A nurse is caring for four clients. Which client should the nurse assess first?

Priority assessment follows the ABCs (Airway, Breathing, Circulation) and Maslow's hierarchy of needs. Physiological needs come first, and within physiological needs, airway and breathing concerns take priority. The client with new-onset shortness of breath and O2 saturation of 88% has an acute respiratory problem that could rapidly deteriorate — this is the highest priority. Normal O2 saturation is 95% or higher; 88% indicates significant hypoxemia. The postoperative client with 6/10 pain needs assessment and intervention but is not in immediate physiological distress. Routine IV antibiotics and a chronic pain request can wait several minutes. NCLEX priority questions consistently test the ability to recognize which client is most unstable; airway and breathing issues almost always come before bleeding, pain, anxiety, and elimination concerns.