Never prioritize a psychosocial or teaching need over an unmet physiological need such as hypoxia, hemorrhage, or severe pain.
Before you read
Test yourself first: 5 questions
Question 1 of 5
An RN is prioritizing care for a group of clients. According to Maslow's hierarchy, which client need should be addressed FIRST?
Answer: B. Physiologic needs are the base of Maslow's hierarchy and take priority over safety, love/belonging, esteem, and self-actualization. A client with an obstructed airway has an unmet physiologic need that is immediately life-threatening. Anxiety, knowledge deficit, and a request for spiritual support are addressed after physiologic stability.
Question 2 of 5
A nurse is delegating tasks for a stable postpartum client to unlicensed assistive personnel (UAP). Which task is appropriate to delegate to the UAP?
Answer: A. UAP may perform tasks that are routine, standardized, and do not require nursing assessment or judgment, such as measuring and recording vital signs on a stable client and assisting with hygiene and ambulation. Assessing the fundus and lochia, teaching about danger signs, and evaluating the perineum require nursing assessment, judgment, and education and cannot be delegated to UAP.
Question 3 of 5
An RN is supervising an LPN/LVN. Which task should the RN retain rather than delegate to the LPN/LVN?
Answer: A. Developing the initial nursing care plan and performing the comprehensive admission assessment are RN functions because they require independent nursing judgment. The LPN/LVN may collect data, reinforce teaching, and give routine medications.
Question 4 of 5
When several clients need attention, which framework helps the nurse prioritize physiologic needs?
Answer: B. Use the ABCs (airway, breathing, circulation) for immediate life threats and Maslow's hierarchy (physiologic before psychosocial) to prioritize. Alphabetical or convenience ordering is not safe.
Question 5 of 5
A client with a chest tube accidentally has the tube pulled out of the chest. What is the nurse's immediate action?
Answer: B. If a chest tube is dislodged from the chest wall, the nurse immediately covers the insertion site with a sterile occlusive dressing (taped on three sides to allow air to escape) and notifies the provider. Reinserting the tube is not a nursing action.
Keep the streak going with more questions like these, each with a full rationale.
What is maslow hierarchy in nursing?
Physiological needs (the bottom of the pyramid) take priority because they sustain life. Memory aid: Physiological, Safety, Love/belonging, Esteem, Self-actualization, bottom to top.
Key points to remember
- Physiological needs (oxygen, fluids, nutrition, elimination, sleep, pain relief) are first priority and align with the ABCs.
- Safety and security needs (fall prevention, infection control, a safe environment) come after physiological needs.
- Love and belonging needs (relationships, support, freedom from isolation) come next.
- Esteem needs (self-respect, dignity, independence) follow belonging.
- Self-actualization (achieving full potential) is the highest level and lowest immediate priority.
- When choosing between a physical and an emotional problem, address the physiological/physical need first.
Nursing priorities
- Meet life-sustaining physiological needs (airway, oxygenation, fluids, nutrition, elimination, pain) before all else.
- Establish a safe environment and prevent injury once physiological needs are met.
- Address psychosocial needs such as anxiety, support, and belonging after physical needs are stable.
- Use Maslow alongside the ABCs to rank competing client problems.
- Recognize that a physiological complaint generally outranks a psychosocial one in NCLEX prioritization.
Red flags: report now
- Never prioritize a psychosocial or teaching need over an unmet physiological need such as hypoxia, hemorrhage, or severe pain.
- Report-now: a physiological deterioration that an emotional concern was masking.
- Do not skip a life-threatening physical problem to address anxiety or coping first.
References
Clinical references for this topic
