NCLEX-RN Prioritization Questions 2026: 100 Nursing Priority
Questions with Answers and Detailed Rationales
1. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client 1 hour after thyroidectomy who has new stridor. Which action
is the priority?
A. Reassess a stable client with unchanged chronic findings first
B. Assess the client with stridor first
C. Administer a routine PRN analgesic to a stable client with chronic pain
D. See the stable client requesting discharge teaching
Correct Answer: B. Assess the client with stridor first
Rationale: Stridor after thyroid surgery can indicate airway obstruction from edema or
bleeding. Airway compromise can progress rapidly, so this client takes priority over stable pain,
teaching, or routine care.
NCLEX Client Need: Safe and Effective Care Environment
Clinical Judgment Focus: Prioritize hypotheses; Take action
2. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with COPD whose oxygen saturation has fallen from 92% to
82% and who is increasingly restless. Which action is the priority?
A. Assist a stable client with hygiene before assessing the acute change
B. Return a nonurgent family telephone call first
C. Assess the hypoxemic client first
D. Complete routine documentation before assessing the new symptom
Correct Answer: C. Assess the hypoxemic client first
Rationale: An acute drop in oxygen saturation with restlessness signals worsening
hypoxemia. This is an immediate breathing problem and outranks stable chronic symptoms or
nonurgent needs.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
3. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with chest pain unrelieved by nitroglycerin and new
diaphoresis. Which action is the priority?
, A. Return a nonurgent family telephone call first
B. Administer a routine PRN analgesic to a stable client with chronic pain
C. See the stable client requesting discharge teaching
D. Assess the client with persistent chest pain first
Correct Answer: D. Assess the client with persistent chest pain first
Rationale: Unrelieved chest pain with diaphoresis suggests ongoing myocardial ischemia or
infarction. Rapid assessment and treatment are required to reduce myocardial injury.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
4. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with a newly inserted tracheostomy who has absent airflow
and increasing distress. Which action is the priority?
A. Return a nonurgent family telephone call first
B. Assist a stable client with hygiene before assessing the acute change
C. Complete routine documentation before assessing the new symptom
D. Assess airway patency immediately
Correct Answer: D. Assess airway patency immediately
Rationale: A newly inserted tracheostomy with absent airflow presents an immediate airway
emergency. The nurse must assess and restore airway patency before attending to non-life-
threatening concerns.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
5. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client receiving heparin who develops sudden severe headache and
vomiting. Which action is the priority?
A. Assess for intracranial bleeding immediately
B. Return a nonurgent family telephone call first
C. Administer a routine PRN analgesic to a stable client with chronic pain
D. Reassess a stable client with unchanged chronic findings first
Correct Answer: A. Assess for intracranial bleeding immediately
,Rationale: Anticoagulation plus sudden severe headache and vomiting can indicate
intracranial hemorrhage. Neurologic assessment and urgent escalation are required.
NCLEX Client Need: Reduction of Risk Potential
Clinical Judgment Focus: Prioritize hypotheses; Take action
6. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with neutropenia and an oral temperature of 38.3°C (101°F).
Which action is the priority?
A. Assist a stable client with hygiene before assessing the acute change
B. Assess and report possible neutropenic fever promptly
C. Reassess a stable client with unchanged chronic findings first
D. Administer a routine PRN analgesic to a stable client with chronic pain
Correct Answer: B. Assess and report possible neutropenic fever promptly
Rationale: Fever in a neutropenic client may be the only sign of a rapidly progressive
infection. Prompt cultures and antimicrobial treatment are time sensitive.
NCLEX Client Need: Reduction of Risk Potential
Clinical Judgment Focus: Prioritize hypotheses; Take action
7. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client 24 hours after hip replacement with sudden calf pain and
unilateral swelling. Which action is the priority?
A. Complete routine documentation before assessing the new symptom
B. Reassess a stable client with unchanged chronic findings first
C. Return a nonurgent family telephone call first
D. Assess for venous thromboembolism
Correct Answer: D. Assess for venous thromboembolism
Rationale: New unilateral calf pain and swelling after surgery suggest DVT. Assessment and
prevention of embolization take priority over routine postoperative needs.
NCLEX Client Need: Reduction of Risk Potential
Clinical Judgment Focus: Prioritize hypotheses; Take action
8. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with diabetes who is awake but has a glucose of 48 mg/dL.
Which action is the priority?
, A. See the stable client requesting discharge teaching
B. Reassess a stable client with unchanged chronic findings first
C. Assist a stable client with hygiene before assessing the acute change
D. Treat hypoglycemia immediately with fast-acting carbohydrate if safe to swallow
Correct Answer: D. Treat hypoglycemia immediately with fast-acting carbohydrate if
safe to swallow
Rationale: Symptomatic or significant hypoglycemia can quickly cause seizure or loss of
consciousness. Immediate treatment is required before routine tasks.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
9. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with asthma who is now silent on auscultation despite severe
dyspnea. Which action is the priority?
A. Complete routine documentation before assessing the new symptom
B. Return a nonurgent family telephone call first
C. Assist a stable client with hygiene before assessing the acute change
D. Assess and intervene for impending respiratory failure
Correct Answer: D. Assess and intervene for impending respiratory failure
Rationale: A “silent chest” in severe asthma indicates minimal airflow and impending
respiratory failure. This is more urgent than audible wheezing because airflow may be critically
reduced.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
10. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client after cardiac catheterization whose affected foot is cool, pale,
and pulseless. Which action is the priority?
A. Reassess a stable client with unchanged chronic findings first
B. Assess for impaired arterial perfusion immediately
C. Return a nonurgent family telephone call first
D. Administer a routine PRN analgesic to a stable client with chronic pain
Questions with Answers and Detailed Rationales
1. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client 1 hour after thyroidectomy who has new stridor. Which action
is the priority?
A. Reassess a stable client with unchanged chronic findings first
B. Assess the client with stridor first
C. Administer a routine PRN analgesic to a stable client with chronic pain
D. See the stable client requesting discharge teaching
Correct Answer: B. Assess the client with stridor first
Rationale: Stridor after thyroid surgery can indicate airway obstruction from edema or
bleeding. Airway compromise can progress rapidly, so this client takes priority over stable pain,
teaching, or routine care.
NCLEX Client Need: Safe and Effective Care Environment
Clinical Judgment Focus: Prioritize hypotheses; Take action
2. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with COPD whose oxygen saturation has fallen from 92% to
82% and who is increasingly restless. Which action is the priority?
A. Assist a stable client with hygiene before assessing the acute change
B. Return a nonurgent family telephone call first
C. Assess the hypoxemic client first
D. Complete routine documentation before assessing the new symptom
Correct Answer: C. Assess the hypoxemic client first
Rationale: An acute drop in oxygen saturation with restlessness signals worsening
hypoxemia. This is an immediate breathing problem and outranks stable chronic symptoms or
nonurgent needs.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
3. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with chest pain unrelieved by nitroglycerin and new
diaphoresis. Which action is the priority?
, A. Return a nonurgent family telephone call first
B. Administer a routine PRN analgesic to a stable client with chronic pain
C. See the stable client requesting discharge teaching
D. Assess the client with persistent chest pain first
Correct Answer: D. Assess the client with persistent chest pain first
Rationale: Unrelieved chest pain with diaphoresis suggests ongoing myocardial ischemia or
infarction. Rapid assessment and treatment are required to reduce myocardial injury.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
4. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with a newly inserted tracheostomy who has absent airflow
and increasing distress. Which action is the priority?
A. Return a nonurgent family telephone call first
B. Assist a stable client with hygiene before assessing the acute change
C. Complete routine documentation before assessing the new symptom
D. Assess airway patency immediately
Correct Answer: D. Assess airway patency immediately
Rationale: A newly inserted tracheostomy with absent airflow presents an immediate airway
emergency. The nurse must assess and restore airway patency before attending to non-life-
threatening concerns.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
5. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client receiving heparin who develops sudden severe headache and
vomiting. Which action is the priority?
A. Assess for intracranial bleeding immediately
B. Return a nonurgent family telephone call first
C. Administer a routine PRN analgesic to a stable client with chronic pain
D. Reassess a stable client with unchanged chronic findings first
Correct Answer: A. Assess for intracranial bleeding immediately
,Rationale: Anticoagulation plus sudden severe headache and vomiting can indicate
intracranial hemorrhage. Neurologic assessment and urgent escalation are required.
NCLEX Client Need: Reduction of Risk Potential
Clinical Judgment Focus: Prioritize hypotheses; Take action
6. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with neutropenia and an oral temperature of 38.3°C (101°F).
Which action is the priority?
A. Assist a stable client with hygiene before assessing the acute change
B. Assess and report possible neutropenic fever promptly
C. Reassess a stable client with unchanged chronic findings first
D. Administer a routine PRN analgesic to a stable client with chronic pain
Correct Answer: B. Assess and report possible neutropenic fever promptly
Rationale: Fever in a neutropenic client may be the only sign of a rapidly progressive
infection. Prompt cultures and antimicrobial treatment are time sensitive.
NCLEX Client Need: Reduction of Risk Potential
Clinical Judgment Focus: Prioritize hypotheses; Take action
7. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client 24 hours after hip replacement with sudden calf pain and
unilateral swelling. Which action is the priority?
A. Complete routine documentation before assessing the new symptom
B. Reassess a stable client with unchanged chronic findings first
C. Return a nonurgent family telephone call first
D. Assess for venous thromboembolism
Correct Answer: D. Assess for venous thromboembolism
Rationale: New unilateral calf pain and swelling after surgery suggest DVT. Assessment and
prevention of embolization take priority over routine postoperative needs.
NCLEX Client Need: Reduction of Risk Potential
Clinical Judgment Focus: Prioritize hypotheses; Take action
8. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with diabetes who is awake but has a glucose of 48 mg/dL.
Which action is the priority?
, A. See the stable client requesting discharge teaching
B. Reassess a stable client with unchanged chronic findings first
C. Assist a stable client with hygiene before assessing the acute change
D. Treat hypoglycemia immediately with fast-acting carbohydrate if safe to swallow
Correct Answer: D. Treat hypoglycemia immediately with fast-acting carbohydrate if
safe to swallow
Rationale: Symptomatic or significant hypoglycemia can quickly cause seizure or loss of
consciousness. Immediate treatment is required before routine tasks.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
9. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client with asthma who is now silent on auscultation despite severe
dyspnea. Which action is the priority?
A. Complete routine documentation before assessing the new symptom
B. Return a nonurgent family telephone call first
C. Assist a stable client with hygiene before assessing the acute change
D. Assess and intervene for impending respiratory failure
Correct Answer: D. Assess and intervene for impending respiratory failure
Rationale: A “silent chest” in severe asthma indicates minimal airflow and impending
respiratory failure. This is more urgent than audible wheezing because airflow may be critically
reduced.
NCLEX Client Need: Physiological Adaptation
Clinical Judgment Focus: Prioritize hypotheses; Take action
10. At shift change, the nurse must decide which client need is most urgent. One
assigned client is a client after cardiac catheterization whose affected foot is cool, pale,
and pulseless. Which action is the priority?
A. Reassess a stable client with unchanged chronic findings first
B. Assess for impaired arterial perfusion immediately
C. Return a nonurgent family telephone call first
D. Administer a routine PRN analgesic to a stable client with chronic pain
