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The ScrubNerdHQ Priority Framework

ABCs: Airway > Breathing > Circulation
Safety: Risk for falls, infection, or injury
Maslow's: Physiological needs come after safety
Unstable vs. Stable: New/unexpected changes are priority

Question 1

A nurse is receiving report on four clients. Which client should the nurse assess FIRST?

A. Chronic COPD, O2 sat 89%

B. 2h post-op cholecystectomy, 8/10 pain

C. DVT reporting sudden shortness of breath

D. Fractured femur awaiting PT

✅ Correct: C

Sudden SOB in DVT suggests Pulmonary Embolism (ABC emergency).

Question 2

Which client is the priority after change-of-shift report?

A. Blood glucose 250 mg/dL

B. Tracheostomy with thick green secretions

C. Casted leg, "pins and needles" and extreme pain

D. Scheduled for colonoscopy in 2h

✅ Correct: C

Signs of Compartment Syndrome (Neurovascular emergency).

Question 3

Which situation requires IMMEDIATE intervention?

A. Chest tube with 50 mL drainage in last hour

B. HR 110 bpm after walking

C. IV site red and warm

D. Asthma history, suddenly restless using accessory muscles

✅ Correct: D

Restlessness is an early sign of hypoxia (ABC emergency).

Question 4

Using Maslow's, which client need is addressed FIRST?

A. Asking for PRN sleep med

B. Crying/afraid of diagnosis

C. No BM in 3 days

D. Choking on food

✅ Correct: D

Choking is an immediate threat to survival (Physiological/ABC).

Question 5

Which client is "Unstable"?

A. Temp 101F two days post-op

B. BP 90/50 mmHg just returned from surgery

C. ESRD, Potassium 5.1 mEq/L

D. History of seizures, currently sleeping

✅ Correct: B

Hypotension post-op suggests hemorrhage/shock (Unstable).

Question 6

Which client should be seen FIRST?

A. Chest pain radiating to left arm

B. UTI requesting pain med

C. Diabetes needing insulin before breakfast

D. Scheduled for discharge in 1h

✅ Correct: A

Potential MI (Circulation emergency).

Question 7

Which post-op client requires IMMEDIATE attention?

A. Temp 99.2F

B. Incisional pain 6/10

C. Respiratory rate 8 breaths/min

D. Requesting assistance to bathroom

✅ Correct: C

Bradypnea indicates respiratory depression (Breathing emergency).

Question 8

ED Triage: Which client is seen FIRST?

A. Hand laceration, bleeding controlled

B. Stridor and difficulty swallowing after bee sting

C. Sprained ankle with swelling

D. Nausea/vomiting for 24h

✅ Correct: B

Stridor indicates airway obstruction/anaphylaxis (Airway emergency).

Question 9

Which client is HIGHEST risk?

A. Pneumonia receiving IV antibiotics

B. CKD, Creatinine 3.2 mg/dL

C. Type 2 Diabetes, glucose 180 mg/dL

D. New onset confusion, glucose 45 mg/dL

✅ Correct: D

Severe hypoglycemia + altered mental status (Safety risk).

Question 10

Assess FIRST after morning report?

A. New tracheostomy coughing up blood-tinged mucus

B. COPD, O2 sat 90%

C. Heart failure, gained 2 lbs overnight

D. Wound infection requesting dressing change

✅ Correct: A

New trach bleeding could indicate major vessel erosion (Airway emergency).

Question 11

Which client receives care FIRST?

A. Stable angina requesting nitro

B. Pressure injury needing dressing change

C. Sudden severe headache and blurred vision

D. Scheduled for PT in 30 min

✅ Correct: C

Potential stroke or hypertensive crisis (Unstable/Circulation).

Question 12

Which client should the nurse see FIRST?

A. Chronic pain requesting med

B. Potassium level 6.8 mEq/L

C. Sodium level 148 mEq/L

D. Hemoglobin 10.5 g/dL

✅ Correct: B

Severe hyperkalemia causes cardiac arrhythmias (Circulation emergency).

Question 13

Assess FIRST using ABC framework?

A. Pulse ox 85% on room air

B. BP 160/95 mmHg

C. Urine output 20 mL in last hour

D. Temp 102.5F

✅ Correct: A

Severe hypoxemia (Breathing emergency).

Question 14

Which requires IMMEDIATE intervention?

A. Pneumonia with productive cough

B. Hip fracture reporting 7/10 pain

C. Diabetes ate 50% of breakfast

D. Blood transfusion reporting back pain and chills

✅ Correct: D

Hemolytic transfusion reaction (Life-threatening emergency).

Question 15

HIGHEST priority?

A. Stage 2 pressure injury

B. Fell, unresponsive, GCS of 6

C. Constipation requesting laxative

D. Arthritis requesting assistance

✅ Correct: B

Severe impairment, risk for airway obstruction (Airway/Safety).

🛡️ NCLEX Priority Drill

The ScrubNerdHQ Priority Framework

🎯 Quiz Complete!