Prioritizing which client to see first

Question

1. The nurse is assigned to care for four clients. In planning client rounds, which client should the nurse assess first?
2. A client with asthma requested a breathing treatment during the previous shift.
3. A client is scheduled for a chest x-ray after inserting a nasogastric tube.
4. A client requiring daily dressing changes of a recent surgical incision.
5. A postoperative client preparing for discharge with a new medication.

Answer 1

The nurse should assess the client with asthma who requested a breathing treatment during the previous shift first. This is because airway and breathing problems are always the highest priorityin nursing. Asthma can worsen quickly and become life-threatening, so the nurse needs to address it before less urgent tasks.

The other clients are lower priority:

1. Scheduled chest x-ray – this can wait until the nurse finishes urgent assessments.
2. Daily dressing changes – important, but not immediately life-threatening.
3. Postoperative discharge teaching – also important, but can wait until urgent needs are addressed.

NCLEX tip: Always remember the ABCs—Airway, Breathing, Circulation. Clients with airway or breathing issues are assessed first, even if other tasks seem more “scheduled” or routine.

Answer 2

The answer would be A. C and D can be eliminated because they have nothing to do with airway, breathing, or circulation. B is an airway possibility but there is more dire need for A because the patient REQUESTED the inhaler, implying that they are currently having problems breathing.

Answer 3

The answer to this question is A. This is a prioritization NCLEX question. Basically who is the least stable client. Also ask yourself, if you can only see one client who will it be? The first thing you need to start with in a priority question is analyzing Maslow's Hierarchy of needs. The most important thing to start with in Maslow's is physical and then you analyze is there an ABC (Airway, breathing, circulation) physical need that is immediate. In this case the answer is yes, an asthma client's breathing is compromised. Also, this client requested a breathing treatment during the previous shift.