Prioritizing

[snursee2b]

Could I get some advice as to how to answer questions stating which clients I would look at first... I always get those questions wrong on my exams. I am a 1st year student and unfortunately, the teacher does not allow us to get back our exams so I cannot remember exactly how to phrase the question and the choices. But, it almost always says what is the high priority...

[SarasotaRN2b]

Could I get some advice as to how to answer questions stating which clients I would look at first... I always get those questions wrong on my exams. I am a 1st year student and unfortunately, the teacher does not allow us to get back our exams so I cannot remember exactly how to phrase the question and the choices. But, it almost always says what is the high priority...

First, of course, you need to go by the ABC's (airway,breathing and circulation), these would always take priority over others...this you know.

If you could give examples (they don't have to be verbatim), that might help.

Using NCLEX reviews such as Saunders, may give you some practice and they will usually give you the rationale of why one choikce would take more priority over another.

Kris

[Daytonite, BSN, RN]

prioritizing most often involves treating, or going after, the presenting symptom that is likely to be the most deadly in a list of symptoms from mild to fatal. a nclex review book is very good about listing disease symptoms in this fashion if a textbook isn't clear in doing this. a patient's symptoms of a problem always start out as kind of mild and as they are ignored proceed to become more and more intense. you go after the ones that are more intense first. you also go after any symptoms that are a threat to life. those are best prioritized in terms of maslow's hierarchy of needs as follows:

• oxygen (these are your abcs-you prioritize by which organs need oxygen the most critically: brain [brain cells start to die after 4 minutes without oxygen and can never regenerate], heart [cells start to die after 15 to 30 minutes without oxygen and can never regenerate], lungs [take longer than 30 minutes for the tissues to start dying without oxygen], other body organs)
  
• food (this include water and all nutrients taken orally and delivered to the cellular level)
  
• elimination (urine and fecal routes)
  
• temperature control
  
• sex
  
• movement (bones and muscles and resulting problems as a result of)
  
• rest
  
• comfort (pain)

here is the strategy for answering test questions.

• know and consider the normal anatomy and physiology
  
• know and consider abnormal anatomy for the disease in question
  
• know and consider the resulting signs and symptoms when the disease occurs and how they proceed from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
  
• know and consider how the doctor diagnoses and treats the disease in question
  
• know nursing interventions for the signs and symptoms you are being asked about
  
• know the steps of the nursing process and what goes on in each of the steps and consider how they are affecting the question you are being asked
  
• know and consider the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
  
• read the stem of the question carefully and answer that because the test makers try to trip you up by distracting you with conflicting information they give you in the answer choices that sounds good but has no relationship to what the question is asking for
  
• ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. nursing like other disciplines treats the problem/signs and symptoms.

you should review the information and links in this thread as well:

• https://allnurses.com/forums/f50/looking-test-taking-stratagies-224581.html - looking for test taking strategies (on the nursing student discussion forum)