Prioritization questions in the NCLEX RN exam can be challenging, but with the right strategies, you can tackle them effectively. Here are some key tips to remember:

1. Use the ABCs (Airway, Breathing, Circulation): Always prioritize issues related to airway, breathing, and circulation first. These are critical for patient survival.
2. Apply Maslow’s Hierarchy of Needs: Focus on addressing physiological needs (like oxygenation and hydration) before psychological needs (like emotional support).
3. Differentiate between acute and chronic conditions: Acute issues often take precedence over chronic conditions unless the chronic condition is exacerbating.
4. Stable vs. Unstable Patients: Prioritize unstable patients over stable ones.
5. Safety Risks: Always consider potential safety risks and prioritize interventions that prevent harm.
6. Read Each Option Carefully: Make sure to read all answer choices thoroughly before selecting the most appropriate one.
7. Practice, Practice, Practice: Familiarize yourself with different prioritization scenarios by practicing with sample questions.

Let’s understand in more depth:

ABCs (Airway, Breathing, Circulation)

• Airway: Check if the airway is open. If not, establish an airway.
• Breathing: Assess breathing. If it’s compromised, address the issue (e.g., provide oxygen).
• Circulation: Evaluate circulation. If there’s an issue (like bleeding or shock), treat it promptly.

Maslow’s Hierarchy of Needs

• This hierarchy starts with physiological needs (air, water, food) at the bottom and moves up to safety, love/belonging, esteem, and self-actualization. In prioritization, address the most basic needs first.
• For instance, if a patient is both anxious and has difficulty breathing, prioritize interventions to improve breathing first.

Acute vs. Chronic Conditions

• Acute Conditions: Sudden and severe (e.g., myocardial infarction, anaphylaxis). These often require immediate attention.
• Chronic Conditions: Long-term and managed over time (e.g., diabetes, hypertension). Prioritize acute exacerbations of chronic conditions.

Stable vs. Unstable Patients

• Stable: Vital signs are within normal limits, no immediate threat to life.
• Unstable: Vital signs are abnormal, there are significant changes, or there’s a potential threat to life. These patients need urgent care.

Safety Risks

• Consider interventions that prevent falls, medication errors, infections, etc.
• For example, if a patient is at risk of falling, prioritize measures to prevent that fall, such as bed alarms or proper use of assistive devices.

Reading Each Option Carefully

• Often, prioritization questions include subtle differences. Carefully read each choice to determine the best answer.
• Look for keywords that signal priority, like “immediate,” “first,” “urgent,” etc.

Practice

• Use practice questions to become familiar with different scenarios.
• NCLEX practice books and online resources can be beneficial for this.

Here is an example question to practice:

“A nurse is caring for four patients. Who should the nurse see first?”

1. A. A patient with chronic kidney disease with a potassium level of 5.0 mEq/L
2. B. A patient with COPD and an oxygen saturation of 88%
3. C. A patient with diabetes and a blood glucose level of 350 mg/dL
4. D. A patient post-op who is diaphoretic and restless

Correct Answer: D. A post-op patient who is diaphoretic and restless could be experiencing complications such as hypovolemia or shock and requires immediate assessment.