👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Management of Care🔖 Free to read, print, and share
Also known as: ABC priority · airway breathing circulation · who do I see first · what comes first nursing · see first · which patient first · decide who to see · patient to see first
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Use this quick-reference guide to spot, treat, and prevent Prioritization (ABCs) on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Order
Airway first → obstruction = fatal
Breathing → SpO2, distress
Circulation → bleeding, perfusion
📌 Next
D = Disability (neuro/LOC)
Then safety, then comfort
📌 Rule
Acute/unstable before chronic
Actual problem before risk
Unexpected before expected
🩺 Watch
Sudden change → see first
Stridor/silent chest = emergency
📚 Prioritization (ABCs) — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
The ABCs (Airway, Breathing, Circulation) are the master framework for deciding which client or problem to address first. A patent airway is always the highest priority because without it the client dies within minutes. Memory aid: Airway before Breathing before Circulation before Disability/everything else.
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Key points
Understand these first
Airway problems (stridor, choking, obstruction, absent gag) come before breathing problems.
Breathing problems (low SpO2, respiratory distress, ineffective ventilation) come before circulation problems.
Circulation problems (bleeding, shock, no pulse, dysrhythmia) come before all non-life-threatening issues.
After ABCs, use 'D' for Disability/neuro and then Maslow and the nursing process to rank remaining problems.
Actual life-threatening problems outrank potential or chronic problems.
An unstable client or one with new/abnormal findings is seen before a stable client with expected findings.
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Nursing priorities
What to do, in order
Assess and secure a patent airway first in any deteriorating client.
Address oxygenation and effective breathing next, applying oxygen and positioning as needed.
Control bleeding and support circulation and perfusion after airway and breathing.
Reassess after each intervention to confirm the ABCs are stable before moving on.
Rank multiple clients by who has the most immediate threat to airway, breathing, or circulation.
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Red flags — report now
Escalate immediately
Report-now and act first: stridor, choking, gurgling, or any sign of airway compromise.
Never address a lower-priority complaint (pain, comfort, teaching) while an airway, breathing, or circulation threat is unresolved.
Sudden drop in SpO2, absent pulse, or active hemorrhage requires immediate intervention, not documentation first.
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Labs & values
Numbers to know
SpO2: 95-100% (below 90% is hypoxemia, intervene)
PaO2: 80-100 mmHg
PaCO2: 35-45 mmHg
pH: 7.35-7.45
❓ Prioritization (ABCs): NCLEX FAQs
What are the priority nursing interventions for Prioritization (ABCs)?
Assess and secure a patent airway first in any deteriorating client. Address oxygenation and effective breathing next, applying oxygen and positioning as needed. Control bleeding and support circulation and perfusion after airway and breathing. Reassess after each intervention to confirm the ABCs are stable before moving on.
What are the warning signs of Prioritization (ABCs) a nurse must report?
Report-now and act first: stridor, choking, gurgling, or any sign of airway compromise. Never address a lower-priority complaint (pain, comfort, teaching) while an airway, breathing, or circulation threat is unresolved. Sudden drop in SpO2, absent pulse, or active hemorrhage requires immediate intervention, not documentation first.
What do I need to know about Prioritization (ABCs) for the NCLEX?
Airway problems (stridor, choking, obstruction, absent gag) come before breathing problems. Breathing problems (low SpO2, respiratory distress, ineffective ventilation) come before circulation problems. Circulation problems (bleeding, shock, no pulse, dysrhythmia) come before all non-life-threatening issues. After ABCs, use 'D' for Disability/neuro and then Maslow and the nursing process to rank remaining problems.
What lab values are associated with Prioritization (ABCs)?