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Leadership & Management in Nursing
Almost every stem is really asking what the safest nurse does first. ABC, Maslow and the nursing process, the five rights of delegation, and safe assignment.
This family of questions is deliberately built so that MORE THAN ONE option is a reasonable nursing action. Nothing on the screen is 'wrong' in isolation — the skill being tested is RANKING. The stem almost always contains a priority signal word: which patient should the nurse assess FIRST, what is the PRIORITY/INITIAL action, which is the MOST IMPORTANT, which patient is the nurse MOST concerned about, or which task is APPROPRIATE to delegate. Read that word first — it tells you the question wants an order, not a yes/no.
A reliable frame for any priority or delegation stem:
Two traps to expect. First, a beautifully correct-sounding option that is not the PRIORITY — it may be something you would indeed do, just not first. Second, an option that is safe on its own but delegates the WRONG thing (an unstable patient, a first-time teaching, or an assessment) to an unlicensed worker. Both are designed to catch the nurse who reacts to a single option instead of ranking all four.
Scope of practice, staff titles (registered nurse, enrolled/practical/licensed practical nurse, nursing assistant/care technician) and what each may legally do vary by country, employer and setting; the principles below are widely used, but confirm the exact boundary against your local Nurse Practice Act and job description.
Every note. Every question. Every Gulf exam.
6 more sections of this note are part of Premium.
Prioritisation is not intuition; it is a set of ORDERED rules applied in a fixed sequence. When two options both look important, drop to the next rule until one clearly wins. Learn the order and most 'which first' items become mechanical.
1. ABCs — AIRWAY, BREATHING, CIRCULATION (the top rule, always):
2. MASLOW's hierarchy — when no immediate ABC threat separates the options:
3. ACTUAL over POTENTIAL, ACUTE over CHRONIC, UNSTABLE over STABLE:
4. The NURSING PROCESS (ADPIE) — when options mix thinking and doing:
5. SAFEST/LEAST-RESTRICTIVE and 'expected vs unexpected' thinking:
Anchor: run the ladder in order — ABC → actual/acute/unstable → Maslow physiological → safety → psychosocial, with assess-before-act unless it's a clear emergency. The first rung that separates the options is your answer.