hey Remar nurses we are live and we are about to talk about the NCLEX topic myasthenia gravis we're going to do some NCLEX questions on it tonight as well this is our winning Wednesday NCLEX review right here hi if it's your first time joining me my name is Regina callian I am happy to be here with you I've been a nursing educator now for over 12 years helping thousands of nursing students past the NCLEX so you are in the right place if you are planning to get your nursing license in 2023 oh my goodness guys and so since you're nurses you probably can help and you probably can tell me what is going on with my daughter today so last night she started complaining of a sore throat and when I looked at the back of her throat I saw these white patches right white patches on the back of her throat and I said to myself okay you'll go to the doctors in the morning and by the time the morning came she was nauseated she couldn't sit up she was throwing up and I was just like what is going on I didn't know uh because you guys know we were in Aruba last week for my birthday thank you guys so much for all the birthday wishes and so our oldest came back we literally have been home for just two days and so yesterday she had the sore throat white patches on the back of her throat but then she was like throwing up constantly and she couldn't sit still she laid down even when I took her to the doctor she could hardly sit up for him to even listen to her lungs or anything like that and he looked at the back of her throat and he was like oh it's nasty in here it's so nasty and I was like is it covet because I was thinking why is she so nauseated why is she so dizzy um she said she had chills and it was not covet it was strep throat and so just as I Was preparing to go live she started having the symptoms of strep throat again I did not know strep throat could be so bad but my nine-year-old is suffering right now in a in a in a crazy way so um I just settled her and I said I'm gonna do my astina gravis with the Remar nurses and then I'll be back with you and she said okay mommy I'll be okay okay so um I am in dear dear dear dearly my heart is with her and I'm going to deliver this winning Wednesday to you guys help you pass your NCLEX and then I'm going back to being a mama so we are talking about myasthenia gravis myasthenia gravis and this topic I see some of you guys talking about quick facts I am so ashamed to show this quick facts guys um this is the quick facts book that I have right now and if you have quick facts and it's the only Remar product that you have we do talk about myasthenia gravis in this quick facts but I wanted to develop it more to read more nurses about this part of myasthenia gravis because it will help them for NCLEX so I'll be doing that on tonight with you guys so we're gonna get into it also if you have the quick facts book you got it on Amazon or you got it from my website remarknurse.com we still have this going on which is the complete set for the V2 and it's just 89 still guys it's just 89 now if you have quick facts already that price goes down to even lower to 69.69 so still a great great great value for your NCLEX review NCLEX review okay so now you guys have 20 seconds to get the kids out the room clear out everything because we are going to study we are going to study these small steps that you take will be great distances very soon so we'll start with the small steps which is winning Wednesday so myasthenia gravis when we talk about this condition remember that it is in fact an autoimmune disease so whenever we see autoimmune we are thinking that the body is what to itself the body is an enemy it is attacking its own self and particularly the immune system mistakenly begins to attack its own body tissues oh my goodness so in myasthenia gravis I'll say m mg the Hallmark is that muscle weakness occurs and specifically it worsens after periods of activity and it will improve after periods of rest okay after periods of rest so when you look at the term myasthenia gravis you can learn a lot by just the name and so gravis there means it's a great condition and we know my means muscle so it is a grave muscle weakness okay it's a grave muscle weakness and when we talk about the muscles that are involved we're talking about the skeletal muscles so the skeletal muscles are going to be the muscles that you're able to control for movement so lifting up your arms right your diaphragm you can control your diaphragm you can control if you want to breathe fast or if you want to breathe slow so if we talk about a condition that affects your ability to control your diaphragm what what kind of emergency could this patient have this patient could have respiratory emergencies so myasthenia gravis is a serious condition and that's why it's on the NCLEX exam okay all right so I hope we got the name we're starting with our definition definitions if we understand them they will make us more confident and we will be able to uh continue to build upon the simple definitions this is uh this is also another reason why I tell you guys don't just jump into question Banks and start doing questions about conditions start first with this step which is reviewing the condition reviewing the terminologies right so when we talk about an etiology all right an etiology and we're not going to get too deep in this but just let me read it to you let me read it to you in your hearing myasthenia gravis is caused by an error and how nerve signals are transmitted to muscles so this is a neuromuscular disease so it is caused in an error in how nerve signals are transmitted to muscles and it occurs when communication between the nerve and muscle is interrupted at the neuromuscular Junction which typically means the place where nerve cells connect to the muscles where nerve cells connect to the muscles all right and so who is at risk this is very important who is at risk both men and women can get myasthenia gravis and it occurs all across different racial lines and ethnic groups it most commonly impacts young adult females so females under 40 and older males over 60. isn't that interesting so younger females or older males okay but it can occur at any age during childhood okay so are we still good are we are you having any questions class tonight about this topic I am expecting you guys to be able to answer the questions at the end of this flawlessly okay all right now when you talk about myasthenia gravis we understand that this is a muscular or neuromuscular condition so we expect some muscle weakness but what does that look like in your minds now can you think about can you think about um some some symptoms that you would expect all right before I show you before I show you I want you to think about what that neuromuscular weakness will present as all right this is kind of getting you to critically think so we have weakness of the eye muscles oh my goodness weakness of the eye muscles this is ocular Myasthenia very common and so what you're going to see is the drooping of one or both eyelids okay ketosis you're also going to see double or blurry vision in your patient I like that difficulty walking some people are putting it on the comments excellent job changes in facial expression because the muscles are weak difficulty swallowing shortness of breath so is this a serious condition yes it can be okay um impaired speech weakness in the arms hands fingers legs and neck beautiful comments on the screen and so sometimes we we have a range of symptoms with myasthenia gravis and it can go from just you know a little fatigue with activity but all the way up until respiratory failure which is a immediate medical emergency so if your patient is having some of these signs you get a a female and she comes in and she's you know 25 years old but tells you that her eyes get really tired you know she's having a hard time keeping her eyes open we we have to do some diagnosis what are we going to do what are we going to do well let's start with the physical and a neurological examination diagnosis that's how we're going to do it a physical and neurological examination muscle strength and tone coordination looking at the sense of touch and definitely definitely any any impaired eye movement androphonium test now this is a test specifically for um eye muscle weakness and what happens is with androphonium it it is injected and what it will do is it will help to block the breakdown of the acetylcholine and so the acetylcholine is what is being attacked in myasthenia gravis and so sometimes when we're in nursing school the the instructor will use the term you know acetylcholinesterase or acetylcholine or acetylcholine Inhibitors right and we don't really know how it applies but acetylcholine is very it is very important to muscle strength and so with the androphonium test the the endraphonium is injected and it will help the patient to regain their strength because it is allowing acetylcholine to last a little bit longer okay also a blood test will a blood test people who have living with myasthenia gravis may have abnormally elevated levels of the acetylcholine acetylcholine receptor antibodies and so remember this is an autoimmune disease so if you have antibodies against acetylcholine then you know hey the body is attacking itself which it should not be doing because acetylcholine is okay for the body to have all right also I'm going to get into some electrodiagnosis we're going to talk about the diagnostic images and the pulmonary function test okay all right so the the electro Diagnostics this is really interesting and um this is when we are asking for a nerve impulse or nerve stimulation to be repeated okay and you can actually honestly you can do this with um the electromagnetic test if you want to but any kind of repetitive movement is going to demonstrate muscle fatigue after a while so if you ask the patient with myasthenia gravis to just do this just lift up their arm 20 times you'll see that after a certain amount of times their arm is going to get weaker and weaker because remember with myasthenia gravis that connection from the nerve to the muscle is is disrupted so you're not going to be able to do it or what doctors will do is tell their patient to just blink just blink because blinking is a controlled activity right it's subconscious but you can also control it so and remember with myasthenia gravis we have what we have I we have eye changes and so after a while the patient's not going to be able to open their eyes their eyes are going to be closed right they're not going to be able to open it because it takes muscle strength to be able to open your eyes too all right so we're talking about how we can tell if a patient has myasthenia gravis and you guys are learning a lot about this topic tonight I think after this lecture you can answer any NCLEX question that you'll get on the exam the diagnostic tests are going to be a a CT or an MRI that may help um to determine if you if you have a thigh thymoma which is um which is the thymus right and you have a growth on your thymus gland pulmonary function testing measures the breathing strength of the patient and we want to know their respiratory capacity because we know with myasthenia gravis if you have respiratory failure it can lead to a myasthenic crisis so if this is the case and your patient has it how are we going to treat it what just by learning uh the few facts that we had tonight what what is the medication going to be focused on if you had a patient with myasthenia gravis what kind of medications are going to help this patient put the comments on the screen I like to read them okay I like to read them I know I have nurses literally from all over the planet watching tonight but we're talking about myasthenia gravis and I'm asking you I'm not asking you to name medications I'm asking you to consider the symptoms of your patient consider the uh the pathophysiology of myasthenia gravis and then tell me what do we want our medications to focus on yeah muscle okay so I'm I'm seeing we may want our patients to focus on the muscles not so much muscle um not so much muscle relaxers we don't want the muscles to be more relaxed we want them to be strengthened we want them to have some strength um maybe some antidepressants that that that may that may be relevant to the patient oh plasmapheresis I like that term I like that term actually that's a very important term in your quick facts book we have a whole section on plasmapheresis it's a definitely a definite um when you think of plasmapheresis you definitely want to think of myasthenia gravis because it applies to that acetylcholine Gabapentin good job okay everybody excellent job that's what we mean we show up your attention your presence is required in class and these little things just like commenting engaging in the lecture is going to help you greatly when you get this kind of professional NCLEX all right so very good you guys got it we're going to do some cholinesterase inhibitors because remember it is the breaking down of acetylcholine acetylcholine that is causing our muscle weakness so you have drugs and this is something that you do want to know this is a this is a medication that you guys can know and remember Neil stag mine this is a medication that is going to be helpful for myasthenia gravis why asthenia gravis all right um also these are the medications that I want you guys to know specifically immunosuppressive medications why immunosuppressive because immunosuppressive is going to suppress the what tell me what tell me what immunosuppressant tell me what your Prednisone right is going to do your your steroids what are they going to do I took it off the screen because I wanted you guys to think about it why would we give the client with myasthenia gravis a steroid what's going to be the um what's going to be the benefit to that patient because we know steroids come with their own complications so if you're giving a patient a steroid there needs to be a very good reason because steroids can cause you to have other medical conditions so we're given the steroids um so I see a lot of people saying to reduce the inflammation the problem here is uh well I I know which I know where you're going with that whereas where you're saying reduced inflammation um but it's not so much to inflammation I want you to be I want you to be thinking about with myasthenia gravis it's the antibodies it's the antibodies okay so it's going to suppress the immune system so that it doesn't produce the antibodies that is that is attacking all right okay so um again it's going to improve muscle strength by suppressing the production of the abnormal antibodies and then complement Inhibitors uh this is just the idea that they're uh from a and how can I say this from a like cellular pathway I guess when I look this up it helps to it helps to inhibit the immune response in the production and destruction of you know the overactive antibodies but there there's not a specific drug name that you need to know for NCLEX so the two drugs that I want you to know are the neostagmine and then also you can know prednisone or immunosuppressive therapies uh for the antibody suppression okay cool the thymectomy these are also um more like surgical treatment or procedures as opposed to just medicine so thyroid thymectomy is a surgical operation to remove the thymus okay and the thymus gland does anybody know what the thymus gland is I'm going to be responsible for put it on the screen I need somebody to put that on the screen in the comments because I have here a thymectomy but what does the thymus gland do okay because a thymectomy is removing the thymus gland so I'm going to read the comments of people put on the screen you are contributing to the studying process on tonight plasmapheresis okay this is this is the treatment that I want you to be aware of plasmapheresis and it's a procedure in which a machine is used to remove harmful antibodies in plasma and and replaces them with good plasma or plasma substitute so I'm actually looking for it in quick facts because it was one of the topics that I added to the five star version and I um and it's very important so we talked about here what does the thymus do produce hormones producing T lymphocytes okay white blood cells okay so we see that the thymus gland is is a plays a huge part in the antibody production right and so we know that if we remove the thymus then the patient won't be able to have the same immune response I want to look at the uh can you guys see it probably not this is plasmapheresis in quick facts so I'm just going to read plasmapheresis if you guys don't mind um so this is the quick facts for plasmapheresis what is plasmapheresis plasmapheresis is the removing antibodies that attack the uh immune system from a client's plasma what kind of patients need this treatment okay these are the type of patients that need plasmapheresis clients with lupus make sense lupus is an autoimmune disease clients with multiple sclerosis yes we could be talking about multiple sclerosis we're going to get the same kind of things Gillian Barre Syndrome you need to know about Guillain-Barre myasthenia gravis is one that I'm um putting in there and other autoimmune diseases all right and then it says um when plasma is removed what is it replaced with so when plasma is removed from the body during plasmapheresis it is replaced with say saline or albumin okay um during plasmapheresis is just the plasma removed what do you guys think all right and this is how quick facts helps you because you can actually you can't see it you can ask yourself the questions on one side and then think if you know the answers on the other so during plasmapheresis is only plasma removed from the body no whole blood is removed then the plasma is separated how long does a plasma exchange take one to three hours so it's something like dialysis right it's kind of in the in the mind of dialysis and what are the potential complications of plasmapheresis well if you're removing whole blood your patient is going to have issues perhaps with hypotension hypotension all right so that's the quick facts on plasmapheresis let's get back into it now intravenous immunoglobulin this is a highly concentrated injection of um well let me say this it works by binding to the antibodies that causes myasthenia gravis and removing them from circulation that's all okay so it works by binding to the antibodies and then removing them from circulation removing them from circulation so our nursing responsibilities our nursing responsibilities we need to monitor our patients Vital Signs we need to monitor their respiratory status and very importantly ask them to cough can your patient with myosinia gravis cough and deep breathe that is so important what is the importance of coughing as a nurse um as a mother um if my if my kids are uh eating something and they begin to cough and say oh Mom I'm choking I'm choking I just calmly look at them and I say if you're coughing you're not joking if you're talking you're not choking like right if your patient cannot produce a cough that means that they have no muscle strength their respiratory strength is done all right because coughing means you have an open Airway it means your Airway is opening when your Airway is closed you can't cough you can't talk you can't swallow so it's good it is good when your kids are coughing up water like you want them to be coughing okay all right um also monitor for respiratory failure monitor suctioning and have Emergency Equipment at the bedside because the myostinic crisis is it can come on very fast and it is an exacerbation that takes an emergency monitor speech and swallowing swallowing abilities to prevent aspiration good good good good also encourage the client to sit down when eating and and this is also because we know that eating can also take a lot of activity out of you and so when a client is in a resting state that also helps monitor for a myasthenic and cholinergic crisis administer medications as prescribed and instruct the client to wear a Medic Alert bracelet all right okay so now that we've gone over the content we are ready for the question so here we go Remar nurses first question is this Mrs Carlos and by the way after this review I'm expecting at least four out of five so if you got a four out of five all right here we go Miss Carlos is suspected to have myasthenia gravis which of the following findings should the nurse expect number one weakness of the eye muscles two unexpected weight loss three black tarry stool four reddish orange urine uh let's say if you guys we are expecting flawlessly you guys are answering of course it is going to be number one absolutely number one weakness of the eye muscles in myasthenia gravis the immune system attacks and interrupts the connection between nerve and muscles and neuromuscular disease the following symptoms are weakness of the eye muscles drooping of the eyelids blurt or double vision changes in facial expression difficulty swallowing impaired speech all the things we went over in the beginning and weakness in the arms hands fingers legs and neck okay next question is this Mrs Cannon 32 years old is experiencing muscle weakness that worsens after periods of activity and improves after periods of rest for three weeks now the health care provider orders diagnostic tests to confirm this condition which test are we going to use are we going to use a urine culture chest x-ray indrofonium test Fern test I would say it you guys you learned something new tonight I'm so happy you showed up today okay correct answer is going to be number three you got it add this one to your correct column remember to diagnose mycena graphic gravis we use endraphonium test and it is going to be an injection that is going to strengthen the endraphonium chloride that's going to strength strengthen the muscle weakness in the eye and the reason why is because that acetylcholine that is being broken down is going to be able to hang out a little longer hang out a little longer question number three which among the following is considered a vulnerable and high-risk client for myasthenia gravis is it number one less than 40 years of age okay number two less than 10 years of age three infants or four are Travelers Travelers Travelers Travelers who is considered a vulnerable and high-risk client for myasthenia gravis welcome if you're just joining me my name is Regina callion we do a free NCLEX review every Wednesday night we call it winning Wednesday and tonight's topic was myasthenia gravis correct the answer is under 40 years of age because we know that in myasthenia gravis even though it affects both male and females and occurs across all racial and ethnic groups it commonly impacts young adult females under 40 and older males over 60. okay question number four which amongst the medications will the health care provider anticipate to order for clients with myasthenia gravis number one remdiz navir two azithromycin three neostagmine or four metformin oh yes mm-hmm all right the correct answer is the one that is going to be slowing down the breakdown of acetylcholine okay acetylcholine at that neuromuscular Junction so which one is going to affect acetylcholine that is going to be number three the neostag mine and so it is a cholinesterase inhibitor used in the treatment of myasthenia gravis and reverses the effect of muscle relaxants so we would never for NCLEX pick muscle relaxants for a client with myasthenia gravis remember that it slows down the breakdown of the acetylcholine at the neuromuscular Junction question number five is this okay one of the medications used to treat myasthenia gravis are immunosuppressive drugs such as number one prednisone two cephalosporins three aminoglycosides for antivirals what sayeth you hey I got it I got it I got it I got it and I'm saying I got it because I was able to clearly explain this topic to you guys tonight for you to receive it and become very proficient in understanding the topic so I'm taking a little bit of the credit tonight for these beautiful answers the correct one is indeed the immunosuppressive drug to improve muscle strength is prednisone okay suppressing the production of abnormal antibodies by suppressing the immune the body's immune system that stops the um the body from damaging that neuromuscular Junction and you got to know prednisone the other the other medications azathiopran myofino late moffatil right these are all as well um Amino suppresses but the prednisone is going to be the most common one for your NCLEX exam how many people are glad they showed up and learned about myasthenia's gravis and now you can explain it and when you see it on NCLEX you'll feel so much better about it okay and that is the whole goal of winning the week because there were there were many people that needed to be here tonight but you showed up you showed up and so definitely your sacrifices today are going to pay off big when you're in front of the NCLEX and you're like give it more give me more about myasthenia gravis because I studied that one and I know it so give yourselves a round of applause I'm seeing so many five out of fives uh tonight which means that we are doing something right you and me we're doing it right we make a good team we make a good team so thank you guys so much for studying with me your time I value it I know it's very I know it's very very important and so I thank you guys so much for showing up to class as always I will be here also if you want to text me directly you can do so at 855-696 text the word NCLEX okay eight five five six nine six zero one three two zero one three two and if you want to keep on studying you can get inside of my V2 the NCLEX review right now it is just 89 for you I'm giving it away basically because I want the remark nurses to get in there get in the V2 start watching these lectures I have a full lecture on many different Topics in the last section you'll learn about management of care legal issues you'll also learn about um your your priorities how to master NCLEX all of that all right all of that it's like Concepts so I just want to take a second before I go is there any questions about V2 the question Bank um anything like that I don't want to leave somebody that has a question about V2 or the question bank at all do you guys know how to you know how to create the test do you know how to um you know look at the topics do you know how to make them optional or not optional ask me questions now about V2 or forever hold your peace over ever hold your peace uh great question the course is for next-gen NCLEX is also for those who are taking NCLEX now however if you are at this point testing for NCLEX you need to get the V2 um you need to get the B2 because you never know what could happen and you may find yourself actually having to extend your day and actually take the next gen NCLEX anybody taking their NCLEX after April 1st will be getting the next-gen NCLEX okay all right um do you have a two-week program my time my program could be modified can it be modified into two weeks of pushing it you guys know I don't I don't suggest cramming for this exam I I would say um I would say might put a lot of stress on you to try to finish my program in two weeks four weeks four weeks is and I have you studying five days a week so you would have to literally be studying six or seven days a week to do it in four weeks okay all right um um is there is there a replay there's a replay on this there will be yes absolutely is there a live class or pre-recorded so all of the videos in V2 are pre-recorded they're there they're available for you anytime that you want to study the entire course is there and you can go in the reason why I created V2 and I know V2 is not for everybody but the reason why I created V2 is because most of my nursing students are non-traditional so that means they work they have kids they have you know a job and so uh the videos being pre-recorded in the course being there for them to study whenever they can is a huge benefit to them some people like to go to live classes and sit in class and I think that's a great traditional way to learn but I created the V2 for people that needed flexibility but accountability too okay um I see how can I see how can I see you have difficulty let me know how that's why I'm on here now how can I see all the grades I made in V2 so when you when you go to the V2 and you take an exam once you take that exam and you pass it you're able to view your test results so if you I don't know if I have any here um that I can show you you can view the test results let me see how did I take this test all right you should be able to see those test results when you take an exam thank you so I had to take that exam yet um what he says I have the V2 when I do a test I need to go back there is no continue on the test it makes you start over again yeah so if you have you have to get a certain level to pass the V2 so it won't let you but I think the you know in the in the original program you needed a 90 or 95 to pass the V2 it's just it's a 60 so you have to make the 60 and the V2 will not let you proceed unless you make that 60 so you may have to take the test over once or twice it'll let you take it over again as many times as you need to but you definitely have to get that minimum you have to get that minimum okay um yes can you go through how to create a test I can absolutely I will do that what else thank you four out of five all right I have the books assessment exam if ready for exam yep also that's there I think honestly though in the in the Q Bank you have the easy moderate or difficulty level questions I'm going to say starting the moderate and see if you can do them if you can do well on the difficult questions in the V2 question Bank I think that is a great great assessment and it'll tell you at the end of the test whether you are doing well or not um yeah no when you are done with the whole VT it won't let you take it again yeah so once you're done with an exam once you pass a quiz for VT uh V2 it will not let you take that again that is your performance because at the end of it you're going to get a certificate that you can turn into the Board of Nursing to say hey I did this review course it was so many hours and you can use that for proof that you did the course okay love the case studies what's the mobile app the mobile app is being developed yeah the mobile app is being developed so it will be coming I received all right um okay so let me know all right remark nurse.com is how you can sign up let me try to I was actually looking for a quiz that was already taken because this is um I'm in Mark's account and I don't think he took any of the quizzes yeah he didn't take any of the quizzes so let me show you in your course you will have and I know that the writing on the screen is small but in your course oh here it is so he did so when you when you take a test and you pass a test all right you're able to review view your results once you pass it and the V2 will show you okay these are the questions you got right it will show you partial credit too okay and it will also tell you what you got wrong as well but you won't be able to you won't be able to take that quiz again all right so that is where you get your results at inside of the lectures all right so that's the courses somebody said they just brought the V2 how to how do you use it so just really quickly when you first log into your V2 what you're going to see is actually the 30-day challenge that I created you're going to see the 30 day challenge now so with the 30-day challenge if you watch the getting started tutorials it will explain to you how to use the V2 so you log into your V2 watch these videos okay watch these videos and that will help you to feel more comfortable the 30-day challenge are the videos that you can watch after every study session now this is after you do the work don't start by watching these videos what you're going to do is go to your NCLEX V2 review and not this first Circle but the second Circle okay so when you download your workbook you can go to this circle right here and you can begin to watch the lectures the first lecture that you will watch is your pregnancy lecture but again this is once you have your workbook in front of you in your study calendar because I don't want you guys just in the V2 just watching videos and things like that I want you to be able to get in here get in here and then I want you to be able to have your calendar okay if you don't know where your calendar is just check out your file Vault this is one thing about the V2 it is all inclusive it has everything that you need okay all right so if you go to your file vault this is a registered nurse you can get your study calendar and you can get your workbook right from the file Vault so even if you're like hey I didn't get the workbook I don't know where to download it I need my workbook you can get your workbook right here okay you just click on the link and it will um click on the link it's going to take you to your workbook you just download the file right here okay all right and then also like I said you can get your daily study calendar the study calendar you can download it and the great thing about the V2 you can do this in four weeks okay if you wanted to do it in less than four weeks you're gonna have to study do these study sessions uh six days a week I guess all right all right so this is where you get the study calendar from um if you don't know where the workbook is go to your file Vault again registered nurse student workbook is right here okay and you can download it right here that's it it's all it's always here for you it is always in there for you so everybody should have their workbook you should not have any reason why you don't have this workbook because it's already in the V2 okay all right okay any other questions any other questions about the V2 all right um the trial version of the V2 is available somebody said I'm trying to get the free version of the V2 yes you can also do the trial version if you go to the website remarkness.com you can do a trial of the V2 to see if you really like it one thing I will say is that you will be able to watch the lectures and take some quizzes but you won't have access to the question Bank all right you won't have access to the question bank so the purpose of the free trial is for you to experience the lectures and so forth like that the question Bank just really quickly to create a quiz on the question Bank um you go to this button here that says create new test and remember you have to name your quizzes okay you want to knit you have to name your quizzes because V2 will keep track of your test history okay so you go to create new test here you go to create new test and what's going to happen is the first thing you're going to need to do is put in a name for your quiz so I'll put this um I'm gonna name this winning Wednesday and I don't know if you guys can see this or not but you do have to name it all right um as far as why can't you pause the quiz it's just not a feature so once you leave or exit the exit the V2 quiz if you're in the middle of exiting the V2 quiz it is going to call it a wrap all right and so you want to make sure that if you're creating a quiz you have enough time to complete those questions so when I create a quiz most of my quizzes are like 10 quiz 10 questions 15 questions 20 questions um because I know that that's the amount of time that I have do you have study material for next gen yes this is what it is all right this is the next gen NCLEX review and so here you get to choose whether you want tutor to test or computer adaptive right so we'll just do a tutor test real quick also you get to choose um the question pool if you want all the questions unanswered um also you want easy moderator hard a lot of different metrics here and then you get to choose the subjects of course under easy we have 20 next-gen case studies we also um under easy we have 21 next-gen items and when you do moderate you'll have more of all the different question types most of our most of our questions in the V2 or at a medium level that was what I focused on so you're able to to do that as well all right so easy moderate hard you can select how many questions you want put in the quality say we just want to do five not Fifty four five from all of the subjects or maybe you guys I don't know if you want to see the next gen let me show next gen most people like to see that let's do [Music] um next-gen case studies let's just do some of those so you can see them and the questions will begin to populate all the case studies that you have and you can put how many that you want to do so let's do them on time and we can start our test okay can I print out the workbook so it's creating our test can I print out the workbook so that I can write in it along for the videos absolutely absolutely you can do that okay so our test is completed this is the case study screen remember with case studies in my V2 you do have the clickable tabs on the case studies all right um and so you can read the presentation read the Ed notes and we have the next gen question types so this is a x y question it's a rationale question which means the patient has this condition as evidenced by one of these things that you read here and so once you answer that you can go to the next screen of your case study and it will say identify three findings so this is a select in that apply here and it will tell you um the options that are correct here okay and here okay then we move on this is a select all that apply remember on next gen you can still have some of the question types that we have now okay Yep this is just like next this is just like the NCLEX we've worked really hard and so this is a highlighting question and so you have to highlight in the text what orders should be that should be prioritized all right so those of you who are preparing for next-gen NCLEX this is going to be really valuable for you to be able to get in there and begin to utilize the function and the technology of the new NCLEX all right and this is a drag and drop question and this is a um this is a a matrix question here that we have and we are asking we are asking whether a patient's condition improved declined or was unchanged okay so again one of the main reasons why I converted from the VT to the V2 is because I really wanted to be able to offer you guys this technology for a reasonable price if you guys see there are very few NCLEX reviews right now that are able to offer you guys electronic health records in equestrian Bank actually I only know of two two NCLEX reviews that have this technology and the other one is charging hundreds of dollars for you to be able to practice these questions so you have to you have to see that there is a real value in being prepared for this exam the NCLEX actually the passing rates for NCLEX have been um historically going down and with next-gen coming with next-gen coming I am like I'm on pins and needles waiting to see what this presentation will do to the passing rates and um hopefully we're all surprised and you guys do really really well you guys do extremely well on your NCLEX that's the goal right that no matter how the questions are presented to you you will be able to answer them no matter what it doesn't even matter the the nursing license can give you videos or pictures or whatever case studies and they go up the passing rates may go up so but you will have to definitely be able to Now read a great deal of information and be able to make sense you have to be able to make sense of it all right and that's going to be up to you nobody's going to do that for you all right nobody's gonna do it nobody's going to you know there they they need to make it they need to make it a little bit more realistic and this is what you do as a nurse you you come in you take a report and you have to be able to read a patient's information and make sense of it know when something is inappropriate this is what you do you click through a chart this is part of your charting you guys know if in nursing school you had to learn epic right or or Cerner or something else this is what that documentation looked like didn't it did you admit the patient yes did you feed them yes did they ambulate and so doing these things in your studying time will help you feel so much more comfortable so I say all that to say guys get in the V2 get in the V2 you can do the trial version but the paid version right now will give you access to the question bank and you can see how you really do all right um also also also also it doesn't matter to me it doesn't matter to me if you're studying for hours and hours and hours okay if you break your study session down to short Focus times 15 minutes 20 minutes and you're really putting a hundred percent into that 10 minutes 15 minutes 20 minutes you're going to do and and comprehend so much more than the person that's studying six hours a day seven hours a day and being distracted so make the study sessions count like we did tonight all right we didn't study myasthenia gravis long and we covered a great deal of information about it so use that and move forward with the rest of your week I will see you guys soon remember remember this it's my favorite thing to say you can you will and you must pass NCLEX you got questions text me directly the word NCLEX 855-69601 32 okay yes you can go to the question Bank First you can go straight to the question Bank you can give V2 go straight to the question bank if you want to if that's your thing you can do it it's there for you guys all right thank you guys for studying with me later