NCLEX Prioritization Questions: A Simple Strategy That Works
Nurseclex Editorial Team · Updated · 6 min read · Written around the NCSBN test plan
Short answer
For 'who do you see first' questions, apply the same ladder every time: airway, breathing, circulation; then unstable or unexpected changes before stable expected ones; then acute before chronic; then actual problems before potential ones.
Key takeaways
- ABC first — but only when an option is truly an airway or breathing problem.
- New and unexpected beats chronic and expected.
- Assess before you intervene, unless the stem already gives you assessment data.
- A 'potential' problem almost never outranks an actual one.
The priority ladder
Work down the ladder in order and stop at the first option that fits: airway, breathing, circulation; unstable versus stable; acute versus chronic; actual versus potential.
If two options both look urgent, ask which one kills fastest. Stridor, anaphylaxis and active hemorrhage sit at the top.
- A-B-C
- Unstable > stable
- Acute > chronic
- Actual > potential
- Unexpected > expected
Common traps
Post-op pain of 7/10 feels urgent but is expected; a silent drop in blood pressure is not. 'Call the provider' is rarely first when you can assess or act within scope.
Psychosocial answers win only when no physiological option is unstable — but safety (suicide risk, abuse) always competes at the top.
How to practice
Do small sets of prioritization questions daily and say your ladder out loud for each one. The goal is a habit, not a memorized list.
Practice questions
1. The nurse has four clients. Which should be assessed first?
Answer and rationale
Correct: B. A sudden SpO₂ drop is a new, unstable breathing problem — top of the ladder. The others are stable or expected.
Frequently asked questions
Is it always ABC?
ABC is the first filter, not the whole answer. If no option involves airway or breathing, move down the ladder to unstable versus stable.
Study these topics next
Keep going
Sources
All practice questions are original and are not actual exam items. NCLEX® is a registered trademark of NCSBN, which does not endorse this site.