ABCs, Maslow, and the nursing process: the three tie-breakers
Written and reviewed by Dana Whitfield, RN, MSN · 6 min read · Updated August 2026
Short answer
When two NCLEX answers both look correct, three frameworks break the tie, in this order: ABCs for anything physiologically urgent, the nursing process when the options are actions at different stages, and Maslow when nothing is acutely unstable. Applying them in the wrong order is why candidates who know all three still miss the item.
ABCs, and the exception that decides items
Airway, breathing, circulation. A client who cannot maintain an airway outranks everything, and a breathing problem outranks a circulation problem. This resolves a large share of 'see first' items on its own.
The exception matters more than the rule: in cardiac arrest the sequence is CAB — compressions first. If an item describes an unresponsive, pulseless client, chest compressions precede airway. Candidates who apply ABC everywhere miss that one reliably.
The nursing process as an ordering tool
Assessment, diagnosis, planning, implementation, evaluation. When the options sit at different stages, the earlier stage usually wins — you assess before you intervene, and the exam punishes acting on incomplete data harder than it punishes waiting.
The trap is that 'assess first' is not universal. If the stem already gives you the assessment data, or the client is in immediate danger, the answer is the action. A client with an oxygen saturation of 84% does not need another assessment; they need the head of the bed up and oxygen on.
Maslow, once nobody is unstable
Physiological needs, then safety, then love and belonging, then esteem, then self-actualization. Maslow is the tie-break for items where all four options are reasonable and nothing is acute — common in psychosocial, health promotion, and long-term-care items.
The usual misuse is reaching for Maslow first. Between 'listen to the client's fears about surgery' and 'reposition the client with an oxygen saturation of 88%', Maslow and ABCs agree — but on an item where one option is airway and another is a physiological need lower down, ABCs decide, not the pyramid.
Safety and the risk-management overlay
Sitting across all three is a preference for the answer that removes risk from the client and everyone else. Given a choice between assessing a client who has fallen and a client actively climbing over a bed rail, you go to the one still falling.
The same logic decides many equipment and infection-control items. If one option contains ongoing harm and another contains documentation, notification, or teaching, stop the harm first — the paperwork answer is almost never first, and it is almost never wrong later.
Whatever you take from this, the next step is the same: answer questions and read the rationales. Our prioritization and delegation practice questions are the closest set to what this guide covers, there are ten more on the practice questions hub, and the pricing page spells out what the free tier includes.
Common questions
Should I use ABCs or Maslow first on the NCLEX?
ABCs first. Maslow is the tie-breaker only when no option involves an airway, breathing, or circulation threat. Using Maslow first is a common source of misses on prioritization items.
Is 'assess first' always the right answer?
No. Assessment comes first when data is missing, but if the stem already supplies the assessment or the client is in immediate danger, the correct answer is the intervention.
When does CAB replace ABC?
In cardiac arrest. For an unresponsive, pulseless client, compressions come before airway. Everywhere else, airway leads.