foreign [Music] welcome back again Mark so Mark Clement here with Clinic reviews the founder and CEO CFO everything I'm the whole c-suite the whole seat the whole sabang we're going to talk about some general recommendations you have for passing NCLEX today so what does an NCLEX test taker need to know in order to pass NCLEX well I firmly believe as I said I've said before in other interviews is uh to pass NCLEX you really need to have be facili functional in what I call Ace Ace three abilities a you have to acquire knowledge you have to have a certain knowledge base every nurse is expected to have a fundamental generalist knowledge base and then you have to be able to have confidence and you have to be able to be exam proficient knowing uh how to take an example I think I'll talk about how to prepare for NCLEX uh using those three so first I'd like to talk about you said what do they need to know yes well that focuses on the knowledge base let me say one thing I think the biggest mistake that it's made by review companies is they say the truth but then they write materials that are not operating according to that truth for example the NCLEX is a test of generalist knowledge generalist knowledge now there's a generalist and there's a specialist so you understand generalist specialist opposites those are opposite ideas a NCLEX is a generalist test it is not a specialty test a specialty test would be something like a ccrm or a intrastomal therapists test those are a maternal nurse newborn Specialties specialty or mental health specialty uh the NCLEX is a test of generalist knowledge they test your general knowledge of all areas they are not the NCLEX is not a set of five specialty tests a special knowing special knowledge in mid-surge special knowledge and mental health special knowledge and maternal newborn special knowledge in Pediatrics special knowledge in management and care those aren't those are not it's not a compilation of specialty exams okay it is a generalist test which means this how do you know what's general knowledge and what specialty knowledge here's how you know that if a person if a nurse practicing in one specialty knows this about your specialty a different specialty then it's probably generalist knowledge but if so if a nurse who's a maternity nurse knows something about med-surge it's probably a generalist test but that maternity nurse doesn't have to know everything about Med surgent the med surg nurse knows if conversely the med surge nurse doesn't need to know all the OB maternal newborn information knowledge that a maternal newborn nurse knows maternal newborn nurses know they can look at fetal heart tracings and know exactly what it is and what's causing it that is specialty knowledge you go on any floor Med search floor you go on any Med search or in any institution in the United States you pull out uh fetal heart monitor tracings and you show them what will that surgeon or say it doesn't look like an EKG does it look like an EKG why are all these what are these are these the heart rate but what's this other thing yeah do you see what I'm saying it looks like a slow v-tac with a wide QRS right so wear it conversely if I take uh uh hey um strip of electromechanical dissociation or third degree heart block into the maternity unit and asked these maternity nurses that have been nurse successful excellent practitioners for 20 years what's this they'll say well where's the contraction where's the rather contractions we just see the heart rate you see what I'm saying so there's no do you see what I'm saying in a specialty knowledge is something that only a person practicing in that area would know and anyone in any other area would not know but general knowledge is what cuts across all Specialties okay now my big ah issue with a lot of reviews is they say you need to have knowledge but when you look at the knowledge they tell you to have it's all kinds of specialty stuff I looked at one review book and it said all 12 cranial nerves where are there nuclei how do you test them oh what does it deficit in this cranial nerve mean are you serious that is not generalist knowledge that is specialty mode so the point is our review the review I have minimizes the amount of knowledge and information you have because what I develop is what are the facts what are the facts that every nurse knows about every thing not everything there is to know about everything and when I look at these other review books that are review books put together that thick other review books are that big one put together because they're including absolutely everything that you could possibly know they're preparing you for five specialty tests instead of generalists so a lot of times what people do is they try to memorize all this and the essentials get lost in that sheer amount of information so you're really not learning anything that you need to know as a generalist so what we do is we narrow it down to just what does what do generalists know about these diseases and people always say but Mark you don't cover half the stuff that other people cover yeah yeah we don't because that's specialty knowledge we hit like for example on EKGs when we test teach you on Rhythm strips we teach you normal sinus asystole vpac V FIB AFib a flutter and a flutter and pretty and PVCs okay actually we don't do a flutter do we we don't even do it well we talk about a flutter but we don't really hit it we show you how to with the Sawtooth pattern of the p waves but but these other ones are teaching wanky Bach phenomenon both Parkinson White and Taurus is on the point okay could those be on NCLEX yes they could be on end clocks but you understand those are the questions that are super difficult that they don't even you don't have to know that the computer will never get to those questions for you because you're normal those are on there for those super brainiacs that really needed a life during nursing school you know that really had to learn everything but you just need to know those things so we focus on what what you want to learn and I really believe this if I were studying for NCLEX and I had textbooks and review books what I would do I would pull out my Potter and Perry my fundamentals book because what cuts across all Specialties the fundamentals those are the generalist knowledge bases acid bases electrolytes ethics culture basic care infection control all of those Concepts because you understand maternity questions yes but it's an infection control and maternity psych yes it's with psych but it's infection control and psych and yes it's Pediatrics but it's infection control in Pediatrics do you understand and it's it's these things that I cut across and I would pull out my fundamentals book and they always have questions at the end of every chapter I would start there before I did any other things I would start and do I would make sure that I knew the knowledge that is in my fundamentals book because what makes it do you understand because the NCLEX is a test of safe nursing practice and what makes something unsafe is not knowing the fundamentals you if you know the fundamentals that you don't know the Specialties you're not very knowledgeable but you are safe if you know all this specialty knowledge you're extremely knowledgeable but you don't know the fundamentals you're unsafe so knowing all those facts from the Specialties you're a highly educated knowledgeable unsafe person but if you know your fundamentals you're a I don't know everything but I have my fundamentals nailed safe and that's what they're looking for yeah they don't want to know if you know you know all the signs of systemic lupus erythematosis or idiopathic thrombocytopene or bullous pentagus they want to know what do you see when a person with congestive heart failure has too much fluid on board what do you see you know you know duh well that's because what do you see when anyone's overloaded influence so fluid overloach could show up anywhere that's right in maternity oh my goodness an eternity definitely where your blood volume increases by 33 yeah you know in at Surge and Pediatrics think of all the Pediatric fluid babies are mostly fluid so I mean it cuts across so I would not even start those other books until I knew my fundamentals and that's what our Blue Book is designed at so you really have to know knowledge and best way to learn knowledge is drill there is no better way to learn facts than drill and drill by drill I mean you get a question for a fact and then you have to respond and you either right or you're wrong and then you look and go oh I was wrong that's the answer and you just like flash card drill flash card drill you don't learn your knowledge Base by multiple choice and select all their plot questions it's the worst way to learn your knowledge because the right answer in those situations is only right because of the other answers but it's not a fundamental this is the truth this shall right all right so what else where I know I've gotten off tap oh that's no I ask you what they need to know in order to pass NCLEX you said the fundamentals that that answered my question yeah um what are common mistakes in class NCLEX test takers make well first off on the heels of the last question they try to learn everything they try to learn everything they think well I have to have a really good knowledge base therefore I have to know everything and if there's anything I don't know I'm dead so this first mistake is I have to know everything okay so they over prepare and then they get into the NCLEX and all these facts start flooding their head while they're taking the question and by golly they learned it they're gonna use it you know I learned my 12th cranial nerves so I'm gonna use it whether I have to or not because I went through all that I'm gonna use it and then they try to use the 12 cranial nerve knowledge to answer a a level of Consciousness question within a cranial pressure do and cause they learned that they're going to use it so the point is learning more than you need to learn actually is dangerous because then you you have the the reservoir of knowledge to read into all kinds I say it always pays a little bit it does a little ignorance here and there doesn't hurt because it prevents you from reading into everything the more you know the more you read into and you don't want to get into that that thing so learn the fundamentals well and then don't try to learn everything yeah the second thing is what do they do wrong is when they don't know something they think they're dead people give up they they read a question and they don't know the drug or they don't know the disease or they've never heard of the test so one of the things they do wrong is when they're preparing they think they have to know the answers to the question to get the question correct what they need to learn when they're preparing for inflex is how to answer questions where they don't know the answer because any nurse that practices knows that they know they often know how to respond not because they know this situation or have ever been there but they know what they've done in similar situations in comparable situations direct thinking say it applies here so I've never done that before but the same thing applies this is the same kind of situation so I'm going to pick the same kind of concept and so one thing that students do when they prepare is they think they have to learn everything then they think that they're dead when they don't know the facts of the question when you can probably get 75 percent of your questions right even if you don't know the information by applying fundamental principles so that gets so the first thing is know your fundamental knowledge base the second mistake they make is once they have that when it when the question gets to a level that's higher than fundamentals they don't think their fundamentals can get them to the right answer when it can they they think I I didn't learn that so since we didn't learn that it's not in my knowledge but it's therefore I'm dead I can't I'm I'm gonna miss this question no go back to the fundamentals that you and say if these fundamentals are true how could that play out in this how can I show the NCLEX that I know these fundamentals in my answer I may not know the answer okay I may not know all this specialty knowledge but I'm going to show you how I think fundamentals apply in this situation and you know what that's what they're asking you they're not asking if you know idiopathic they're on the cytopenic purpura they're saying what do you do what does a nurse do when a nurse doesn't know what to do and that's they don't prepare for that they it never crosses their mind that they need to prepare for answering questions they don't know the answer to because what they want when they go through these test Banks what they're praying and hoping for is Lord let the next question be something I want no no let it be something I know no no you need to say okay this next thing's gonna be something I've never heard of how can I take what I know and get the answer you see it's a very different mindset and you understand that's what the test is trying to find out because no nurse practicing knows everything right and the key is not a safe nurse is not a person who knows what to do all the time a safe nurse of practice safe nursing practices how does the nurse act when they don't know what's happening with insufficient data or ambiguous name or confusing and conflicting data what do they do what is a safe nurse do right and you got to show them that yeah and fundamentals is going to get you that yeah I uh I tell students and when I do the reviews that I think the biggest mistake they make is thinking they're going to know the answer to every question oh exactly that's what that's exactly what I'm right that's what you're saying yeah they're looking for a question oh give me an answer where I know the answer no no and then they freak out because they think oh none of my preparation worked well you're not using what you were preparing and instead I say you have to expect most of the questions you're not going to know how much you study no matter most of the questions you're not going to immediately know the answer to it you have to think through it and think what's the what's the concept you use the word principles a lot but what's the principle or the concept that's being tested here and then what's the the best answer based on the concept that's being tested the um the other things in the question don't even matter that much as much as the basic fundamental concept is being tested correct um what does it mean to be a good test taker or a bad test taker well I think part of it's it's threefold I there again I think you either have don't have the generalist knowledge base or you don't have the confidence or you don't have the exam efficiency in any one or all three of those or any two of those can make you a bad test taker so most people say a bad test taker is someone who has high test anxiety that is like saying all people with heart disease have congestive heart failure yes it's a big part of it but it's it's if all we treated was congestive heart failure a lot of people with mis would die you know so that's not the solution your anxiety isn't the your anxiety has to be part of the solution but and I do see people who are anxious often do not see the 800 pound gorilla staring them in the face in the question you're going how could you miss it and then later on if they were taking it it weren't NCLEX they go how did I miss that well I get that anxiety anxiety does do strange things with your thinking I agree um but good test taking actually says what do I do when I don't know what to do good test takers good test takers always do I would say three things good test takers always read well mm-hmm and they read with a purpose they read well and they read with a purpose reading well means they make sure they say the correct words because I've seen people who don't do well on tests and they read a sentence and they read three words wrong they said three words wrong yep and you're going well you didn't even read what they wrote so reading accurately and then um being able to read with a purpose because you can read well and read the answers beautifully accurately but you're just reading them you've got to read with a purpose meaning okay now here's this sentence what's the purpose for which they wrote this sense what were they trying tell me when they went with the sense oh they're trying to tell me this is an older person who doesn't have many resources that's why that sentence is there um oh they're trying to find out if I know the order in which things are done um they they don't they just read but they don't read trying to find the key Concepts on which the answer hinges is it age yeah is it uh time frame yeah is it uh order yeah is it prioritization is it grow growth and development human growth and development stages what what is it that they're doing here because you understand their words are not without a purpose and you've got to read trying to find the purpose and then they don't write they don't write down that those key words just a word or two on their notepad on English so reading well and reading with purpose is one thing that test takers do very very well and they they like if it says unilateral they write unilateral now knowing that bilateral is not what they want to be they see increase they write increase down because they know that there's going to be some decreases there and they're not going to go that way um or they'll write the time frame down you know in the hour after well what's key with the hour after versus six hours later you know on discharge or something like that they'll write those down so reading well accurately and reading with purpose and then writing it down so that when they do the answer they don't forget what all that good thinking they had yeah okay so that's one good thing they do uh another thing that the good test takers do is they always answer based on their knowledge and not their ignorance they don't worry about what they do not know they take the question as an opportunity to show what they know kind of show-offs a little bit of show off yeah I'm going to show you what I know you know and you thought you thought you said okay you're talking about a cholecystectomy I don't remember what a color cystectomy is but I'm going to show you I know post-op care right you know I'm going to show you I know post I don't care you said uh you said thrombo angiitis obliterins I don't know what obliterins means I don't know what thrombo I guess thrombo is Claude and I guess angio has to do with blood vessels so I'm going to show you what I know about clots in blood vessels you know um the patient has nephromythiasis I have no idea what that is uh but I do know nephro so I'm going to pick something to do with the kidney I'm going to talk about creatinine I'm going to talk about the output I'm going to talk about edema I'm going to talk about uh all of these things related to the thing but what people poor test takers do is they focus on what they don't know and they get all focused on well nevertheless I had never heard of that it must be something I don't know and if it's something I don't know the answer is probably something I've never heard of so now I'll pick something I've never heard of because I don't know the situation I don't know the facts and good test takers always if good tests okay so they do that and another third ability that good test takers do and this is sort of related to the last one but it's more specific is when a good test taker when they don't know something specifically they go General they generalize it for example if they get a question on Mexico the drug Mexico they do not know Mexican they'll say okay I don't know Mexico so they'll generalize and say a drug the patient is receiving a drug or if they know a little bit about the situation they say it looks like it's a heart so I'll do that a classic situation where good taste takers are so much better than poor test takers because of the things I've talked about is a question well they'll say you're getting your patient is uh your patient was admitted for severe depression and he's on Celebrity uh which of the following diets is good for him immediately four testers ago celebrity I've never seen alleged diets for depressed people I guess what I'll do is I'll go I'll I'll pick uh high fiber diets well yes but they gave you a drug okay and with depression we usually give antidepressants and there's only one class of antidepressants where you worry about the diet and those are your maois so therefore I'm going to assume that selegitine is an MAOI even though I've never heard of it gotcha I have no idea but given the context I'm going to show them what I know about what do you do with maois because they're I've got a situation here where it's a mental it's a mental health education they're getting a drug for that and they're asking about the diet the only time I know those three are in the court at the same time is with maois so I'm gonna I'm gonna assume that that that's what I'm going to answer and they get it right and the other person says well I knew what drug what the person who poor test taker says I know what food you're not allowed to have with MAO is but they didn't ask me that well how do you know they did because I didn't know what salinity was did you know it was a drug yes did you know your patient was depressed yes do you know they were asking about diet yeah when do those all show up depression deny it and deny diet diet and drugs well I guess maois okay so why did you go that route well I never thought I didn't think that mm-hmm a good test taker says I can do this let me figure out how a poor tester who says I don't know this I'm dead and that's the difference because if you don't even think you have a chance you're never going to get that question correct when if you believe you can do it and you use your general knowledge be able to do it and yeah it may only happen that may only get you half of the questions you would have missed correct did you understand if you took all the questions you missed on Xbox and half of those you got right everybody would pass yeah everyone would pass because usually you're only you're within what a few questions of passing or failing yeah you're just within a few questions if you could just turn a few of those so good test takers um read well and read with purpose and document it good test takers uh biggest answers on what they know instead of their ignorance good test takers have the positive attitude if I can't get this rather than I'm dead in the water and good test takers if they don't know specific they go General and then another thing about good test takers is they don't foreclose or over analyze now those are two extremes foreclose means you read a question you say I know the answer because of one word in the question I know the answer or they immediately say I know it's not a I know I can't say how many times I hear people say that I'm like it's a because because they've never seen a be the answer in another question or they pick some word out of the question that made them think hey couldn't have been the right answer because if that's one word in the question or they don't like it yeah they don't like it you know like saying I had in the clinical instructor tell me don't you don't do that yeah so they'll they'll what they'll do is they'll they'll just immediately say no that's not the answer and and that what then what they do or they say a is the answer and then they read the others with bias yeah because if you decide a is not the answer you're reading the other three with positive bias if you say a is the answer then you're reading the other three with negative bias and and that changes everything so the idea is a good test takers don't foreclose they read all the answers before they even decide whether they think they're good or not then based on where the question's going they then go back and reread the question to see if there's anything there that can help me between because how many times have you read a question where you think you know where it's going and by the third answer you're going oh it isn't going there at all but already you've biased your thinking by foreclosing The Other Extreme is over analysis meaning that you you they always say fisher cut bait you know you got it at some point in time you've gotta say okay I'm just gonna go General basic fundamental and that's the answer let's move on and not bringing in all sorts of other information yeah so the extreme the extremes are poor test takers either either fixate and obsess with questions and sit there over and over and over again or they real quickly foreclose and what I find is foreclosure tends to be higher in the population of people who hold licenses and certificates in other health care Fields before they went into nursing so your foreclosures tend to be your EMTs your paramedics your LPNs and those your respiratory therapists your aides because they've seen it they know it that well that's what we do and they don't even read critically so foreclosures for those ones who really have to watch it and then the over analysis is for the people who are have no experience at all and don't know whether don't know how to filter out noise from reality yeah so that's a good Clinic good clinical experience does help you prevent the reading into but it promotes the Foreclosure oh yeah so so those are things that they do I could go on and on there's a lot of them there are a lot of them yeah no that's okay we can have another conversation another day um this may be a little redundant question so I'm not sure um but how does Clinic reviews help test takers pass NCLEX for test takers just anyone uh what's the and you've already talked about Ace so I think that's the answer um is there anything else you want to say about how I think that we I think one of the reasons why it helps us a lot is everyone that works on the team that works on the on the questions in the program are personality wise tend to be very different than a lot of nurses that you meet none of us really fits the mold you know you look at Sharon and Pete and Trevor and Mark and Tim and all we don't fit the mold of the cookie cutter nurse we we are very very different and we see things very differently and very uniquely which enables us and we're all different from each other so the perspectives we all bring we focus on students who have the issues problems the difficulties because we're not the ones that I don't know when I went into nursing I had almost a 4.0 two years of college four point I started taking nursing classes it was another two years until I got another a I just got B's and C's all the time because I couldn't I didn't know what this nursing at least the way a nurse thinks was like a mystery to me and I think everybody else has the secret agenda and I don't know what it is and I'm not picking it up here but I keep thinking you know in the reviews as I tried to develop I try to think how does a person like that still be able to communicate a positive test outcome what did I what have I learned because I am a very unusual learner I'm a very unlikely nurse I'm a very atypical nurse an odd nurse in some ways and how do we those of us that don't fit the mold how do we communicate in a way that gets our point across so that we're understood by the majority of these people who write the questions for the majority of ways people think so I think we're very we we cater very strongly students who may have some learning challenges ways to remember ways to think the way approaches to do we we don't tailor the class for the student who doesn't need it I tailor the class for the student who doesn't he does need it that's why we we are we have probably in any review we're in I would say confidently that a third to to a half of this people sitting out there are what we would call high risk oh half of the people who take my reviews have already failed board at least once right and I have people who failed three four or five times yes yes the record I have is eight times yeah and so we we nothing else is working for them and they come to us and then that's what works for them now it doesn't work for everybody you know but many times it does work for them and they are successful in the past you I don't know how we have what stacks and testimonials say you know I took it for six times and then I did this right we also have an occasional who said I took yours last year and I failed but you know that's they usually say but truth be told we had we had a death in the family we had a divorce I moved I lost my job and I I didn't really study at all or whatever the other thing I find with people who don't pass after they take Clinic reviews because people come and they fail three four times and their confidence is killed right and I'll say we're going to increase your confidence taking this review and they always say how are you going to do it yeah yeah and I say your confidence is going to go up when you know the strategies and you start getting answers right yeah but what doesn't help is when they take the review and they don't actually learn the strategies yes so they they sound really good to them and they make all kinds of sense while they're there but then they leave and don't really study the yellow book and try to apply it yes and maybe they even go back to doing what they were doing before they took the clinic review which is trying to memorize the rationale from whatever cubic they're using exactly and they don't really use the strategies and in that case it doesn't it's not going to work yeah but yeah knowing the the um the strategies it will increase your confidence every time you got to know them though you got to actually know and those strategies were developed based on where do people's thinking go wrong and how can we correct it rather than how should a person think I'm saying again because if you if you just say this is what you're supposed to think this is what you're supposed to think this is what you're supposed to think and you don't think that way okay so I know I'm not supposed to think that way great that really helps me yeah you know but we said okay you're not supposed to think this way think this way this is how they want you to think do you have a recommendation for a q bank or would you prefer not to make it well there are every Q bank has at least 10 percent bad questions minimum 10 some as high as 20 bad questions because it's just that it's just the mechanics of how that's reviewed and every review process is only as good as the uh intensity and the quality of the reviewing that goes on and since they're only paid like maybe five bucks a question you know or not even that people that get reviews they just yeah that looks good that's something but they're not the people they're not take they're not reading that question in the exact same mindset that a student taking it would on end products and so they don't see the problems with the questions because they all looks good to me so boom here's here's 100 questions I reviewed for you you review your company and I'll take my 50 gift certificate you know that kind of thing so um I don't think reviewers really seriously take the questions that they're given to review so I I think there are a lot of problems there are missed keys there are they're just bad questions they're focusing on one thing and forget about the big picture so I guess what I'm saying is every time I go through questions with students in review books at least 10 to 20 of the questions are wrong and bad so the question is which ones keep that to a minimum and rather than say the ones I don't okay I'll just say the ones I do like and I have no uh call it Financial stake in these companies whatsoever I just find that the um Lippincott materials are students are able to see the operation of principles Better In Those Questions than they do other questions they're able to use what they learn and what they know in those questions and and Lippincott tends to test the general rather than the exception for example they will if they're going to test a benzodiazepine they'll pick uh Valium diazepam and not uh Alprazolam or something that works differently it has different they'll pick the Prototype the typical the the common facts rather than the exception you know which is the which beta blocker does not do this no they test what does a beta blocker do right and so I really like them for that reason uh very few errors in grammar syntax or keying um they're just it's just a lot I find it better quality also uh Davis has a book out just look up Davis they have a book out that does the same I I like their materials quite a lot the point of review books should be for you to apply the knowledge you have and the principles you know not to memorize facts from it and so I would say the bigger problem is not that this book is bad but the fact that Ace the big the problem is that with it is a good book okay book bad book that's probably not the biggest thing the biggest thing is how do students use the good book how do they use the okay book how do they use the bad book so the real problem comes in the way the students use the books rather than what book they're using yeah and the biggest danger is no matter what book you use do not memorize answers from the book for the question because even if they ask you what's the most the first thing you do when a person has dyspnea the answer is Elevate the head of the bed but you understand that's only the answer because of the other three answers if you change the other three answers elevating the head of the bed may not be the first thing you do right you see what I'm saying so so you don't memorize you don't memorize your facts and information your take away from the question is not what fact did I learn and what's the answer the takeaway is how did I choose principles that I know in that question so I think the use of the book is more critical than the book itself but there are some bad ones out there that I would steer away from but I won't say that but I'll just say those two are very very good there's a prioritization book that I really like the authors like charity yes are you familiar with that well yes very good I find that very good I've just found that to be very very effective and it's very consistent with the clinic strategy yes so it's not as long it doesn't have as many questions but it's kind of sad it's got a lot of prioritization so it's a good book it's a good book uh well that's all the questions I have is there anything else you'd like to recommendations you'd like to make in general for NCLEX prep well preparation is important uh you should have the confidence that if you're doing preparation you are much better prepared than doing none and many people do not you have to understand it so every preparation you do should both do your confidence that think about the person who's doing nothing they're in danger they don't know it even if you feel a little overwhelmed at least you know doing what you can do and any anything you do is better than nothing so I guess I would say is don't let the enormity of the task or the difficulty of the questions uh make you go into uh static inactivity and you freeze and you just say I give up no just keep doing keep doing yeah something good well thank you Mark and I look forward to having more conversations with you while we will talk about a lot more things okay thank you