If you’ve taken an NCLEX practice test recently, you’ve probably noticed that prioritization questions are everywhere. They test your ability to identify which patient is the most critical and should be seen first. These aren’t just memory-based questions—they require critical thinking and clinical judgment.

So, how do you consistently pick the right answer?

What Are Prioritization Questions?

Prioritization questions ask:
“Which patient should the nurse assess first?”
“Who is the most at risk?”
“What should the nurse do next?”

These questions challenge your understanding of:

• The severity of patient conditions
• Nursing scope of practice
• Clinical urgency
• Safety and delegation

Key Frameworks That Help You Succeed

1. The ABCs: Airway, Breathing, Circulation

This is the #1 framework to apply:

• Airway obstruction? Always first.
• Breathing difficulty? Second priority.
• Circulation issues (bleeding, hypotension)? Third.

Example:
Choose the patient with signs of airway obstruction (e.g., stridor) over one with a low-grade fever or mild pain.

2. Maslow’s Hierarchy of Needs

After ABCs, use Maslow’s pyramid to rank basic physiological needs (food, water, sleep) before emotional or social ones.

3. Acute vs. Chronic Conditions

• Patients with acute changes take priority over those with stable chronic illnesses.
• A new onset of confusion beats chronic COPD with normal vitals.

4. Actual vs. Potential Problems

Address actual symptoms before risk factors.

• Treat pain and shortness of breath before worrying about fall risk (unless urgent).

5. Safety and Infection Control

• Patients in isolation precautions or with contagious conditions should be placed in rooms that prevent spread.
• Prioritize post-surgical patients for complications.

Common NCLEX Mistakes to Avoid

• Choosing the most stable patient instead of the most critical.
• Ignoring subtle signs of deterioration (like new confusion or restlessness).
• Forgetting about the ABC framework and being distracted by lab values or history.
• Failing to consider delegation rules—what can be done by a nurse vs. UAP or LPN.

Example Question Breakdown

Question:
You are caring for four patients. Who should the nurse assess first?

A. A client with diabetes reporting foot numbness
B. A client 1 hour post-op with a blood pressure of 88/56
C. A client with pneumonia who needs to ambulate
D. A client with a pressure ulcer needing a dressing change

Correct Answer: B
This client shows signs of hypotension and potential bleeding or shock—critical and urgent.

Tips to Practice Prioritization Skills

• Practice daily with case-based NCLEX-style questions.
• Review real patient scenarios in your study group.
• Use clinical judgment frameworks (like NCSBN’s CJMM).
• Focus on the why behind your answer, not just memorizing the answer itself.

Final Thoughts

Prioritization questions are a high-yield topic on the NCLEX. The more you practice using structured frameworks like ABCs, Maslow, and clinical cues, the more confident you’ll be when it matters most.

Train your brain to think like a nurse. That’s what the NCLEX is really testing.