I suspect this is wildly inefficient but is quite a simple approach, which worked on a small dataset that I tried it on.
select top 1 field
from table
where field in (select top 5 field from table order by field asc)
order by field desc
This would get the 5th item, change the second top number to get a different nth item
SQL server only (I think) but should work on older versions that do not support ROW_NUMBER().