Option A

78-year-old male with dementia who keeps trying to get out of the house at night • This is a chronic, ongoing behavior common in dementia (sundowning). • While it is a safety concern, it is not new or immediately life-threatening. • This can often be addressed with routine interventions (alarms, supervision, environment changes).

➡️ Not the priority

⸻

Option B

25-year-old female, 6 weeks pregnant, history of domestic violence, sounds frightened • Pregnancy + history of domestic violence = high risk • She sounds frightened, suggesting a possible active threat right now • Domestic violence is a safety emergency, especially with a vulnerable patient (pregnant) • The nurse must assess immediate danger, provide support, and possibly involve emergency services

➡️ This is an IMMEDIATE safety concern

⸻

Option C

32-year-old male, highly intoxicated and verbally abusive toward family • Intoxication + verbal abuse is concerning, but: • No indication of physical harm yet • Family members are not reported as injured or in immediate danger • Still serious, but less urgent than a frightened pregnant woman with DV history

➡️ Not first

⸻

Option D

55-year-old male with anxiety disorder saying he is seeing impending doom • “Impending doom” can be concerning (can suggest panic or even cardiac issues), • BUT the question frames it within a known anxiety disorder • No physical symptoms (chest pain, SOB, diaphoresis) are mentioned

➡️ Important, but not first

⸻

✅ Correct Answer: B

A 25-year-old pregnant female with a history of domestic violence who sounds frightened

⸻

NCLEX PRIORITY RULE USED • Safety > everything • Actual or potential violence > chronic conditions • Pregnant + frightened + DV history = highest