Short answer: Prioritisation and delegation questions in a nursing exam ask who goes first and who does the task. Rank by threat to life and stability, and delegate only stable, routine tasks to someone competent, with clear directions. You keep assessment, judgement and accountability. Learn the pattern rather than a list.
Prioritisation and delegation questions in a nursing exam: two skills
The prioritisation frameworks guide explains the order of airway, breathing and circulation and unstable before stable. This page adds the second half, delegation, and shows how the two often arrive in one question.
Meddex is independent and is not connected to the Dubai Health Authority (DHA) or Prometric. Scope of practice differs by organisation and by law, so answer by principle and check your own rules.
This is exam-preparation revision, not clinical guidance. In practice, follow your own organisation’s policies and the current guideline, and check doses and thresholds against them.
A quick recap of who goes first
Rank patients with a few questions. Is there a threat to airway, breathing or circulation? Has something changed suddenly? Is the patient unstable? Is the finding new or unexpected? A patient with a new problem usually comes before one whose condition is stable, chronic or expected. Patients who are awaiting a routine task come last.
The five rights of delegation
The National Council of State Boards of Nursing and the American Nurses Association describe five rights of delegation. They are a useful frame, even if local scope differs.
- Right task: it fits the person’s role and written policy.
- Right circumstance: the patient is stable and the situation is predictable.
- Right person: the person has the skills and competence.
- Right directions and communication: say what, how, when and what to report.
- Right supervision and evaluation: follow up and check the result.
What the nurse keeps
Some work is not delegated, because it needs a nurse’s judgement. This includes initial assessment, care planning, interpreting findings, teaching new information, giving the first dose of a new treatment and caring for an unstable patient. The responsibility for the outcome stays with the delegating nurse, so supervision is part of the job.
What can often be handed on
In many models, a competent assistant can help with routine care for stable patients. Examples include hygiene, feeding a patient with no swallowing concerns, helping with walking, repositioning on schedule, measuring vital signs in a stable patient and recording intake and output. Even then, the nurse reviews the results and asks the assistant to report any change at once.
Example 1: who first?
Example, written by Meddex. Four patients need help. A. A patient on a long-term catheter asks for a drink. B. A patient after surgery whose pain has risen suddenly with a falling blood pressure. C. A patient waiting for discharge teaching. D. A patient whose blood sugar was low and is now eating. B is first, because a sudden change with falling blood pressure suggests instability. The others are stable or expected.
Example 2: who does it?
Example, written by Meddex. A stable patient needs a blood pressure check and a second patient has just returned from theatre. The nurse can ask a trained assistant to do the first task and report the numbers, and should assess the post-operative patient personally. The wrong options hand the new patient to the assistant or leave the stable patient waiting without a plan.
Common traps
Picking the task you like. Delegating assessment or teaching. Forgetting to supervise or ask for a report. Treating a first-time finding as routine. Treating the loudest patient as the sickest. For team communication, see SBAR handover explained. To build speed, use the mock exams to practise ranking under a clock.
Words in the stem that change the answer
A few words do a lot of work. “First” and “priority” ask for a ranking. “Initial” asks for assessment before action. “Needs follow-up” points to the finding that is out of range or new. “Stable” and “routine” point to tasks that can be handed on. “Unexpected” points to the nurse’s own review. The guide on how to read a nursing exam stem shows how to mark these words under time pressure.
This topic may appear as nursing priority questions, delegation in nursing questions or who should the nurse see first. Treat them as one skill with two halves.
Frequently asked questions
This article is general educational guidance, not official advice. Exam rules, fees and timelines are set by the Dubai Health Authority and the test provider and can change, so always confirm the latest details on their official channels.
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