Are you grappling with passing nursing priority questions?
This is a common struggle among nursing students, especially during practical tests given by clinical instructors.
In nursing school, a senior shared with me a hack in answering priority questions. He introduced me to the ABC Assessment Strategy. It stands for A (Airway), B (Breathing), and C (Circulation).
Yes! These are the common signs one must look for to focus on patient care.
Read on as I unveil to you how to apply this strategy to improve your scores!
The ABC’s
The mnemonic helps nurses to remember basic concepts. Moreover, this is also the order of prioritization in emergencies and in giving nursing intervention.
You may use this without any equipment, even along the streets or upon arrival in emergency rooms.
Let’s discuss them one by one.
Airway
Unconscious patients
If a patient is unconscious, airway management is a priority.
First, you open the airway passage. Remember this savvy technique: Tilt the head, and lift the chin. This has saved lives more than you can imagine.
Higher-level experts open the oropharyngeal airways and intubate the patient if deemed necessary.
Conscious patients
If a patient is conscious, assess if there are any signs of airway obstruction. Check the tongue if it is one of the causes of blockage.
Breathing
Unconscious patients
If a patient is unconscious, the second step is to assess the patient’s breathing patterns. Check if there are any efforts upon respiration. Don’t forget to check the patient’s breathing count. Take note that normal breathing is 12-20 breaths per minute.
If below 12 breaths per minute is documented, CPR must follow. Other professional rescuers’ protocol follows artificial respiration.
If normal breathing is established, treatment continues. Then, the patient sits in a recovery position.
For conscious and breathing patients
If a patient is conscious, assess the pulse rate and breathing. Diagnose conditions that may be life-threatening, which includes severe asthma or pulmonary complications.
Skilled rescuers may take the following actions:
- Check for signs of respiratory distress
- Monitor the respiration including the depth and rhythm
- Observe signs of chest deformity and its movement.
- Auscultate breath sounds upon inhalation and exhalation.
- Use a stethoscope when auscultating breath sounds.
- Pulse check
Circulation
If oxygen travels to the lungs through an airway without any obstruction, it needs to circulate throughout the body.
Patients who are not breathing
“C” stands for Circulation. The third priority in the ABC is, whether circulation is present or absent. One must take the carotid pulse first before taking further steps in treatment.
The assessment of circulation is quite complicated for ordinary people. Some non-experts find it challenging to determine if the pulse rate is present or absent. This will predetermine if the patient may need chest compressions. Chest compressions prove effective in aiding artificial circulation.
It is worth remembering that professionals must still check for pulse rate for one whole minute. This determines if immediate ECG is needed for suspected cardiac arrest.
Breathing patients
Once breathing is back to normal, conduct further assessment to help in the differential diagnosis. Options for assessment are available such as:
- Observation of temperature and any discoloration of the hands
- Capillary refill
- Pulse checks
- Monitor blood pressure
- Observe signs of another failure of circulation
- ECG monitoring
Aims of this approach
- provide life-saving treatment
- break down clinical situations into manageable parts
- serve as an assessment initiative
- promote common situational awareness among all treatment providers
- establish a final diagnosis and treatment
How to Ace Nursing Priority Questions
Now, let’s proceed with the written and clinical tests. These are always tricky. We will recommend these test-taking strategies. So let’s dive in!
First, mnemonics is one effective strategy for prioritizing patient care. This will be a great hack if used right. Not only that, it is easy to remember, and you will have a much easier time hitting on the correct answers.
Again ABC is airway, breathing, and circulation. They will be your top three priorities in doing patient care. You need to remember that your patient must have a clear airway, clear breathing, and proper blood flow.
If these three are present, rest assured that your patient is alive. If not, the game’s over! This is why the ABCs should be your top priority!
Second, let us look at case scenarios in the exams. Usually, the tests present real-life questions. They will have you pick your “first” response to the situation/s or your immediate action.
Suggestions:
- Look at the responses. Prioritize your patient care. Analyze which intervention keeps the patient’s airways unblocked. Check causes of airway obstruction.
- Then, re-read the question to make sure that the answer makes sense. If it does, congratulations! Nursing ABCs is your hero!
In clinical tests, this strategy also works. Remember to always rank patient care using ABCs! If a patient isn’t breathing well, check on them using the ABCs. When instructors ask what patient you’ll check in first, always go back to the basics.
This, by far, is the most effective strategy in acing nursing school exams and clinical tests.
Other healthcare professionals use ABCDE for a more precise patient prioritization technique.
- ABCDE:
- Airway, Breathing, Circulation, Decreased Consciousness, and Everything else
- The latter includes the overall checking of the patient. Check if there are abnormalities present such as bleeding, fractures, rashes, or the like.
- Check the vitals. Blood pressure, urine, pulse, heart rate, and breathing
- Charting.
- Drug administration. Always observe the five “rights”—right patient, drug, dose, route, and time.
Pro-Tip:
You may come across a nursing process with an acronym of ABCDE. They are A- assessment, B- basic vitals, C- charting, D-drugs, E- Evaluation. This is what makes up the everyday life of a nurse.
I am sure you got it all figured out by now. These helpful hacks will not only give you higher scores in written tests or practical exams; they will help you respond to emergencies better and save someone’s life.
Again, the nursing exam questions are just as easy as ABC!
Follow these, and you are sure to ace your next exam. Go, and may you touch more lives with your healing hands!
