The National Council Licensure Examination (NCLEX) is designed to test your ability to think critically and apply nursing knowledge in real-world scenarios. Among the most challenging question types in the NCLEX are prioritization and delegation questions. These require you to determine which patient needs immediate care, what tasks can be safely assigned to other healthcare team members, and how to effectively manage time and resources.
If you’re preparing for the NCLEX, mastering these questions is crucial. In this blog, we’ll break down prioritization and delegation, provide key strategies, and offer practice scenarios to help you ace this section with confidence.
Understanding Prioritization Questions
Prioritization questions ask you to decide which patient requires the most urgent intervention. The key principles that guide these decisions include:
1️⃣ The ABCs: Airway, Breathing, Circulation
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Always prioritize airway first, followed by breathing and circulation.
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If a patient has a compromised airway, they must be treated before someone with a broken bone or fever.
💡 Example:
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Patient A: A 45-year-old with asthma who is wheezing and has an oxygen saturation of 88%.
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Patient B: A 60-year-old with a leg fracture and a pain level of 7/10.
✅ Who gets priority? Patient A needs immediate intervention to improve oxygenation.
2️⃣ Maslow’s Hierarchy of Needs
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Maslow’s theory prioritizes basic physiological needs before psychological or social concerns.
🛑 High priority: Oxygenation, pain, elimination, and nutrition.
⚠️ Medium priority: Safety, security, and psychosocial concerns.
✅ Low priority: Emotional support, self-esteem, or education needs.
💡 Example:
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Patient A: A 72-year-old with pneumonia who is short of breath.
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Patient B: A 30-year-old anxious about an upcoming surgery.
✅ Who gets priority? Patient A (physiological needs) before Patient B (psychological needs).
3️⃣ Acute vs. Chronic Conditions
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Acute conditions (sudden onset, life-threatening) take priority over chronic conditions (long-term, stable).
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Patients with unexpected changes need immediate assessment.
💡 Example:
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Patient A: A diabetic patient with a blood sugar of 500 mg/dL and confusion.
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Patient B: A hypertensive patient with a BP of 140/90, reporting no symptoms.
✅ Who gets priority? Patient A (acute emergency) over Patient B (stable condition).
4️⃣ Actual vs. Potential Problems
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Always prioritize actual problems over potential ones.
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A patient actively deteriorating should be seen before one who might develop complications later.
💡 Example:
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Patient A: A post-op patient with a heart rate of 120 bpm and hypotension.
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Patient B: A patient with a history of stroke who is due for physical therapy.
✅ Who gets priority? Patient A (actual issue: tachycardia and low BP) over Patient B (potential rehab need).
Understanding Delegation Questions
Delegation is an essential skill for nurses, ensuring that tasks are assigned appropriately to licensed practical nurses (LPNs), unlicensed assistive personnel (UAPs), or other team members.
💡 Golden Rules:
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RNs handle assessment, planning, and critical decision-making.
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LPNs can perform basic interventions and monitoring but cannot assess or initiate care plans.
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UAPs assist with routine, stable patient care tasks but cannot perform clinical judgment tasks.
Common Delegation Scenarios
💡 Example: Who can take vital signs for a stable post-op patient?
✅ Answer: UAP (Unlicensed Assistive Personnel) – this is within their scope.
💡 Example: Who can reinforce education on insulin administration?
✅ Answer: LPN – while LPNs can reinforce teaching, the RN must do the initial education.
💡 Example: Who can assess a patient admitted with chest pain?
✅ Answer: RN – Only the RN can perform initial assessments and determine interventions.
Strategies to Master NCLEX Prioritization & Delegation Questions
🔥 Follow the Nursing Process (ADPIE) – Assess before you intervene.
🔥 Eliminate Wrong Answers First – If an option suggests an LPN or UAP doing an RN task, eliminate it immediately.
🔥 Think About Patient Safety First – If there’s a risk of harm, that patient is your priority.
🔥 Use Common Sense – If a question seems tricky, go back to the ABCs and Maslow’s Hierarchy.
Final Thoughts
Prioritization and delegation questions can be challenging, but with the right strategies, you can tackle them confidently. By mastering ABCs, Maslow’s Hierarchy, acute vs. Chronic conditions, and appropriate delegation, you’ll be well-prepared for these high-scoring NCLEX questions.
At Nurse Assist International (NAI), we specialize in NCLEX coaching that simplifies complex concepts, helping you succeed with confidence. With high success rates and expert instructors, we’re here to guide you every step of the way.
💡 Ready to conquer the NCLEX? Enroll in NAI’s NCLEX review program today and take one step closer to your RN dream!