NCLEX PRIORITIZATION QUESTIONS NGN MEDICALSURGICAL
🔹 Question 1: Airway First
A nurse is caring for four patients. Which patient should the nurse see first?
A. A patient with asthma who has expiratory wheezes
B. A patient with COPD who has an oxygen saturation of 91%
C. A post-operative patient with snoring respirations
D. A patient with pneumonia who has a productive cough
✅ Correct Answer: C
Rationale:
Snoring respirations indicate airway obstruction (often the tongue). Airway issues are the
highest priority.
• A & D: Breathing present
• B: O₂ sat acceptable for COPD
• C: Airway is compromised → FIRST
🔹 Question 2: Acute vs Chronic
Which patient requires immediate intervention?
A. Chronic kidney disease patient with creatinine 2.0 mg/dL
B. Diabetic patient with blood glucose 450 mg/dL
C. Hypertensive patient with BP 160/98 mmHg
D. Patient with heart failure and bilateral ankle edema
✅ Correct Answer: B
Rationale:
Blood glucose of 450 mg/dL is acutely life-threatening and can lead to DKA or HHS.
• A, C, D are chronic/stable findings
• Acute > Chronic
, 🔹 Question 3: Unexpected vs Expected
The nurse receives report on four patients. Who should be assessed first?
A. A post-op patient with pain rated 6/10
B. A heart failure patient with crackles at lung bases
C. A post-thyroidectomy patient with tingling around the mouth
D. A COPD patient using pursed-lip breathing
✅ Correct Answer: C
Rationale:
Perioral tingling after thyroid surgery suggests hypocalcemia → possible laryngeal spasm, a
medical emergency.
• A: Pain is expected
• B & D: Expected chronic findings
• Unexpected + dangerous = PRIORITY
🔹 Question 4: Circulation (Bleeding)
Which patient should the nurse see first?
A. Patient with a platelet count of 90,000/mm³
B. Patient with INR of 3.5 on warfarin
C. Post-operative patient with saturated surgical dressing
D. Patient with hemoglobin of 10 g/dL
✅ Correct Answer: C
Rationale:
A saturated dressing indicates active bleeding, which threatens circulation.
• Lab values are important but actual bleeding is priority
🔹 Question 5: Neurological Changes
Which finding requires immediate nursing action?
🔹 Question 1: Airway First
A nurse is caring for four patients. Which patient should the nurse see first?
A. A patient with asthma who has expiratory wheezes
B. A patient with COPD who has an oxygen saturation of 91%
C. A post-operative patient with snoring respirations
D. A patient with pneumonia who has a productive cough
✅ Correct Answer: C
Rationale:
Snoring respirations indicate airway obstruction (often the tongue). Airway issues are the
highest priority.
• A & D: Breathing present
• B: O₂ sat acceptable for COPD
• C: Airway is compromised → FIRST
🔹 Question 2: Acute vs Chronic
Which patient requires immediate intervention?
A. Chronic kidney disease patient with creatinine 2.0 mg/dL
B. Diabetic patient with blood glucose 450 mg/dL
C. Hypertensive patient with BP 160/98 mmHg
D. Patient with heart failure and bilateral ankle edema
✅ Correct Answer: B
Rationale:
Blood glucose of 450 mg/dL is acutely life-threatening and can lead to DKA or HHS.
• A, C, D are chronic/stable findings
• Acute > Chronic
, 🔹 Question 3: Unexpected vs Expected
The nurse receives report on four patients. Who should be assessed first?
A. A post-op patient with pain rated 6/10
B. A heart failure patient with crackles at lung bases
C. A post-thyroidectomy patient with tingling around the mouth
D. A COPD patient using pursed-lip breathing
✅ Correct Answer: C
Rationale:
Perioral tingling after thyroid surgery suggests hypocalcemia → possible laryngeal spasm, a
medical emergency.
• A: Pain is expected
• B & D: Expected chronic findings
• Unexpected + dangerous = PRIORITY
🔹 Question 4: Circulation (Bleeding)
Which patient should the nurse see first?
A. Patient with a platelet count of 90,000/mm³
B. Patient with INR of 3.5 on warfarin
C. Post-operative patient with saturated surgical dressing
D. Patient with hemoglobin of 10 g/dL
✅ Correct Answer: C
Rationale:
A saturated dressing indicates active bleeding, which threatens circulation.
• Lab values are important but actual bleeding is priority
🔹 Question 5: Neurological Changes
Which finding requires immediate nursing action?
