Prioritization and delegation questions make up a big share of the NCLEX because they fall under Management of Care, the largest client-needs category on the NCLEX-RN (15–21%). Learn these frameworks and you will answer “Who do you see first?” questions with confidence.
NCLEX Prioritization Frameworks
1. ABCs: Airway, Breathing, Circulation
Airway problems come first. A client with stridor or a compromised airway takes priority over one with low blood pressure.
2. Maslow’s Hierarchy
Physical needs (oxygen, fluids, nutrition, elimination) come before safety, then love and belonging, esteem and self-actualization.
3. Acute vs. Chronic
A new or sudden change is usually more urgent than a long-standing condition, even if the chronic finding looks worse on paper.
4. Unstable vs. Stable & Expected vs. Unexpected
Choose the client whose findings are unexpected for their condition. Crackles in a client with heart failure may be expected; new crackles after a blood transfusion are not.
5. Safety and Least Invasive First
When no physiological threat exists, choose the option that protects safety. Assess before acting, and use the least restrictive intervention.
NCLEX Delegation Rules
| Role | Generally appropriate | Do not assign |
|---|---|---|
| RN | Assessment, teaching, evaluation, care planning, unstable clients | — |
| LPN/LVN | Stable clients with predictable outcomes, data collection, reinforcing teaching, many medications | Initial assessment, initial teaching, unstable clients |
| UAP | Vital signs on stable clients, hygiene, ambulation, feeding, intake and output | Assessment, teaching, evaluation, medications |
Looking for help with NCLEX prioritization? You are in the right place. This guide gives nursing candidates across the USA and Canada clear, practical steps to prepare for the NCLEX with confidence.
The Five Rights of Delegation
- Right task
- Right circumstance
- Right person
- Right direction and communication
- Right supervision and evaluation
Test yourself with our free NCLEX practice questions, including a delegation question with rationale.
Master Management of Care
Practice hundreds of prioritization and delegation questions with expert rationales.
View NCLEX CoursesWhat is the priority on NCLEX questions?
Start with airway, breathing and circulation, then apply Maslow, acute over chronic, and unexpected over expected findings.
Can an LPN do assessments on the NCLEX?
LPNs/LVNs collect data and reinforce teaching for stable clients, but initial assessment and initial teaching are RN responsibilities.
Official exam information: NCLEX.com and NCSBN. Always confirm current details with your board of nursing or provincial regulator.