NCLEX Wednesday #9 – Priorities
Here’s your latest set of NCLEX study tips!
This week, we’re focusing on priority questions, which appear often on the National Council Licensure Examination. Priority questions can be tough. They’re meant to help you think critically, or to “think like a nurse,” which is a skill you will be using every day when assessing the needs of your patients. Using the right strategies when answering priority questions can help guide your decision-making toward the right answer every time.
As we mentioned in our NCLEX study tips post about delegation, you may not see priority questions when you take your exam, but they’re so common, you need to be prepared for them. So, without further ado, we present to you our weekly NCLEX study tip: advice on answering the tricky priority questions.
1. Remember: They might all be “right”
NCLEX priority-type questions often begin with phrases like “Which action should the nurse take first?” or “What is the priority nursing action?” The operative words here are “first” and “priority.” They’re tricky, because with questions like these, all answers are often correct actions. In the scenario, you may have to perform all of the actions, but these questions test your knowledge about which to perform before the others. Even if they all look like proper clinical actions, they may be, but one of these actions will take priority over the others.
Related Resource: Test-Taking Strategies for the NCLEX
2. Consider these categories
As you’re studying the answer options, the first thing you should do is consider them in light of three categories: client safety, the nursing process, and Maslow’s hierarchy of needs. Ask yourself: Which of these actions will immediately improve the patient’s safety? Considering the basic tenants of the nursing process, and remembering Maslow’s hierarchy of needs during the NCLEX, you can often narrow which action to take first on priority questions. This can make your deliberation over the options a lot less complicated.
3. Address physiologic first
At the bottom of Maslow’s hierarchy pyramid sits the physiological needs, because those are the most basic needs a person has to survive. In a given NCLEX scenario on priority questions, the client may be visibly distraught, and one of your answer options will probably involve calming her down. That’s important as a nurse, of course, but less so than physiology. Every time you come across priority questions, remember that according to Maslow’s hierarchy of needs, the client’s physiologic needs come before psychosocial needs. This is where the ABC’s (airway, breathing, circulation) come into play. Prioritize stabilizing your patient, if that action applies to the scenario.
Related Resource: How to Address Therapeutic Communication Questions on the NCLEX
As you’re weighing your options, Maslow’s pyramid can be invaluable, but it can also trick you. While the hierarchy of needs will apply to many questions throughout the NCLEX, physiological needs aren’t always pertinent to the scenario at hand, even on priority questions. When using the ABC framework, you should know “airway” is not always the correct answer, particularly if the question does not give you an airway problem. If airway and breathing are not the problem, then look to circulation and see if that applies. If it doesn’t, then look farther up the pyramid for a clue about which option takes priority.
5. Care should begin with the client
Client safety is of utmost importance when planning and implementing nursing care. This includes prevention of errors and accidents, standard precautions, and environmental safety. Client safety should take priority, so when analyzing NCLEX questions, think about first meeting the client’s basic needs (e.g., oxygen, nutrition, elimination). The answer to many priority questions is often the option that will benefit the client the most, even if it doesn’t involve direct nurse-to-patient treatment.
6. Assess first, unless…
When using the nursing process to answer questions, remember that the first step is assessment. Assessing the client and situation must be done first in order to plan and implement care. However, if in the question you receive data that indicates an assessment has already been done, it is now time to act! Read the stem of the question carefully to understand what is being asked. Is the question focusing on implementation or evaluation? This will help guide your answer.
We know nursing, and we know the NCLEX — that’s why we have one of the highest pass rates in all of Utah! After you pass the NCLEX, the learning never stops. Prioritizing situations is foundational to nursing, but you’ll continue to develop and refine skills and learn new information throughout your career. If you’re interested in further degrees, we developed our online RN-BSN degree completion program to fortify working nurses’ skills and improve patient outcomes.
– Cheryl Armstrong, MS, RN
– Britt Baer, RN, MSN-HCSM, SANE
About NCLEX Wednesday: Ameritech College of Healthcare’s NCLEX review course has helped our nursing students pass the NCLEX with flying colors. We’re spreading the love to all nursing students as part of a weekly series. For more NCLEX study tips, advice, and strategies, download our free NCLEX ebook. Nurses unite!