How to answer Priority Questions on the NCLEX?

RN59217 · Jan 19, 2014

I had the question about the adolescent psych patients, too, and it said on mine that the correct answer was 4, because safety is a priority.
As for the ED question, I would personally choose option C as the priority, suicide is a greater priority than a patient in DKA, etc. I learned that I read into the questions, so unless they give you particular symptoms pointing out to distressing issues, don't assume someone with CHF has difficulties breathing at this moment in a priority situation, unless it is spelled out for you. Also, actual problems (active suicide risk) are more concerning than potential problems (DKA, fluid overload w/CHF).
Again, this was my biggest issue with test-taking, but thankfully I am starting to train myself NOT to do this, haha.

Just for the record... DKA is considered an actual problem. Suicide risk is considered potential. They are not actively attempting suicide. That's really splitting fine hairs, but if you're asked to determine the correct Nursing Dx, it makes a difference.

nurseprnRN, BSN, RN · Jan 19, 2014

You know, knowing this sort of thing isn't just for psyching out the NCLEX. You do know that you will be seeing situations like these demanding your assessment of priorities just about every day of your working life, right?

kfitzy89 · Jan 20, 2014

You are right, I realize now that I may have worded my response inappropriately and for that I apologize. Unfortunately, the NCLEX is somewhat like splitting fine hairs. Most of the questions are so highly subjective that you need to learn how to adjust your mentality to the "perfect" world that this test expects you to live in. DKA is an actual and life threatening problem, but suicidal ideations (" It's going to end soon", etc.) are almost always the priority patient in this setting. At least with the questions I've seen and encountered. :-)

nurseprnRN, BSN, RN · Jan 22, 2014

You are right, I realize now that I may have worded my response inappropriately and for that I apologize. Unfortunately, the NCLEX is somewhat like splitting fine hairs. Most of the questions are so highly subjective that you need to learn how to adjust your mentality to the "perfect" world that this test expects you to live in. DKA is an actual and life threatening problem, but suicidal ideations (" It's going to end soon", etc.) are almost always the priority patient in this setting. At least with the questions I've seen and encountered. :-)

No, "most" of the questions are not "highly subjective." They do not expect you to leave this world for another, unobtainably perfect one.

You might find the rationales for some practice workbook questions not to your liking, but that doesn't make them "highly subjective," and I don't know where you got "most," either.

In my experience, the people who are the most bitterly disappointed about their NCLEX scores are the ones who blame the examination for their failures. Considering that the national pass rate is somewhere north of 90% (that's not the passing grade, that's the pass rate) I would say that it's that one out of ten who lives in an unreal world.

psu_213, BSN, RN · Jan 22, 2014

btw.
If a patient is diagnosed with a particular disease and is exhibiting signature signs and symptoms. It is not a big deal.
Ex 1 . Diagnosed with hypertension and has a headache is expected. It is not an urgent response
Ex 2. Diagnosed with hypertension and diminishing LOC is unexpected and is urgent.
You may see Ex 1 combined with other patients and Ex1 is not a big deal. vs Ex 2 which is possibly showing bleeding.

There is some truth to what you are saying, but this is not the best example. Even if a person has a known dx of HTN, if they are coming to the ER with a BP 196/102 and a headache--there is most certainly going to be an urgent response.

bmdbmd · Jan 23, 2014

I saw the question with the teenager who only drinks water/eats veggies vs then teen bully. I answered the teenager who drinks water/eats veggies and Kaplan said it was correct. My rationale was electrolyte/nutritional imbalance (physiological is 1st for Maslow's) and while safety (second for Maslow's) is definitely huge, the answer did not state that he was being threatening to the staff.