NCLEX Prep: Prioritizing Nursing Care Using the Maslow’s Hierarchy of Needs Theory

The Maslow’s Hierarchy of Needs Theory is an important tool and strategy to utilize when preparing for and taking the NCLEX-RN Exam as it guides the nurse in prioritizing, triaging, planning, and implementing care.

The Maslow’s Hierarchy of Needs Theory consists of 5 levels to prioritize care from highest priority to lowest priority as follows:

1.     Basic Physiological Needs:

a.     E.g. Respiratory effort and status, cardiovascular health, gastrointestinal needs such as food, fluids, and nutritional intake as well as elimination, etc.

2.     Safety and Security:

a.     E.g. Preventing injuries or illnesses from occurring, establishing security and safety, building trust between the patient and medical staff, etc.

3.     Love and Belonging:

a.     E.g. Ensure adequate support systems are maintained and in place while preventing feelings of isolation and loneliness.

4.     Self-Esteem:

a.     E.g. Promoting a sense of worthiness and acceptance, establishing competence and control, and building a positive outlook, etc.

5.     Self-Actualization:

a.     E.g. Supporting an environment that improves one’s wellness through hope, growth, spirituality.

When using the Maslow’s Hierarchy of Needs Theory, the nurse should always view the physiological needs as the priority concern to address first followed by safety and security needs next, etc., with self-actualization as the lowest priority to address.

When writing the NCLEX-RN exam and the nurse encounters a question that involves more than one need, the Maslow’s Hierarchy of Needs Theory will serve as a guide to answer what the priority action is or what the nurse should do first.

If the question does not involve a physiologic need, but does involve a safety and security need, then the nurse should answer that question by addressing the safety and security need first as it is the most important concern that needs to be addressed.

NCLEX Question Example:

Which of the following concerns should the nurse prioritize, regarding their 47-year-old patient who had open heart surgery 24 hours ago?

a.     Ensuring physical therapy begins working with the patient to prevent injury

b.     Mottled and cool upper/lower extremities with a capillary refill of 4-5 seconds

c.     The patients concern with how their sternal incision scar will look once it is healed

d.     Completing teaching with the patient regarding sternal precautions to prevent complications

The correct answer is B, the nurse should prioritize the concern of mottled and cool upper/lower extremities with a capillary refill of 4-5 seconds as this involves a basic physiologic need demonstrating possible compromised perfusion and a possible complication related to the patient’s cardiovascular system. Using the Maslow’s Hierarchy of Needs, the nurse is able to prioritize the concern that is related to a basic physiologic need first. The other answers are incorrect as ensuring physical therapy begins working with the patient to prevent injury involves safety and security, the patients concern with how their sternal incision scar will look once it is healed involves self-esteem, and completing teaching with the patient regarding sternal precautions to prevent complications involves safety and security.

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Sources: Silvestri, L.A., Silvestri A.E. (2020) Saunders Comprehensive Review for the NCLEX-RN Examination. Saunders 8th Edition.