NCLEX Questions Neurologic System Review Class for Nurses
Good morning and good evening wherever you are. Guys, this is Dr Paul Biluan and we are live with Connetics College and Aspire RN. I will be doing an NCLEX class today. This is hosted by Dr Paul Biluan USA, one of the top leading agencies us recruiter for foreign nurses. So if you are interested, we'll be flashing a link down under here. We are offering scholarships and recruitments for nurses or interested to come here to the United States. Again, this is Dr Paul Biluan and live for Connetics College and Aspire RN. And today we're going to talk about the neurologic system. And I've been doing a bit of introduction by myself and for everyone. We are streaming in multiple Facebook pages, YouTube, LinkedIn Today I can see your comments, all of your comments from different streaming areas or websites. Please write your comments here to decide.
This will be a very interactive show. Today I will be doing a little lecture and then towards the end, we're going to have a question and answer portion. And of course, if you have questions about NCLEX scholarship and US recruitment, I will be able to answer that as well. We can flash our link here below. If you want to visit this link, we're offering scholarships and click Scholarships, IELTS scholarship and US recruitment. Everything is going to be paid for. Please answer this link below. That's a form. You fill it out and we're going to take care of you. All right. To introduce myself. I'm Dr Paul Biluan. I'm currently located in Honolulu, Hawaii. And time right now in my location is 02:00 in the morning. Yes, I stayed awake for all of you guys because I really wanted to do this show. It's two in the morning here in Honolulu, Hawaii.
Can you please tell me where you are located right now and your local time? And aside from telling me which country are you from or you're located right now, can you also give me a little fun fact or something nice one or two words or three words about the country where you're staying? So. I'm from the United States. It's the land of the free in Honolulu, Hawaii. I say it's tropical weather all year round. This is what I say about it. How about you guys? Where are you guys located? We have people from Edinburgh, Texas. I used to work in Edinburgh, Texas. It's down south coast of the Mexican border. We have people from Canada. It's. 05:00 am. Philippines 08:00 PM. United Arab Emirates and Philippines There are people we have a student from Ghana and more people from the Philippines.
I want to see fun facts about your country where you're watching right now. Our city, where you're watching from. All right, while I set up my slides. And we have one of my friends is watching as well, Haley. She's in Vancouver, Canada. We have students coming from Brazil. Kenya. Germany. We're all over the world right now. I flash the map on the screen so we can at least have an idea where everybody's coming from. We have people coming from Australia. Oakland, California. Abu Dhabi, Saudi Arabia. All right, guys, do me a favor. While we're still waiting for people to come in, can you guys please hit the Share button under this video in your Facebook links or in your Facebook pages? If you can, click the Share button and share it to your page or to the groups that you are members of, this will help us bring more nurses that can benefit from this free and quick lecture that I'll be doing.
For those who do not know me, my name is Dr Paul Biluan. I'm a DMV doctor of nurse practitioner. I'm also an advanced practice registered nurse in the States. I'm a family nurse practitioner, certified. I currently practice as an emergency room nurse. I've been an NCLEX instructor for 15 years. I look young, but I'm really not young. We have people from Pakistan and Poland. Wow, this is so amazing. I feel very overwhelmed and lucky to be sitting here right now and hosting this show. Can you guys please do me a favor and click the Share button on your Facebook pages so more people can come in and join? There are more people coming in from the Philippines, from Kuwait. We're all over the world today.
All right, now, we are conducting the Connetics College, which is a combination collaboration project between Connetics USA and several providers for IELTS and NCLEX, including Switch Niners and Aspire RN. And for Aspire RN, we do this class every first Monday of the month. So beginning September, we're going to be doing every first Monday of the month. Please watch out for our events we posted in Connetics, USA. You can also follow me on my personal social media account at Dr. Nurse Paul. The handle is there on your screen. That's my Facebook, Instagram and TikTok channel. And I'll be posting more events soon, so please make sure that you have the notifications on for your Facebook when you follow my page so you can see all the future events that I'm going to be doing. I'll be doing a lot of free classes and free webinars and free shows to help you guys.
This is my Pay it forward for the community, for nurses that I know would need help. I was struggling like you in the past. I was a poor student. I didn't have money to finance my American dream. But I'm 35 now. I'm living here in the States. I just passed my citizenship exam, and I'll be swearing an oath to the American country. And I feel so blessed to be here right now and be able to share the knowledge that I have to all of you. So this is my paid forward. I'm not getting paid for this, but I want to share what I have to the people who need it. All right, we have more people coming in from Australia, from Oman.
And again, you can watch us every first Monday of the month. Mark your calendars. I'll be doing NCLEX classes, free NCLEX classes every first Monday of the month under Connetics College and Aspire RN, which is the company that I own for NCLEX programs or NCLEX review courses. We offer NCLEX scholarships and us. Recruitment. The link will be posted here on the screen. Right now, all you got to do is copy that link and put it in your web browser, press Enter, fill out the form, and we will process your scholarship application. All right, so we'll be flashing our link below, right here, below your screen in a little bit, of course.
Let's talk about neurologic system. All right? This is one of my favorite topics in nursing. I love cardiology. I think last month I did a free cardiology and EKG class. Several months back, I did free pharmacology class. I do a lot of free classes, actually. You guys are not aware. Follow my Facebook page and you'll see all my videos there. The basic unit of the nervous system is the neuron, right? So the neuron you see on your screen, we have the dendrites, which are the small finger leg structure. We have the cellular body, which is the nucleus. And the accents, the accents are like long tails where your nerve impulses are transmitted to the next nerve or to the muscles, right? So in the accents, the accents being long, some of them is coming from the brain and then travels all the way to your extremities or your body or your organs very long, right? They have protective sheets. We call myelin sheath. In the picture on the screen, it's the yellow sheath. It protects your neurons from conducting the impulses to the muscles. It prevents electrical misfiring’s or from the impulses from going somewhere else. So it directs the impulse towards the end of the accent, towards the next nerve or the muscle. So they're all connected interconnected fibers.
All right, so that's about the neuron. We're going to talk more about diseases and symptoms later on. So please pay attention because I'm going to have a small quiz question and answer towards the end, all right? Of course, there are two major parts of your nervous system, the central and the peripheral nervous system. All right? So the central, we have the brain and the spinal cord. We're going to talk about the parts of these brain and spinal cord nervous system. And then we also have the peripheral. So for peripheral, we have the sensory when we say sensory, other name is apparent nerves. What happens with sensory nerves is it brings impulses peripherally towards the brain going up, because it's sensory.
So whatever you pick up, for example, I touch your hand, right? Or your arm. The impulse coming from your arm will travel through the sensory nerves to your spinal cord up to your brain. So your brain can interpret, oh, that's touch or maybe that's hot, maybe that's painful. That's the sensory nerve. On the other hand, the modern or current neurons, motor nerves, transmit impulses from the brain or central nervous system to your body, all right? So if you come in contact with a hot surface, your sensory nerve will deliver the impulse and interpreted by the brain as hot, right? So what will happen is it will send impulse to your hand to say, let's take your hand away from the heat source so you won't get injured. So that's what sensory and modern nerves are. And then for modern nerves, we have voluntary and involuntary. For involuntary, we have sympathetic and parasympathetic. We're going to talk about this later and I just want you to visualize the whole nervous system. It's very complicated, but we're going to try to simplify it today. Hello, everybody. More people are coming in. Thank you for watching. Please share on your Facebook page so more people can benefit from this class.
All right, now let's talk about the central nervous system. Guys, anytime you have a question, please type on the comments because I can see all the comments coming from Facebook, from LinkedIn and YouTube channels, all right? So please put it in the comment section. So for the central nervous system, let's talk about the brain, one of the largest organs in your body. So we have three major parts, the four brain, all right? The high brain and the mid brain inside the two lobes of the fore brain. So the forebrain is here. Outside you can see the picture. We have four major parts. Frontal, right? We have the parado, temporal and occipital. And there's many functions. I do not have time to explain everything, but for frontal, think about brokers communication process. So this allows you to express yourself expressive receptors in your brain.
So this allows you to communicate. It's also controlling a lot of motor function on your body. That's the frontal lobe, right? Thinking memory. When you have a patient that has a nutrition, it's probably the frontal lobe that's affected. For Paris, think about language and touch sensation. For occipital, think about vision, all right? So whenever you have acceptable damage, say for example, traumatic brain injury, they can go blind. And temporal close to the ear. So think about hearing. Also think about Veronica receptor where it allows you to understand language. So when I'm talking to you right now, you can understand what I'm saying. That's your Vernex receptor in your temporal lobe. So that's the forebrain in the hind brain, all right, right here at the bottom of your brain, we have the brain stem, the medala and the pond.
So the cerebellum, the orange portion on your screen behind your head, right below the occipital area, it controls balance and coordination. People with cerebral problems would have balance and in coordination problems, they won't be able to walk straight. They'll be at risk for fall. Whenever we talk about fall, your priority for ethics is safety, right? And then for ponds and medulla, I think I have a better picture here. This controls the breathing. Whenever you talk about ponds and medala, think about the breathing because that's where the French nerve comes from. So when these are damaged, the brain stem, the patient is at risk for respiratory depression. Okay?
Now, for the midbrain, we do not usually see it because it's inside the two lobes. If you split the brain open, you'll see the midbrain there. So we have the thalamus hypothalamus. We have the pituitary amidela corpuscleosum. There's many functions, particularly Italymus and endocrine function. They release hormone that can control thirst, appetite, hunger, sexual function, emotions and so many other things, hormones in your body, because the hypothalamus and that this hormone starts your petro tagline, which is the main endocrine gland. So think about many functions in your body as far as regulation or homeostasis. That's the main function of your mid brain. All right. So much about the brain, I don't think Anthrax will ask you about the function of the frontal load because we're not taking a medical exam, we're taking a nursing board exam. Right. So your ability to apply this to clinical situation. All right.
And the spines, of course, are divided into the different areas we call cervical, thoracic, lumber and sacral. This is important when locating the spinal cord injury. So say for example, this is cervical spinal cord injury. We're more concerned about quadriplegia or pledge. We're more concerned about breathing problems or respiratory depression because of the level of the spinal cord injury. If it's lower, like Bloomberg sacral, we're more worried about genital organ function and lower extremity injury. Right. So that's about speed. We're not going to go into details for that. I only have 1 hour. And for peripheral, I want to focus on this because a lot of questions come from the autonomic nervous system, right? So I couldn't upload my slides. I have nice with this animations that are prepared to get us to answer. What do you think will happen with sympathetic response or sympathetic response?
But I was having issues with sharing my screen. I was already online 1520 minutes before the show and I couldn't share my screen. I'm using a Mac. Maybe that's the problem. And this show is streaming from Google Chrome. So now you can see my PowerPoint and everything's there. It should have been little animations where we go from one point to the next, but now everything's there. Right? But anyway, let's focus on the blue part first.
On the sympathetic part. I think sympathetic part is on your right side, right? I'm so sorry about that. Again, it should have an animation, but now it's not animating because I have to upload the PowerPoint here to the streaming service. Anyway, so for sympathetic, think about the receptors. Focus on the blue part on the right side. You have your alpha receptors on your blood vessels. And beta receptors, there's two beta receptors that I want you to remember, especially when talking about pharmacology. Beta one and beta two receptors. Beta one is located in the heart, all right? And beta two receptors are located in the lungs, all right? So easily remember this, all right? How many hearts do you have? One. How many lungs do you have? Two. So that's beta one, beta two receptors, right? Beta one, beta two receptors. Alpha receptors in various areas in your body, particularly the blood vessels, all right?
Now these are just receptors. We need neurotransmitters to actually cause the receptors to work. Neurotransmitters for sympathetic responses are epinephrine and norepinephrine. Or epinephrine and norepine are mainly secreted by your adrenal gland. So whenever we have cancer, there copy hospitalitoma. We talk about increasing epinephrine hormone going around your body. So that's sympathetic responses, very dangerous. Okay? So epinephrine is the main neurotransmitter that causes sympathetic effects. Whenever you talk about epinephrine, the other name in the hospital is what's the other name in the hospital for epinephrine? It's adrenaline, right? Adrenaline, okay.
Now when you say sympathetic response, think about the situation. You're walking out the door from your apartment or work or your house or the mall or whatever. As you walk out the door, you see a big pit bull running towards you. Angry, aggressive, aggravated, about to bite you, all right? Now you'll have sympathetic response because sympathetic response is about fight or flight. We've gotten all these responses from evolution of man from long time ago, 5000 BC. When men used to hunt for food. They developed these responses and it's evolved. And now it's become part of our nervous system response. So it's fight or flag, right?
Now let's talk about the eye first. Talk about the eye. So when the pinball is running after you, what do you think should happen to the iris? Delayed or constrict. The late means or medical term is mediocre. And constrict is meiosis. Easy to remember, midriacis because there's a letter D, which means people are in dilation, right? So think about it. When the people is about to bite you, it's running after you. You need to see where you're going, right? You need to see where to run, how to climb the wall, or whatever you want to do. All right? So it dilates. The pupils dilate to allow more light so you can see better. Because you're going to do fight or flight. You don't know if you're going to go fight or if you're going to fly or run away, right?
So dilate, open your pupils. I'm sorry. So pupillary response is dilation, allows more light so you can see better. That's sympathetic. Let's focus on sympathetic first. And then of course, for your mouth, think about this. For sympathetic response, all the secretions are decreased. All secretions from the mouth. So we have serosome or dry mouth GI secretion. So decrease acid production, decreased GI Motility, and urine decreased urine output, right? Why? Because it's fire flight. You don't want to be peeing while the dog is running after you, or you don't want to be peeing if the fire is about to burn you. You want to be able to run. So when you run, all the screens go down so your body can focus on running faster. All right? So that's the epinephrine response. Remember, sympathetic response, all the secretions are low. You don't need secretions when you're in sympathetic mode. Okay?
So dry mouth in the lungs, you need to be able to breathe better, right? So you can run faster. Think about, again, the dog chasing you, that sympathetic response, what you feel so bronchodylation, so you can breathe better, right? When you're anxious, you breathe faster and better, right? More air is coming into your lungs. It's bronchodylation, all right? And then of course, your heart rate increases. There's stacky cardiac, your blood pressure increases because the blood vessels constrict. Okay? And then I mentioned earlier for GI Motility, you think about decreased GI Motility, decreased Giacid production, so think about constipation, okay?
Constipation for urine, we've mentioned this earlier, decreased urine output is urinary retention, right? So urinary retention, again, all secretions for sympathetic response decreased. All right? And then penile ejaculation. I wish I was able to use the animation so we can be interactive, but ask questions about this later. So make sure you know your sympathetic response. All right, on your screen, on your computer, I want you to type, what are the two neurotransmitters for sympathetic responses? Again, for sympathetic response, what are the two neurotransmitters still on your screen right now? What are the two neurotransmitters you guys can hear me clearly. I'm making sure I'm still connected. EPI and norepy. Very good. All right, what glands in your body mainly produce the epinephrine and norepinephrine? Which endocrine gland mainly producer epinephrine and norepinephrine. Which endocrine gland? Adrenal gland. Very good.
What's the receptor found in your heart? Is it betray one, B one or B two? In your heart, what type of sympathetic receptor do we find there? Is it b one or b two? B one or b two? Hello, guys, more people are coming in. Welcome. Better one. How much for lungs? What do we find there? Better one or better two? Better two. Right, very good. Now question. What happens to the secretions when you're in sympathetic response? Secretion in the tummy, in the urine, what happens? Increase or decreased secretions for sympathetic response? Increased or decreased? Decreased secretion. So, dry mouth, decreased GI Motility, urinary retention, constipation. That's what we see.
All right, how about the pupils? Dilate or constrict? Still on your screen. Think about the dog. The people is running after you, you need to see where you're going. So dilate, midrias. Very good. How about your heart rate, your blood pressure? What happens? Do you need more circulation? So you can run better. Yes. Increases. Right. Heart rate. Circulation increases. Very good. So now that you know everything about the sympathetic, you just reverse the whole thing. And that's your parasympathetic. Parasympathetic is otherwise known as the recover and repair. After you run from the dog and now you're in a safe place, you pass out, your body starts to recover. That's the parasympathetic response. And there's two major receptors nicotine and muscularenic. Nicotine and muscularini, right.
So the main neurotransmitter is acetal clean. It's coming from the brain. It's a neurotransmitter that promotes parasympathetic responses. So now with parasympathetic response, because you're exhausted after the dog tried to run after you for 5 miles, you passed out, right? Your pupils constrict, right? Your mouth started salivating. When you're sleeping, you're salivating, right. Your heart rate goes down to decrease the workload of the heart. Your bronchi relaxes, and sometimes if it's too much, it constricts. All right? So that's the dangerous part with parasympathetic response because it can cause bronchial construction. Difficulty with the breathing is a problem, and of course, it can promote vasodilation to reduce the blood pressure. And now your secretions are all increasing. Saliva, GI secretions, GI motility. It can cause diarrhea, urine. You start being right. So that's parasympathetic response.
Now, for males, sympathetic response correlates to orgasm and ejaculation, while parasympathetic is female erection. And for females, it's vaginal lubrication. Think about a sympathetic at the height of your emotions and your hormones and surging through your body. Your circulation surging through your body. So that's similar to orgasm. So orgasm, sympathetic response, lubrication and erection. For men, because of vase, dilation of the penal veins is parasympathetic orgasm and ejaculation is sympathetic. All right, now let's recap. It's still on your screen. What's the main neurotransmitter again for parasympathetic response? What's the main neurotransmitter for parasympathetic response? I'm waiting for your responses. Let's see.
Please continue to share this page to your Facebook pages. That way more people can benefit from the free lecture. And I did a lot of free lectures. Please check Connetics page, aspirer and Facebook page or my at doctor nurse book page. And I have all the free lectures there that I did in the past few months. And I'm going to do a lot of free lectures and webinars. So stay tuned. I'm going to announce later as it Colleen. Very good. All right. And then we have what receptors? Two receptors for parasympathetic? Two receptors. Two receptors. Two receptors. Nicotine and muscarini. It's still in your screen, right? Nicotine and muscle. Very good.
So my question is what happens to the secretions with parasympathetic response? Secretions? Saliva, GI, urine. Increase or decrease? Increase or decrease? I'm trying to stay awake, guys. It's 02:30 A.m. Here in Hawaii. I don't want to wake up my neighbors. I'm in a small apartment because I'm doing with this travel, nursing. All right. It's like condo. Increase. Very good. Yes, I'm here temporarily. My home base is Houston, Texas. That's where I conduct my business. But I love traveling, so I do travel nursing as well. So Hawaii is such a good place to be during summer. It's tropical weather all year round for people who lives in Tropics. I used to live in Tropic. I'm a Filipino. I love the mountains and seas. I love the sun. All right, anyway, so increased secretion. How about the heart rate, the blood pressure? What happens with parasympathetic response? Increase or decrease? Increase or decrease? I'm looking at the comments right here. It's decreased, right? That's why, guys, you take your end click.
So when you come over here to the States, there's so many options. You can stay in whatever city you like. You can be in the rural area, big cities like New York City. You can be travel nursing like me, where I moved every three months or two months to another destination, another place, and they pay me good money, and then I travel again. That's my dream job. I want to be everywhere. I want to experience new things. All right, but there's so many opportunities. You can be a nurse manager, nurse leader, you can be a nurse executive and whatever you like. There's so many nursing specialties here, all right? So please pass your influence. We'll help you pass your NCLEX, let me know, message me on Facebook or Instagram and ticktock, and I'm going to help you pass your MC, okay? Decreases. All right?
Now, whenever we talk about pharmacology, I did pharmacology classes in the past, I might do it again, so watch out and stay tuned, all right? When we talk about neurologic pharmacology, all right, remember, sympathetic and parasympathetic, okay? When you hear the word alpha or beta, those are sympathetic medications. When you hear the word alpha or beta blockers or antagonists, those would have parasympathetic effects. All right? Let me repeat that again. You hear alpha agonists. Beta agonists, like albuterol, those are sympathetic medications. When you hear alpha antagonists or beta antagonists or beta blocker, alpha blocker, those are parasympathetic effects. So we use those medications to reduce blood pressure, okay? Now that you know it's parasympathetic, it's easy to remember. Oh, it can be used to reduce blood pressure because those are basic dilatory medication, right?
But be careful with beta blocker. Lebanol, Propranolol, metoprolol, particularly propaneyol because it's nonselective, right? It can cause broker constriction. So do not this is an express question, right? Patient has asthma or COPD, struggling to breathe, labor breathing. Which medication are you not supposed to give? Do not give labor. All right? So if the question is which medication would you need to question the doctor? Choose proprietal or whatever beta blockers, because it can cause or they can cause bronco constriction, all right? Now, when you hear the word from the word acetylcolline, right? Acetylcholinergic, those are parasympathetic medications. So if you put antiurgic, anti acetal, choline, which means it doesn't like acetylcholine, those are sympathetic medications, right? Because acetalcholine is parasympathetic. So if you say antiparasympathetic, then that's sympathetic, right? You got me. You got me again. Ethical allergic medications are sympathetic.
Example hypertrophy bromide, which is a branch of the labor triotropium. What else? We have your entropy, very common name for ethicalenergic for collinergics, the parasympathetic medications. Examples are neon tiger sauce, Sigma, pirate dose Sigma. We use it for Mastina, Gravis and Adrifonia. We use it as a tensile test, all right? And of course in pathonetic from the word mind, which means imitating. So it imitates sympathetic meds or sympathetic responses. Those are sympathetic medications. Sympathynematic like dopamine, right? Dobutamine, sympathymatic cardiotronic medications, parasympathometric or imitating parasympathetic effects. So those are parasympathetic medications. All right? So that's just easy way to remember the most important thing that comes out in your NCLEX are the alphabet of blockers, anticalenergics and call innergic. Right?
But I'm not doing a pharma lecture today, so we're going to skip this for now. I'm just giving you a quick tips of how to remember it, right? Did that help you guys? Because there's a lot of pharmacology questions in the NCLEX. It's about 14%, all right? So hopefully that will help you. But yeah, common neurologic conditions, we're just going to breeze through the common neurologic conditions and we're going to go through the question and answer portion, okay? And let's see. For Parkinson's disease, I'm only going to talk about pathophysiology because our time is limited. I'm not going to talk about science and symptoms. I probably would be mentioning some management, but in depth lecture, I do it for 4 hours. But I'm only doing 1 hour lecture for Connetics College and Facebook Live. All right. So we cannot do too long with Facebook Live. People will sleep. It's really not a property to do webinars that long.
But anyway, Parkinson's disease, when we talk about Parkinson's disease, it's a degenerative disease, usually for males about 50 years old. Those are risk factors. What happens is the basal ganglia, which produces dopamine, one of the neurotransmitters for motor function or muscle function. It's also important for heart function deteriorates. So when the basal ganglia deteriorates, when you age, all yourself deteriorate, right? So the basal ganglia deteriorates, the dopamine production of your brain decreases. So what happens is the people with Parkinson's disease, they lose control of motor functions, fine motor, they have restless tremors. They have tremors like this. They have rigidity bradykinesia.
We give them medicine like levodopa or carbidopa, okay? They have tooth foster, shuffling gate mask like faces. Those are Parkinson disease. We give them levodopa, carbidopa, those are dopamine, all right? And then for myostino ravi, it's a neuromuscular junction problem. Remember the neurons that I've mentioned earlier, actions go all the way to the muscle, all right? Towards the muscle, there's a synapse, there's a space, and then the muscle receptors are there at the bottom of the synapse, or synaptic left acetylcholine transfer from your neurons to. Your synapse to your muscles to start moving the muscles. Right? Acetylcholine is important for muscle movement. In myosino babies, there are antibodies in the cynaptic left.
I don't know if you can see the picture on your screen. There are antibodies that block those receptors in your muscles. So when acetylcholine arrives from your nerves to the synapse, it cannot go into your muscle. They cannot go into your muscle because it's already blocked. Without acetylcholine entering the muscle, muscles are not going to move. So you see what symptoms with patients must like faces, difficulty with breathing, difficulty with swallowing, difficulty talking, dripped eyelids like they're sleeping. Muscles are not moving. All right, management here, we give them neofigma fiscal stigma or pyroidal stigma. That's our management there. Okay? Now, multiple sclerosis is an on and off inflammation of the myeline sheet. I mentioned earlier that myelin sheath protects your nerves, your neurons, your accents. If these mileage sheep continues to inflame, it will interrupt the impulse transmissions of your nerves. So therefore, it affects muscle function.
What happens with multiple sclerosis? We have what we call charcoal's neurologic triad. All right, if you could follow me because you feel like I'm too fast, you can review it later. But Charcuts, neurologic triad are three folds. S-I-N sin, S-I-N scanning speech, intentional tremor, and mistakenness on the eye. Scanning speech, intentional tremor. And nystagmus. Those are typical signs of multiple sclerosis. Right? And of course, management would be antispasmodics like bacon and Leyreali or Dentroid sodium. I wish I could discuss everything about neuro. It's one of my favorite topics. But we don't have a lot of time. This is just a review. It's like an introduction to neurology before your big class. All right? But there's going to be a lot of stuff coming out from this in your ambitions, particularly in pharmacology. Right?
The Anbara syndrome is different from multiple sclerosis. Both of them are demyelinating disorder. But here in Deanburyt, it's actually the schwann cells that produce the myelin sheets that are affected. So what happens is the autoimmune antibodies attack the swan cells. Schwann cells are deactivated. No myelin is produced and then it affects the motor function. Again, when you talk about GBS, think about ascending paralysis. That's the typical symptom, ascending paralysis starting from legs going up. The dangerous part is when the paralysis reaches the diaphragm, patient can die from respiratory depression. All right, so management here is mechanical ventilation, circulatory, supportive. We can also give immunoglobulin because that can help with autoimmune dysfunction.
The cost of debt would be onboard syndrome, respiratory depression and prioritization questions for fax. If it's asked to you, what is your priority for GBS? Your answer is respiratory depression or anything related to respirations. All right, you got it. Amotropic lateral sclerosis. Favorite anthrax question, too. Amotropic lateralisis is a permanent irreversible damage to the neuron. All right? Modern neurons undergoes, they become hard, scarred, and they don't work no more. All right? Think about muscle failure, all right? All the muscle functions will stop. Again, our main concern here is respiratory depression. Again, there is no treatment for amyotrophic lateral sclerosis. It is progressive. It is low, but progressive, which means eventually the patient will die from pneumonia or respiratory depression. All the muscles will stop working, okay, because the nerves are damaged.
The thing is, with ALS, they can feel, but they cannot move. So that's the problem. The sensory neurons are intact, but the modern neurons are dead. Right? And the other name for amytrophic lateral sclerosis is what's? The other name for amnetrophic lateral sclerosis? Anyone knows? Anyone knows? It's Lou Gehrig's disease, right? Lou Gehrig's disease. L-O-U-G-E-H-R-I-G apostrophe s. I hope I said it right. Okay, next. Stroke is about what? Necrosis of brain tissue, right? Irreversible. It could be caused by thrombi, emboli or obstructive ischemic stroke. Or it could also be caused by aneurysm. That ruptured hemorrhagic stroke. All right? The priority with stroke is to identify if it is ischemic or hemorrhagic. If it is hemorrhagic, we cannot give TPMA. If it is ischemic, we give TPMA.
What is TPMA? Guys? What is TPMA? Tissue Plus Management Activator. What's the most common brand name that we give as a TPMA for stroke? It starts with a letter A. Letter A. I'm sorry about that. It's Altiplace. All right, Altipa's. We give it per IV. It's tromboneic, all right? It can dissolve clots very fast. But be aware that the averse effect for Altiplase is bleeding because it's trombolytic. The antidote for Altiplase is aminocappropriate awake acid. All right? So that's one of the questions in the NCLEX Altiplase monitor for bleeding. All right? So these are the symptoms from American Stroke Association. They say, Teach your community about B fast. Check for balance problems. Check for eye that are drooping, face drooping on one side, arm weakness on one side. Third speech, call 911 right away. Okay, this is stroke.
We have what we call stroke protocol. Time is brain, which means every minute that we lose, the infarction grows and we're losing more brain tissue. So we want to be able to give the TPMA within 90 minutes or one to 3 hours per protocol. Beyond 3 hours, TPMA will no longer be effective. In fact, it's a very dangerous medication because it can cause bleeding. Again, CPA is best administered within one to 3 hours. One to 3 hours. Okay. Again, can you write it down in the comments section? TPMA is effective if given within how many hours of the last known well time. The last known well time or LKW how many hours? Are you still there? Very good. One, two, 3 hours. Okay. Very good.
All right, it's about 2:45 here in Honolulu, Hawaii, still awake. All right, I had a lot of coffee today. All right, guys, are you ready for the quiz? Can I say a yes? Can I say a yes. Do you think you can perfect my quiz? Yes. Can you please write? Yes, I can. Yes, I can. Do you think you can pass my quiz and you can pass the NCLEX and come over here to the United States to work with me and many other Filipino and foreign nurses here in the States? Let me just encourage you guys that by 2038 years from now, there is a projection of a shortage of 1 million nurses. By 2030 or eight years away from it, we need 1 million nurses, and every year, we're sending more nurses to the United States from every part of the world. But it's still not enough. I mean, I work here, and I know how bad the shortage is.
So please pass your NCLEX and come over here. Okay. Are you going to be able to take the pass the NCLEX and come over here to the States? Yes, I can type it. Yes, I can. Don't doubt yourself. I don't like the yes question mark. It should be. Yes. I can. All right. All right, let's do it. It's only three questions that these are hard questions. I'm using the new generation and quick style.
All right, I don't know if you guys are aware, but I dropped a TikTok video about two weeks ago that I said, there April 1, 2023, the NCLEX will change. We're now going to use new generation NCLEX. If you have not seen my TikTok go at doctor Nurse Quality TikTok, I have so many videos of NCLEX tips there, but I'm going to give you a link as well later to see all those videos. All right? But I'm using new generation NCLEX time. All right, let's go to question number one. I'm only going to give you 1 minute because we're running out of time. The nurse teaches the sympathetic effects of epinephrine to a new graduate nurse. To a new graduate nurse. Select all that apply for sympathetic effects. I'm going to let you in a secret right these questions.
I wrote these questions about 30 minutes before the start of the class, all right? Because I have questions that I already put in since last night, but I feel like they're not very challenging. I want very difficult questions because that's what NCLEX is. So I was like, you know what? I'm going to use new Generation Network style. All right, so this is new generation networks. Before select all that apply is only maximum of six. Now it can be as many as ten. All right, this is select all the supply guys, so tell me the numbers. It's not only one answer. It's multiple answers. I wrote these questions earlier. I like to write questions, so if you join my program, you're going to have original questions that I write myself, because that's how I test my students. I've been NCLEX industry for 15 years.
All right, let's see the answers and tell me who got it correctly. It's 23579 and ten. All right, I don't think I've mentioned this, but diaphragis is sympathetic response when you're running your diaphragm, right? When you're running your diaphragmic. I forgot to say that. But the sweat glands open up. All right? It relaxes. So now the sweat comes out. So 23579 and ten. All right, next. All right, the patient is to do a treadmill stress test and was instructed to avoid caffeine and stimulants prior to the procedure. I wrote this question earlier. This is so fun. Highlight the medications that can cause sympathetic effects.
It says highlight when you take your new generation and next year you'll be able to highlight the answers. But here, of course you can. But just tell me the numbers of your answers, like select all that apply, which you're going to highlight. Right? What's the answer? This is a new generation NCLEX style. What's the answer? Which medications can cause same pathetic effect? I have yet to see a student that got it correctly. I'm waiting for more answers. I'm not convinced with your answers, guys. All right? There's no one answer here. It says highlight the medications, plural. There's more than one answer. Medications, plural. This is like a select a letter like question, but this time you're going to highlight it. That is, if you take next year. That's the new generation. And the style answer is two and three.
I'm sorry, guys, no, it's only two and three, not 2345. I don't know why this is 2345, but two and three only. All right? I cannot correct because, again, I had issues with using PowerPoint earlier. Two and three, right? The ostegmin is a colonelgic medication. That's parasympathetic libido law is a beta blocker. That's parasympathetic etheraphonium is a colonelgic medication. For mycelina babies, that's called inergic medication. So that's parasympathetic answer is two atrophine and three hypertropheum, which is a property leader. Answers two and three.
All right, last question. Match the pathophysiology to the correct disorder matching. All right? So look at the blues and find the answers in the yellow boxes. Look at the blues and find the answer to the yellow boxes. So in NCLEX, what you're going to do is you're going to drag, you're going to put them together, right? Or you're going to drag them into the boxes, right? Drag, click and drag, click and drag. Of course, you cannot do that on my screen right now, but I'm just giving you an overview of what they're going to do in N clicks, all right? Especially next year.
Nobody likes pathophysiology. If you attend all my medical surgical nursing lectures, I love pathophysiology. I teach all EMS. All right? I believe some of the people here that are attending right now have been my students in the past. If you have been my students in the past, can you identify yourself for those that were my students in the past, you guys know how I teach, right? I love Pathophysiology. I dissect all the conditions and disorders until you understand them because that's how you answer. NCLEX got to be able to understand. All right. Okay. There you go. They're all coming up, my students. Alright, now let's go to pathophysiology. Right. Alright.
Neuromuscular junction blockage. What is that? NMJ blockage. What is that? How about the second pathophysiology? Sclerosis of modern neurons causing loss of motor function. What is that? Lou Gehrig's disease or amentropic lateral disease. All right, I'll show you the answer right now. This is the answer. All right. Irreversible sclerosis of modern neurons causing loss of motor function. Lou Gehrignisation demyelination from damage to Shoine cells. It's Guillonbarray syndrome. Right. Necrosis of brain tissue from obstruction or bleeding. It's CVA or stroke. Cerebral vascular accident or deterioration of basal ganglia causing decrease in dopamine. It's parking suns. Right. And inflammation and damage to the myelin sheath.If multiple sclerosis. Right. Who got this correctly? Who got this correctly?
May I see anyone who got this correctly? These are 12345, six and one. There you go. I think a lot of people got this correctly. Very good. This is a recall type of question. I would say this is a comprehensive and level of question, which means it's a low level difficulty. It's not even that hard. It's just asking you, what is this? What is this? What is that? It's not even application or analyzation level. So when you attend my classes in NCLEX, I do not only teach you the contents, I also teach you teaching strategies or testing, not teaching strategies. You're not educators. I'm sorry. Test taking strategies. How to attack application questions and analysis questions. Those are difficult levels of questions.
I train my students not only to know the content, but also how to answer and attack questions. Okay? Now anyway, these are a preview of the new generation NCLEX. I have a major announcement for everybody. On September, I'll be releasing my own talk show here in Facebook and in other social media that we'll be announcing later on. It's called the Doctor Nurse Paul Show. I'll be talking about the secrets of new generation inquest. These are free classes or free webinars that you guys can attend to talk about what is new generation nuclear. What type of questions do we see there? How do we answer new generation fax?
What are the examples? I'm going to talk about it in this series of videos or live videos that I'll be doing. So please follow me on my social media at Dr. Nurse Paul so you can be updated with the latest events of what I'm doing. Aside from the Dr. Nurse Paul show, we have the Connetics College every Monday. And we're also going to be releasing a lot of shows in the future. So please stay tuned. And if you have questions you can always ask me during the live show. I'll be happy to answer them for you or you can also send me a message in my social media account. I believe a lot of you have sent me messages, and I was able to answer most of you. Not everybody. There's tons of questions. If I haven't replied to you, please message me again. But thank you for Connetics USA for hosting this show.
As far our End is into the business of NCLEX Review program. These are our programs. My prescriber recommended program is the short pass. Plus, you have all the benefits of personal mentorship, high impact tutoring, test banks, live classes three times a week. You have your own student adviser, your own study plan, exam assessments. Plus you get your own account for 90 days. It's your own your old account, all right? That way we can assess you properly. So that's a total of 5000. 10,000 questions by the time you finish the exam and by the time you finish the review. And we have 100 passing rate. 100% passing rate for all students who passed our exam readiness assessment. All right, so I have my links on the other side of Dr. Nurse Paul. Or you can follow my company at Aspire RN.
We have a website there. You can also check my little website that has all my playlists of the videos about NCLEX. It's linktr.ee/drnursepaulaspirern.com if you open that. All the links of the videos that I did in the past and are continuing to do are there. So you can just see the playlist of what is NCLEX, what are the requirements? What is new generation NCLEX. When do I start reviewing or enrolling for the NCLEX? Everything's there. Most questions that I get from my private chat, messages, I answer there. And if you have more questions, send me a message.
I'll do a video about it. Okay? And we're offering 20% off from today. All right, because of my lecture, I'm trying to pay it forward. If you're interested, starting today after my class, you can use the coupon code in my website. Yes, you can. And it will give you 20% off on all programs that you see in my website. All programs, 20% off starting today after my class, until August 31. Until August 31. End of the month. But please join us because we have limited slots per month and we're about to fill them. We also do crash course. If you're about to take your ethics soon and you don't have time to do the full course, which takes three to four months, you can do my ten day crash course. It's called End.
Click hit with final coaching, and the details are in your screen. It's $175. Again, 20% off if you enroll within the month of August. Okay? And last thing that I want to share to you guys is once you put your heart into something, you will achieve it. You will get it. I was once like you guys. Several years back, 15 years back, I was taking my NCLEX. I was very anxious. But look at me, right? I was able to fulfill my dreams because I worked hard for it. All right? I told myself yes, I can. So this is my challenge to you today, all right? As you prepare for the NCLEX, when you open your eyes in the morning, all right, manifest these words, you sell yourself three times. Yes, I can.
Yes, you can. Thank you for joining Connetics College today. You can review this video later. If you have questions, messages, Connetics USA, Aspire RN Facebook pages or at Dr. Nurse Paul. And if you are interested with scholarship again, one last time, we're going to flash the link here below this monitor screen right there. We are offering NCLEX scholarship to our program through Connetics USA. They're also offering us recruitment opportunities. So many opportunities. But please do visit this link, fill out the form, or send me a message, and I can connect you to the recruiters as well in Connecticut. All right, thank you so much for listening to the show and staying with me. It's 03:00 A.m. Here in Honolulu, Hawaii, and I'm about to sign up. You guys have a great day. Bye.