NCLEX · Management of Care

A nurse is prioritizing care for four clients. Using the ABC framework, which client should be assessed first?

Correct answer

A client with an oxygen saturation of 84% and labored breathing

  1. A A client requesting pain medication
  2. B A client asking about discharge
  3. C A client who needs help to the bathroom
  4. D A client with an oxygen saturation of 84% and labored breathing

Why this is the answer

Using the ABC framework (AIRWAY, BREATHING, CIRCULATION), the client with an OXYGEN SATURATION of 84% and LABORED BREATHING is the priority — this is a BREATHING/airway problem that is immediately life-threatening. NCLEX safe care/prioritization.

Prioritization frameworks: ABCs (airway and breathing problems come first, then circulation); MASLOW'S hierarchy (physiological needs before psychosocial); the nursing process (assess before acting); 'acute before chronic,' 'unstable before stable,' 'actual problems before potential.' A respiratory problem (low SpO2, labored breathing) outranks pain, toileting, and discharge questions. Applying ABCs and Maslow to identify the highest-priority client is a heavily tested NCLEX management-of-care skill.

Source: NCLEX Safe Care — Prioritization (ABCs)

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About this topic: Management of Care

Management of care questions cover prioritisation (ABCs, Maslow, acute before chronic), case management, continuity of care, ethical practice, informed consent and the legal responsibilities of the RN. This is one of 11 RN: Safe and Effective Care Environment questions on management of care, each with a full explanation on a single study page.

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