher-level questions that you'll encounter on the NCLEX will expect you to take the info presented and analyze or evaluate the info to make a decision or form a connection. For example, a question may ask you to make a connection between a person's diet and their specific health symptoms or issues.

    Is there a trick to answering NCLEX questions? ›

    Pay attention to critical keywords in the question and answers. Words like “first,” “initial,” “best,” and “most important” can guide you toward the correct choice. Look for Grammatical Inconsistencies. Eliminate answers that do not fit grammatically with the question stem.

    Does priority mean first or best NCLEX? ›

    You will recognize priority questions on the NCLEX-RN® exam because they will ask you what is the “best,” “most important,” “first,” or “initial response” by the nurse.

    What are the 4 P's of nursing prioritization? ›

    What are the 4 ps to remember in prioritization? Purpose for care, current clinical picture, plan according to desired outcomes or results, part played by each team member for delegation or assignment.

    What are the ABCs of prioritization? ›

    Prioritizing care is determining which needs require immediate attention and which can be delayed until a later time because of less urgency.

    What are the key words in NCLEX questions? ›

    An NCLEX® question may ask the reader to address priority by using words such as first response, most important, best, etc. In other words, which answer choice is the most correct?

    What are 3 nursing priorities for patient care? ›

    Because of the importance of recognizing clinical deterioration in a client, a nurse must always be attuned to the set of physiological needs that are important to maintain life and prevent death. These priorities of care are related to the ABCs – airway, breathing, and circulation – introduced above.

    How to determine patient priority? ›

    Generally, you want to focus first on things that must be addressed right away (to prevent serious illness or harm). Then you can move on to things that should be addressed soon, and after that, issues to treat in the near future.

    What are examples of priority 1 patients? ›

    Triage Scale priorities Description Examples Priority 1 Immediately life-threatening Cardiac or respiratory arrest.

    Why is prioritization so hard? ›

    A lack of clear goals is a common obstacle to effective prioritization. Without a clear sense of direction, it becomes difficult to determine what tasks and activities are most important.

    What is considered an easy question on the NCLEX? ›

    NCLEX questions and their difficulty levels are based off of Bloom's Taxonomy. Easier questions assess your ability to recognize, remember, and understand information. Tougher questions ask you to do things like apply or analyze information.

    What does priority mean in NCLEX questions? ›

    Prioritization questions on the NCLEX challenge test-takers to make critical decisions about patient/client care. These questions test the ability to prioritize tasks and manage care efficiently, reflecting real-world scenarios nurses encounter.

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