Final answer:
The highest priority according to Maslow's hierarchy of needs is 'b. Ineffective airway clearance is related to retained secretions' because it poses an immediate threat to the fundamental physiological need for oxygen.
Step-by-step explanation:
Using Maslow's hierarchy of needs, the nurse would determine that the patient problem with the highest priority is b. Ineffective airway clearance related to retained secretions. The rationale for this is that Maslow's hierarchy prioritizes physiological needs above all others for survival. Ineffective airway clearance poses an immediate threat to the patient's ability to breathe, which is a fundamental physiological need. Anxiety, while important, is considered a psychological need, which comes after physiological needs. Similarly, fluid volume excess and thermoregulation issues are also physiological, but the threat posed by ineffective airway clearance is more immediate and can more rapidly become life-threatening.