Please Need Help: Prioritization Asap!

  1. I took my nclex-pn and it was mostly prioritization, which patient to attend to first, NOT what action to do first.....I failed. ...I need help learning and understanding about pt prioritization Please if anyone can help me learn or have advice for me. :trout: Please! Please! Please! I am taking my test again soon and I still haven't learned how to answer the questions correctly to practice. ANY ADVICE PLEASE TO PRIORITIZE WHICH PATIENT TAKES FIRST, SECOND, THIRD PRIORITIZATION>>>>ADVICE PLEASE OR RECOMMENDATIONS>>>>
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  2. 3 Comments

  3. by   Crocuta
    There are a couple of ways to approach this problem. Maslow's hierarchy of needs is a good place to start. Remember Maslow's theory as a pyramid in which you must satisfy all lower needs before building the next level.

    From bottom to top:
    Physiological - breathing, pumping blood, hunger
    Safety - physical security, emotional security,
    Social - friends, relations with others
    Self-esteem - need to be respected
    Self-Actualization - becoming a better person for reasons of one's own

    Like I said, it's a good place to start, but I don't recall NCLEX questions being that cut and dried. The example patients are usually all have physiologic needs.

    So, you have to break it down further. First, remember that your priorities may not be the patient's priorities. If there is any indication that the patient has any opinions on what his priorities are, you'll have to take that into consideration.

    Highest priority patients have conditions which are or will be life threatening without immediate intervention. Within this category rank according to the ABC's:
    Airway
    Breathing
    Circulation

    For example, the 8yo patient with high pitched stridor is a higher priority than the 60yo patient with an acute MI. Patient #2 has an airway; patient #1 might not have one for long if you don't do something. The 45 yo drug addict with a respiratory rate of 6 is a higher priority than the 27yo businessman with profuse bleeding from a 3 inch wrist laceration.

    You should be able to answer most questions by applying the ABC's. If you have to go on, next come non-emergency/non-life threatening conditions followed lastly by those issues which do not directly relate to the patient's illness.

    Do you have some specific study questions with four example patients that you're having trouble understanding why one would have higher priority than the others?
  4. by   GatorRN
    Great advice above. I would also suggest, if you don't already have one, getting a NCLEX review book and focus on the areas you know are your weakest. I highly recommend the Saunders NCLEX Review book. It's a large book with hundreds of sample questions that give you the rationales behind the right answers. It comes with a disk for your computer that you can test yourself with on specific areas. It's an excellent review book/CD.

    Pay close attention to the rationales as to why one answer is the MOST correct answer. The trick with the NCLEX is to pick out the answer that is MOST correct. All the choices given may be correct, to some degree, but one is more inclusive. It's testing your critical thinking skills, by demonstrating your understanding of the rationales behind your actions. Read the questions very carefully. Watch for key words such as, FIRST, EXCEPT, NOT DO etc... Be sure you get a good nights sleep the night before your test, and have a good breakfast.

    There is a student nurses forum here at allnurses, and I believe one specifically for NCLEX as well, if you haven't already found it. I'm sure you can find some helpful suggestions there too. Best of luck on your test! Welcome to allnurses.
  5. by   RN mom of 2
    Airway
    Breathing
    Circulation

    This is what got me through. I also took the NCLEX review course through Kaplan, and that helped a lot. To be honest, during the test (and after) I couldn't tell if I had done well or not. You know how you usually leave a test feeling like you did well, or poorly? I had no idea. I ended up passing with only 76 questions.

    Best of luck to you.

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