Connetics USA Video Media

The Next Generation NCLEX (NGN)

Hi everybody and welcome. It's Friday. So it must be Connetics USA weekly show onwards and upwards, everything that a health care worker needs to know about coming to live and work in the United States. I am your host, Tanya Freedman, CEO of Connetics USA.

And I am very excited today as our topic is next generation NCLEX. Today, we're going to be talking to two experts that we are very excited to bring in, who are going to be talking about first of all, what is the NCLEX? For those viewers who don't know, second of all, what is the next generation NCLEX? All About? When is it going to be implemented? What are the implications for registered nurses? And then we also have a new segment, which is going to be fabulous.

We have our two experts are going to be giving you a sneak peek at sample questions and answers, you're gonna have audience participation. It's kind of like a bonus live class. So we are really excited to get started today. And we are going to be bringing in our two guests now. That is Dr. Paul. And Dr. James. Welcome. Hello, welcome. Hi there. So watching around the world, please put into the chat what your name is where you're watching from. We love seeing our viewers around the world and where you are in the world. And please put in your questions.

Today's topic is next generation NCLEX exam, the index exam is going to be changing. And we're going to be learning today all about that. And what are the implications for registered nurses there are going to be very big differences and changes. So we're going to be learning all about that from our expert panel. So thank you for joining us, Gina who's saying less good morning everyone ever saying Good morning, Dr. Benjamin. Good morning. At those high from Guyana, James is saying hi other saying welcome. You will. So welcome everybody who's joining us. And we're going to start off with some introductions.

So Dr. Paul, and Dr. James, no strangers to onwards and upwards. Please go ahead and introduce yourself. For those viewers who don't know much about you. It starts with Dr. Pol. Alright, hello, guys. Dr. Paul, I'm streaming live from Hawaii. It's 4am here. Currently, you just came up from shower. But to those who don't know me, my name is Paul. I'm the CEO of Aspire RN NCLEX prep course. And we're also partnering with Connetics USA for this scholarship program for NCLEX. So if that's something you're interested with, you can message us Tanya and myself. I'm an ER nurse, but I'm also a family nurse practitioner, and I'm currently in the business of providing NCLEX review classes to foreign students or internationally educated nurses.

Okay, thank you, Dr. Paul, and thank you for getting up so early for us. Dr. James, please introduce yourself to everybody. I know many people know who you are. But please go ahead and introduce yourself. Thank you, Tanya. Good morning, or good afternoon. Good evening, wherever you are in the world. Greetings from North Carolina here in the US. My name is Dr. James. I am currently an assistant professor at the University of North Carolina at Charlotte. I've been a nurse for 30 years, most of my time in nursing has been spent on nursing academia. So I've been teaching a lot. NCLEX has been a part of who I am as a nurse educator. That's actually one of the courses I'm teaching right now prepare our nursing graduates for the NCLEX. As a PhD, I have done extensive research and plaque. So that's actually my dissertation. I have published several studies regarding NCLEX and international nurses. So if you want to know more about you know, NCLEX and international nurses, just Google my name, and you can look for those articles that will probably help you how to navigate the NCLEX my dissertation is actually it's a recommendation of how international nurses can be successful in the NCLEX. Thank you.

Okay, so today, everybody, we have to have the real deal experts in the house. So this is your chance to ask the experts anything that you want to know about NCLEX and also about next generation NCLEX. So this is a really important type of topic for those nurses who know that you cannot come to the United States without your NCLEX exam. So I see we have a lot of viewers that are joining us please put into the chat where you are so fun to see everyone around the world. And Elaine is from the Philippines Jays saying hi marriage Weiss from Philippines. Jay is tagging a friend Amira, thank you for tagging your friends and Jay. This is what onwards and upwards is all about health care workers helping other health care workers. Joy is saying and watching from Philippines when joy is saying Hi, Dr. Pol. When he's watching, enjoy, Judy. Lots of people watching Anna, we love enter, watching from all over the world and is asking where can we get the dissertation? Dr. James?

It's a free online, you can just Google NCLEX international nurses I want to Montegrico those low key words and it should show up. Once you Google my name. All the publications should show up. So it's free. You can you can have download them online. Okay, well, there you go free information. And we'll actually put that into the chat as well, for our viewers who want to find out more about Dr. James's dissertation. Okay, so let's get started for those nurses who maybe would love to come to the United States like Dr. Paul and Dr. James have done and are now living the American dream. And don't know where to start, please check out our success path, which is on the Connetics USA web website. We always like to look at that starting point, because it gives you all the steps of where to actually begin the journey. And you will see the number one spot on the success path is the NCLEX Fast Pass blueprint. In order to qualify as an RN, you need to pass the NCLEX you need that in order to prepare for the interview. To get your visa whether it's the TN visa for Canadian or medic Mexican citizens to or to get your green card to do your licensing your credentialing. Do you have your GED Ready game plan your arrival sequence. And then step number seven, enjoy and prosper like Dr. Paul and Dr. James are doing. So the NCLEX is really the key. Dr. Paul, can you just give us a brief definition of what the NCLEX is? What does that mean? And what is it all about?

Or NCLEX is an acronym for National Council for licensure examination, basically, it's the licensure exam for our ends and P ends here in the United States. And in Canada. In order for you to practice as an RN you got to pass the NCLEX are in examination and this is an exam created by the boards the state boards the National Council for State Boards of Nursing NCSBN. So this is the first step for you to get to the American dream without this license, your immigration process and employment will not really proceed. Okay, so, the NCLEX exam first step, you can you can take it in, in the US, Canada, Australia also have the NCLEX. Now, Dr. James, what would what who qualifies to take the NCLEX? And what are the eligibility requirements? Generally you have to of course be a graduate of nursing program in your country of origin depending on the state so what is unique with the US is each state has a different requirements. So you might have to check with the specific board of nursing like for example, New York versus California they have different requirements, although generally they will ask you to verify your high school diploma your transcript of records and some may require you to be license in in the country of origin.

But there are there are a few states that do not require that it's basically those paper works some depending on how long have you been an international nurse, they may ask you to submit proof for being an active licensed nurse or working as a nurse depending on some states. So there is no like a blanket requirements are the eligibility. So it's I would advise it's best to check the specific board of nursing core you will want to apply for the NCLEX. But those are the basic Yeah, your nursing education and your license. So those are the basic requirements. And I would encourage everybody who's just starting this journey and doesn't know much about the NCLEX to watch some of the previous shows of onwards and upwards. You can see that on the Connetics USA website. You can see them on our social media, on our YouTube channel, on our Facebook page, and there are many shows that we've done about the basic steps of actually how to go about passing the NCLEX exam. Now both Dr. James and Dr. Paul have passed the NCLEX. They needed that as the first step when they came to the United States. Tell us a little bit about your journey of passing the NCLEX let's start with Dr Jain but let's start with Dr. Paul. Sorry.

So I graduated with my BSN in 2007 took my Philippine board examination same year I got my license three months later. As soon as I got my license I found for an NCLEX application. I've always wanted to go to the United States. And I figured at that time there was a retrogression where we have to wait for several years. But for me, it was worth it. Because I'd rather wait for something, even if it takes years, then not do anything and think about it later on in life. So I took my NCLEX at the age of 21 2008, took my NCLEX pass my NCLEX and didn't get to go here to the United States till I was 30. But that was all worth it. Okay, so not an easy experience, not something that should be taken lightly. Definitely something that you have to prepare for. But once you've got it, you got it. Right. You want to share a little bit about your experience of taking the NCLEX? Sure. Paul made me feel like I'm so old. I graduated in 1993. So that's like, you know, last century. Yeah. And during that time, what is different in my time, because, you know, there were no international testing centers for NCLEX

. So I've been teaching in the Philippines. So before I took the NCLEX, I've been teaching med surg, I was actually a dean when I migrated the US. So I took the NCLEX here in the US, so that was kind of different back then. So I signed my contract, you know, but we have no license than that at the time. So it was more of a, you know, you really have to pass the exam, otherwise, you're gonna work, you cannot work as a nurse. So even with a background in academia, you know, I still have to study I have to another thing back then we were required to take the CGFNS. So that's a different layer to pass before applying for the NCLEX. Because back then a lot of the states required the CGF and exact CGFNS exam, the commission and graduates of foreign nursing school certification exam, before you can take the NCLEX. But since the mid 2000s, they eliminated that as a requirement in most states. So that's a good thing. Yeah, it was a good experience, you know, because no matter how experienced you are, it's a different kind of exam. So preparation is the key.

Absolutely. Preparation is the key. And I'm just thinking back, as you're talking, I'm also it also shows my age in this process, because I also remember when I started recruiting nurses, nurses would have to fly to the United States. And nowadays, there are many test centers all over the world where nurses can take the NCLEX. And it actually is, believe it or not a little bit easier. In fact, we actually have a slide of all the different test center where nurses knock and take the exam. And obviously, they would have to apply to a particular state in the United States in order to do that. So there we go. We've got the NCLEX test centers worldwide, lots of different places where nurses can take the exam. And Mostafa has a question about I'm a nurse from Morocco with nine years experience, I will go to the US exactly to Illinois, I got an immigration visa and I want to join the Illinois Board of Nursing and want to know more about InfoPath the requirements. So Mustapha would definitely encourage you to watch one of the previous onwards and upwards shows about passing the NCLEX we have a lot of information about the NCLEX process. And if anybody else is interested in that, please watch those previous shows. Okay, so let's talk a little bit now about next generation in place. Paul, who makes the decision to change the NCLEX exam?

Yeah, so it's the NCSBN, the National Council for State Boards of Nursing, which comprises the State Boards of Nursing from 50 states plus Canada. So they all convene this council talks about are we going to update the exam? Or are we not going to update the exam? What are the updates? What are the passing standards? So it's actually the NCSBN that will tell us what will happen with the NCLEX recently, me and Dr. James attended the anklets conference, there was so much information that you know, we've learned from how the testing processes, the been evaluated picking item writers. So it's evidence based, it's not just you know, them waking up and thinking, You know what, let's make clicks a little challenging. It's evidence based the engine was 10 years in the making. The literature says we need to do this, because the you know, the jobs of nurses, the tasks that we're doing are getting more complex over time. So obviously the exemption also check that competency, if we're safe to practice out there. When we are entry level nurses as entry level.

There's a lot of thought and time and effort looking into making that change. Also, if I'm add briefly, yeah, as Dr. Paul said, you know, they just don't change it for anything. They do a survey every three as they call it the practice analysis. So the National Council of State Boards of Nursing, they conduct a survey nationwide and determine what are the common skills or procedures or medical conditions that are seeing and in practice, and based on those, how frequently they do the skills they perform those what are the common diagnosis that they see? Then they will look into those survey and whatever are those common most commonly things that are done, then they will highlight those on the next test plan. So there's a survey conducted every three years, like the one that's coming out in 2023 is a result of a survey that was done from 2020 to 2022. Okay, based, okay, thank you for adding that. That's really interesting. So tell us about the rationale for changing the NCLEX exam to the next generation. NCLEX. And Dr. James, I think we have a slide on clinical judgment case studies for you to, to speak about that.

Yeah. So Dr. Paul mentioned something about, you know, patient care is becoming more I mean, our patient acuity in the US is, is getting higher, so we're taking care of sicker patients. So care is more complex, and that requires more critical thinking, clinical judgment. So here's just a backtrack. This is historical background about this changes in the NCLEX. This this Ng and the father, that new grads lack the clinical judgment or the nursing judgment that that's leading to the render safe patient care. So they have to, to create an exam that will mimic the real world so that the nurses will be able to look at the data, look at the vital signs, these are the labs and out of this, this this data, what will the nurse do? So it's really far away from the multiple choice questions that we're used to seeing for decades. So the key word there is a clinical judgment. So they are focusing on clinical judgment, and the next generation NCLEX. So it's highly analytical, I would say. And, yeah, that's like they were shown earlier, the focus on this different six steps in the clinical judgment process. So I know you're all familiar with the nursing process, but we're going away from the nursing process, the you know, assessment, diagnosis, all the way to evaluation. So they want nurses to recognize skills, you know, what are the signs and symptoms? How do you know that the patient is getting bad or deteriorating, you have to analyze this data and how the what is going on, you have to be able to generate solutions and you know, take actions to resolve those problems, and evaluate those outcomes.

So it's basically taking from the nursing process and elevating it into something more analytical. So these are like the six different areas that they are going to look at, you know, in any of those questions for the NCLEX. So you may be asked any of this six different categories. Okay, so there's a big change coming and really important to educate yourself about this, if you have not yet passed your NCLEX exam. If you are a nurse, and are watching this today, and you have passed your NCLEX exam, please apply to Conneticsusa.com/apply and our team are waiting online right now to speak to you to see where you want to go to the United States. We literally have 1000s of physicians all over the United States, we focus on direct hire specifically. So you will get paid the same as an American nurse. And you can choose where you want to go work. If you have not yet passed your NCLEX you're willing, you are able to apply as well and see if you're eligible for the NCLEX scholarship. And we'd love to help you to achieve your American dream just like Dr. James and Dr. Pol. And Dr. Wu there is you have another slide on clinical judgment. Is there anything else that you wanted to add? rationale?

Yeah, so one of the rationality was, while why we are changing to the engineers, they found out in the study in the strategic practice analysis that they did years back, that the current and quick setup is actually not measuring the clinical judgment. So there are six categories that Dr. James talked about. They said most of the questions that they have in the test bank, and they said it's about 10,000 questions are only measuring the last two taking actions and evaluating outcomes. So now they have to sit down and formulate new types of questions, new, new, different ways of delivering these questions to actually measure all the six categories. It's getting very interesting as an academician for me, Dr. James because it challenges us to improve the way we deliver our classes and our exams. But on the student side, it's getting harder because now there's too many layers. So we need to talk about we have You know, the eight categories claim categories that we need to know about the ethics, plus the six different layers of the clinical judgment. So it's getting really very challenging. And plus later, we're gonna see the questions are different, the type new types of questions that Dr. James will be talking about. And we're gonna see, oh, it's gonna be very challenging.

Okay, so there's a lot of change coming. And when does this change take place? And what happens to someone if they are already in the NCLEX application process? So yeah, Dr. James, NGN , well, our next generation NCLEX will start on April 1, next year. So if you are in the process of applying, it's now a very critical decision as to when do you want to schedule your exam because you can schedule you can pick the date and wear your will, you will take the exam. So if you will be taking the exam, anytime from today until March 31 2023, you will still take the old claps, after that you will have the new generation and gloves. So for example, of course you want to pass on the first take, right? But say, for example, you are taking for the first time and you didn't make it and then when you retake it, and if it's going to be after April 1, then you will be taking the NG and so make a decision guys, do you want to take this discard or you know, take the NGN and after April 1? Okay, so here's the critical question that I know is probably going through any nurses mind right now, if they have not taken the NCLEX? As yet? Is it going to be harder? Dr. Paul?

Subjectively, I would say yes, well, we don't have a data yet, guess we're gonna find out with the passing rates. That's the objective way to evaluate that with the passing rates, months after or a year after if it's trending up or down if it's getting harder for students. But for me, because of the different ways of presenting questions, which can be confusing, particularly for internationally educated nurses, because this is not something that we were, you know, familiar with, in school, we're only doing multiple choice A lot of times or select a blank, but now we have glows and highlighting and tables, and matrixes. All these things, just the unfamiliarity with these types of questions can actually, you know, become a challenge can actually affect the performance of the test taker, that doesn't include the level of understanding of how deep these questions are going into. As far as you know, the student's ability to connect concepts and pathophysiology and pharmacology, he's, so it's getting very challenging also, for us as educators, because you know, we want, we want to make sure that we're teaching the right concepts, the right strategies to, for the students to pass.

Okay, so it's gonna get harder, everybody, if you have not yet taken the NCLEX, and you're the new the new next generation in Tech Stars, that is probably going to be the easiest thing for you to do right now. And it's not easy, but it's easier. But the but that is also the importance of being aligned with a team that understand these changes, and will be able to help you to navigate them. Briefly. And also, if it's going to be easier, I would say, I agree with Dr. Paul, there's going to be more challenging, I would want to put it that way. Because, you know, I've taught nursing forever. And you know, this NGN and we I mean, in in nursing education, we're changing how we teach nursing, you know, because the test is going to be different, like the class I have last semester, they will be the first ones to take the NGN and when they graduate next year. So yep, it's always changing how you look at the questions, but it's an overhaul of how nursing is taught in nursing schools. And if nursing schools internationally are still taught the traditional way, then that can be a challenge. And just to put it out there, whenever there's a change in the NCLEX pass rates drop that's in the literature if that that's going to be an interesting thing to monitor, you know, in the next few years.

And Dr. James, that the pass rates for international nurses, even historically have always been lower than those of us new grad nurse. That's correct. You want to that's correct. And that's actually my area of research. You know, I did a 15 year trend study from 2002 to 2017. And I updated it we know from 2018 to 21. And internationally, more than half more than half failed NCLEX on the first attempt. Only 47 point for this 70% is passing the NCLEX for international nurses on the first date. And when they retake it, the pass rate is even lower, but like below 30%. So that's a baseline. So it's really important to be familiar with the NCLEX. And really prepare for it because it's an investment. So that's a sad reality about, you know, international nurses. So, my research has been focused on understanding why and you know, what can we do to increase the chances of international nurses passing them collapse? And again, my dissertation will answer some of those questions.

Yes. So please, everybody, check out that dissertation. I know our team is going to put that into the chat for everybody to check out when you use the key word there. And that is investment. You have to think of the NCLEX as an investment in yourself and in your future, and align yourself with partners that going to help you to navigate that journey and make the end result what you all hoping for more to come to live and work in the United States, like Dr. Paul and Dr. James who've done so well in their careers. And so last question from my side is what are the changes in the new and clinics and what didn't change Dr. Paul. So I'm gonna show a slide about the test plan, with comparing it with the current test when 2019 test plan versus the 2023. And this is just an overview. And again, NCSBN said, This is not yet final, they're going to announce in December, if this will be the final test plan. But we can see that management of care will drop by 1%. But we're going to increase I mean, 2%, but we're going to have an increase in safety and infection control and pharmacological therapies by 1% each. So it may not be a lot. But if you're taking an exam, that's only 75 items, it means two points out of management gear may be deducted. And one point for each of the other categories may be included.

So we'll have more questions now with pharmacology compared to physiological adaptation, if you think about that, but that's not only the change, there's a lot of changes, we have three scoring systems, now we have zero over one plus minus scoring system and rationality type scoring system, very, very difficult to understand it's an algorithm built into the computer, there's 14 types of questions, and lab values will be shown. But overall, you know, it's hard to explain and cram it in one hour show. But if you follow Dr. James and my page and Connetics, we are boasting about NGN in the last couple of days or weeks, because we are really advocating for everybody to like, elevate the quality of the way they deliver the NCLEX, you know, in preparation, preparing nurses for the NCLEX, because this is something that's really big, that if we're not preparing students correctly, we're gonna see detrimental results for especially for our internationally educated nurses. So there's going to be a lot of changes, and we still have six months to prepare, you know, to really, you know, evaluate ourselves if we are the takers, if you are thinking you have quick soon, you got to be able to know, are you gonna take it with a Tesla now? Or are you gonna wait to like, April or May because if you're gunning for taking the exam next year, then might as well prepare for NGN now.

Yeah, exactly. So I think that that's really, really important. And that's why this show is so critical. I see we have a lot of questions in the chat. And because we have limited time, and Dr. Paul and Dr. James have prepared an exclusive next generation bonus class for everybody. I'm watching the clock. And I'm like, Oh, my goodness, we're already behind schedule. So we're gonna go a little bit over the hour today. And Dr. Paul and Dr. James are actually going to be taking over now. And I'm going to be handing over to them as they're going to start their class where they're going to be giving you a sneak peek at some of the questions and answers from the next generation NCLEX. But before we do that, I just wanted to make sure that everybody knows that Dr. Paul and Dr. James will go into the chat afterwards and answer any questions that we were not able to get to today. And we will also be having a follow up session in a few weeks or keep watching onwards and upwards. Because we're going to have a follow up session where we're going to have at some additional bonus training materials that Dr. James and Dr. Paul have prepared for the viewers of onwards and upwards exclusively for viewers of onwards and upwards.

So please tag your friends. And again, if you have not yet passed the NCLEX now is the time please if you are in the process of studying, prepare, it's going to get more difficult, more challenging, so really important to educate yourself and tell your colleagues about this as well. With that said, I'm going to hand over to Dr. Paul and Dr. James now, and they're going to be taking you through their, their sneak peek and exclusive class on the next generation NCLEX. Okay, who wants to go first? Can I go first? Or if not, you can go ahead. Yeah. So let me share my screen. Oops. Okay. So what one thing I would like us to mention is that can you see my screen? Can you guys see my screen? I don't think so that predates okay. So, okay, I'm trying to notice. Okay. Yeah, um, I would just like to mention here that, you know, we were talking about how it will be changed, but 25 or 25% of the questions will be NJ and the rest will still be the old downclock. So not all the questions that you will have will be NGN. Um, so I'm trying to navigate I prepared my slide here, but I couldn't share it. So just give me a few seconds. Okay. Can we show that this the slides I couldn't open mine? Sorry. Are it's okay, so I have here I have open it.

Dr. James? And do you want to maybe send your slides to our director Melanes. And she can share them for you? Um, it's actually in the email I sent out. So it's the same. So let me just send it real quick. Or maybe Dr. Paul can go ahead. Sorry. So while I'm emailing my slides, this is live everybody. Alright, so I'll fill in for Dr. James. For now. We both prepared questions. Dr. James will be talking about case studies, drop and drag and drop close questions highlighting matrixes. So there are two types of questions that we will be presented in the ng n. It's case studies, which is like in a 75 item exam, there will be three case studies. And each case study will answer the six clinical judgment assessment model question. So that's like 18 case study questions in the 75 items in the minimum items of ethics, right? I mean, 85 items, because it will change next year to 85 items. But I'm going to talk about the second type of equity question, which is called the stand alone. So standalone. They don't have case studies, but they will still be presenting. Think about it as when you open the question back. I mean, when you open your screen and you see the question, you'll see a form of a chart on the side. So it will tell you all the information of what's going on, you're gonna find cues from there to answer the question which are presented in the right side of the screen.

So for this session, I'm only going to talk about three types of the multiple response, which we are very familiar about. First of all, we have select all that apply. Now what changed from the old one, which is what we're using right now until March 31 2023. To the engine, right now, the select all that apply questions have a maximum of six options, I believe. But with ng n, it could be as much as eight items, which you see in the screen right now, or 10. So it will be it will be containing more items compared to the current one that we're using right now. So more options means can be very tricky, because now you don't know how many answers you'll provide, right? But this is the basic select all that apply question, but this time for those who took the NCLEX already, you might be familiar. We don't have the left side of the screen in the past, we only have the right side, which is the questions in a whole white screen, right but now in the NG and there will be two sides, the left side contain the case or the stand alone scenario. And on the right side will be the questions right.

So let's take this example. Question Right let's take the sample question and let me see your answers in the comments because I can see all governments alright so for example, this is a key I have a patient 1717 year old male client, who was who was who appears slightly diaphoretic bruising, I'm just skimming through it okay, because we don't have enough time to go through this tenderness, guarding and dullness to percussion and abdominal assessment diminished breath sounds EKGs, our normal client is diagnosed with splenic, laceration and the left sided hemothorax for the physician, and the patient was referred to the image surgery. So those are the information that you need to know. You can also flip on the tabs in the actual exam to click History and physicals vital signs and lab results. Because they may contain important information that can lead you to the answers, right, so think about it as a chart. So we use this before in the old NCLEX style as a chart, but this time it's presented as a case study or a stand alone clinical judgment question. Now let's go to the question. Which of the following actions should the nurse take knowing that the patient is going to go to surgery for splenic? laceration for ruptured spleen? Bleeding? spleen, right. And you move thorax which is emergent surgery? Which of the following would we take? So this is still left on play? You can have one answer, you can have two you can have eight answers.

Can you guys put your answers in the comments? And I'm gonna go through each one. All right, how about mark the surgical site that's for the physician provide the client with ice chips, definitely patients would be an NPO. For surgery, perform a medication reconciliation is the provider or the physicians responsibility. obtain consent is the physician responsibility, insert an IV, that's our nursing responsibility. So we'll check number five, informed client about risks and benefits is the responsibility of the physician. Assess the client's previous experience with anesthesia is the responsibility of a physician and assess the client spirits to ask the clients I'm sorry to wait in the waiting room while the plan of care is discussed with the client. We cannot do that because the patient is a minor. So parents has to be there. So here, if you can see that the only answer is number five, in the old NCLEX. There should be at least two answers. But in the new generation and NCLEX there's no rule at all, it could be one answer. It could be all of them. But definitely not less than one because there should be an answer on the screen. Right? So with the mentality of students taking sat there, they would not think that there would only be one answer, right, your, your the first thing that you think about is oh, you know what, I should have at least two questions, because this is select all that apply.

But don't think about that. Just think about what is important, though, there's no rule as for you to answer minimum of two no more, because it could be one or all of them, right? So that's one of the rules that change, right? That's select the fly, but there's another select all that apply version, it's what they're called multiple response, select n, n means number. So now, the question will ask you to give answers for a specific amount of answers or a number. So let's take this example. On the screen, right? This is a case of a surgical unit, patient 50 year old male client, I'm going to summarize to you what's on the screen, because we don't have time to read everything. Again, this can be a standalone, which is just this question. Or it can be part of a case study where the case is evolving, right? As you click to the next question, the case is evolving, right? So basically on the screen, the patient underwent thyroidectomy. And now at 12 o'clock, the patient was moved to the surgical unit. Can you help me with the answers? Let's look at the question to decide. Select the three potential nursing interventions.

So you see, we don't use this in current NCLEX setup. But for ng n, this is one type of the question it will ask you to provide three right answers only three answers. So what do you think guys are the answers here? Do we buy the client side drills to put them in tele number through serum calcium level and reflection of the neck tracheostomy are several boxes of sterile dressings? It looks like all of them are almost correct, right? But what are the top three that we will prioritize as a nurse? So the answer here is monitoring serum calcium level for risk for bio thyroidectomy. I mean, yep, so the calcium will go down. Number four, definitely no movement of the neck and can cause bleeding. And number five, three customers should be at the bedside because of the laryngeal nerve damage post surgery. So 345 Right, and the way they scored is if you get two answers out of three, you get two points if you get one An answer out of four, you get one point, if you get zero answers out of three, then you get zero points. All right? But this is a different version of select a little play now has a number. So you cannot answer four, or five, because it only is asking you for three.

Right? So 345. Now, the last type of question that I'll show, there's 14 types. I'm not going to go through everything, Sir James will show more questions later. But you can follow me on Facebook. I'm doing shows every weekend, right about ng n as well. And I'm going to provide sample questions as well every week. So multiple response matrix, this is scored, plus minus which means right minus wrong. So if you have five wrong answers, and four correct answers that will eat up your score and bring it down to zero. If you have three wrong answers and two correct answers, your score will be zero because the wrong answers will affect your score. So for this question, the patient has nausea, loss of appetite, vomiting, fever, constipation for two weeks for two weeks abdominal pain, seven over 10. The patient said abdominal pain started after my seven year old child accidentally kicked me in the stomach. Vital signs the only significant thing that I see there, the patient has fever, everything else looks normal. So we have GI symptoms here. Let's look at the question for each assessment finding below. Click to specify if the finding is consistent with the disease process. Right. So let's go to the first column in bowel obstruction. Do they have problems with appetite that we see in the patient? Which is loss of appetite? Yes. How about vomiting?

Those are GI symptoms. Yes. How about pain? Level seven over 10 bowel obstructions can have that. That's a check and bowel pattern. What do we see in the case? It's as constipation. Do we see that in bowel obstruction? Yes, so I'll go fast forward to the questions. All right, I'm sorry to the answers. So in appendicitis we see appetite pain level and bowel patterns as presumptive symptoms of appendicitis. Right? When we say appetite, it look at the look back at the case its loss of appetite, we see that the independent side is paying seven over 10. That's high level of pain. We see that in appendicitis and bowel pattern, which is constipation, we see that an apply for ruptured spleen, this is an acute condition and your major concern is hemorrhagic shock, right. So the pain level is consistent do it but not the other things. Right. They don't have loss of appetite. They don't have constipation for two weeks, they don't have vomiting and fever for two weeks, because that would be too late to patients with directors clean die right away. Okay. So now based on the answer, which do you think is the condition?

Well, that's not the question of the NCLEX. But based on this question, it looks like it's about obstruction versus appendicitis and ruptured spleen. But this type of question is, identify, you know, it's you. It's testing you to like, based on the assessment, what are the diagnosis that you can find out from it? Right. So this is one of the challenging questions, because if, for example, in bowel obstructions, you only got two and then appendicitis. You got one ruptured spleen, you got one. And you have four incorrect answers, automatically. Your score is zero. Right. So this is one of those hard questions. Right and Dr. James are going to show more. But if you'd like to join my show more questions on my show every Saturday at 8am, Central Standard Time, My Facebook is the doctor nurse ball and my show is called the doctor nurse ball show. Alright, and that's it. We'll answer. I'll answer questions on the comments leader. I'll give the mic to Dr. James to proceed and show you other questions.

Thank you, Dr. Paul. Um, yeah, just to make a clarification, even the current NCLEX in the selected apply, it's possible that there's only one correct answer. So both and Jan and the current NCLEX may have just one correct answer, that change happened and then 2018. So I just want to clarify that. So yep. Um, can we go have the slides? So Dr. Paul mentioned a different you know, single standalone questions. So meaning there is like one situation per question. Now, I mentioned earlier that there will be three case studies per candidate. So, three case studies. In each case study, you will have six questions. And those six questions can either be, you know, recognizing cues all the way down to evaluating outcomes. Okay, so these are the six questions per case study. So it's really important to know what you're assessing for what is going on with the patient. What will you do, and what will you evaluate when you are after you've done your interventions? So, you will expect 18 questions per candidate using this case? To study method, and this case studies can either be some of those questions that Dr. Paul showed, and I'm going to show you the other types of questions that will come out in the in the next generation NCLEX. Um, next slide, please. Drop, don't cause so this is another new thing we're in, you will be asked to provide bad responses, okay.

So, like in this situation, the nurse should address first the clients blank, followed by the clients. So you have a drop down box where you can select those options. So this is just to show you the format, we're not going to go over this scenario for now, in the first, in the top portion, you only have to have two responses, and you have to get two correct responses to get the point. If one of them is wrong, you didn't get anything. Because of course, you need to know if x is press, and it's because of y kind of thing. Now this, this lower portion has three different drop down boxes, you have to know the diagnosis before you can know that you will be able to answer those interventions. So this is kind of scored differently. If you get one and then you know, you get those two answers. Again, right minus wrong. But if you incorrectly identified the nursing diagnosis, then of course, the intervention will be wrong. So that's the trick in this kind of question. It's really challenging, isn't it? So it kind of it kind of really hard to call this changed our perspective how we will study? Next question. I mean, next slide. So this would be another drop down clause. We're in UAPs, to what symptoms would you expect under neuro pulmonary or vascular or what orders what interventions related to the patient's neuro respirations or cardiovascular is appropriate based on the situation?

Now, I want you to look into this. So this is now my sample question. So, look at the box scenario, a client with limited ability due to weakness complains of leg pain, and you have those data you can read that okay. So, you will be asked to identify now the client is at highest risk for developing what hypoxia stroke this Raytheon's or a PE, as evidenced by the client's vital signs neuro respiratory, cardiovascular. So you got to get those two correct answers to get credit for this for this question. So what do you think is going on here? Based on the symptoms, is it a hypoxia? So this would be a case of at risk for pulmonary embolism because you have there either limited mobility witness, and based on the symptoms, you know, swollen and tender leg and we pedal pulses, it means that this patient is having a clot. And this is based on our as evidenced by the clients, you know, cardiovascular assessment, so you got to get those correct pair. So that's the example of a drop down clause. Dr. Paul mentioned something about yesterday, he showed this matrix multiple response. So again, I don't want to I don't need to repeat this. You've seen it earlier. So can you go to next slide. Um, okay. So, yeah, this is just this is an example. Can you just click forward? And there's a scenario behind that?

Otherwise, the same scenario? So both a question, no, no, go back to the bowtie. So this is I would say, personally as one of the most challenging questions on the NCLEX. Because it will ask you to more or less like diagnosed, I know, we were talking nursing school that nurses don't diagnose. But you know, and the new NCLEX, they don't call it you know, you make a diagnosis, but it's more of hypothesizing remember those six steps in the clinical judgment? So they want you to know, like, what do you think is most likely going on with this patient? Okay. So in this bow tie, you know, like a bow tie, right? So in the middle, it asks you, what do you think is going on with this client? Is it best policy hypoglycemia, and then that is based on the data that's presented to you. And then on the left hand side of the screen is, I mean, the actions to take. So what do I need to do based on what I think is going on? And you see those boxes, action to take two boxes. So you're, you're given a clue, you need to pick two of those interventions. And then the right side of this bowtie question. You have parameters to monitor. In other words, what are you going to assess? Do I need to assess the patient's temperature, urine output based on what I think is going on? So again, clinical judgment, you know, you are the nurse, you're looking at the patient's symptoms. So what do you think is going on?

The first I remember the first time I showed this to my students, they freaked they were freaking out because they're not used to this kind of, you know, thought process. So um, I don't know if you can read here that you know, the scenario is that the client has a slurred speech altered LOC and drowsy as the clock is there for Eric and has called Graham skin, the Santos nurse that the client has been working all day they are despite having flu or we could go so you can make a guess. Is it Bell's Palsy? hyperglycemia ischemic stroke or UTI? Right? So, this would be a case of more of a hypoglycemia because Bell's palsy does not have altered loc. It's not likely ischemic stroke and definitely not UTI. So if you think that this has hypoglycemia, what will be your parameters to monitor? I would say, Yeah, serum glucose level and maybe neurologic status because the patient has altered Loc, right? And what actions do I need to take, then you can just speak whatever is appropriate to resolve that problem. Now, the trick in this question is that if you miss diagnose, or you hypothesize, incorrectly, then you will be picking up wrong interventions and wrong assessments. So that is why personally this is like, a very, very challenging question, because it is really a lot of things, you know, in just one question, and how is this scored? Again? Correct. I mean, plus or minus, correct minus wrong. So if you get five great answers, and two wrong answers, you will have a score of three. Okay, and I think the last slide that enhance hotspot in the current NCLEX, you might be given like a figure or a picture, like you know, and click or you will assess this kind of question.

Now in the new generation NCLEX is called an enhanced hot spot or highlighting. So you will be given again, a scenario, and this will be like going to direct question. And the task is for you to which of these findings, click the findings below that would require follow up. Now, remember, I mentioned earlier that the main reason why they changed this, this to NGN, delta x and g n is they want nurses to have critical thinking, they want us to recognize what's going on to the patient, if you know, they're, they're deteriorating so that we can, you know, resolve those problems, save them a trip from the ICU. So that is a very important thing that you guys need to consider when you study how do I know that my patient is deteriorating? So in this situation, you're given like multiple highlights, and, you know, just click on them. The only thing here is that it may not tell you how many things to click. Right. So any of those questions that Dr. Paul showed, and what I showed can be in any of those six different case study questions, and remember, you will have 18 of these per candidate. I think this last part of my slide, I'll let let's work on this. I don't know if you had time to read it. But it says here, highlight the three assessments that should concern the nurse and must be reported to the healthcare provider. So this actually one of the exercises I gave in my class, because, you know, I'm teaching my students how to think this way. So this is on the under the concept of, you know, post of nursing. So yep, I give them this reading comprehension. And yeah, they had to figure out what assessments to pick and refer to the provider. So it's exciting, isn't it? I mean, that's how the new NCLEX will appear. You know, once you have it, APR, one going forwards.

Wow. Thank you, Dr. James. Thank you, Dr. Poole. Wow, my head is like, I think this is how everybody is feeling when they watching this little taste that you've given us of the next generation NCLEX. So again, just to reiterate, if you have passed the NCLEX already, congratulations, you're not going to have to worry about next generation and please apply to Connetics USA and we will be happy our team is on standby. We'll be happy to help you make your American dream a reality. We have 1000s of physicians all over the United States and our team are waiting online to talk to you and see how we can assist you. If you have not yet taken your NCLEX exam. Let me say this again. If you have not yet taken your NCLEX exam, no problem, you may be eligible for the Connetics USA NCLEX scholarship. Please apply for the scholarship only selected nurses will be able will be eligible for the scholarship. And this is a paid scholarship so you can find out more details about this. Please share this with your friends. We are happy for people to apply and to see if you might be eligible for the scholarship. But I do want to say that if you are not eligible for the scholarship, please don't panic, because you can still obviously go ahead with your NCLEX and come back to Connetics USA and we will be happy to help you match you with one of our prestigious Clients here in the United States.

So let's finish off now I want to just remind everybody about upcoming shows before you leave. On the 14th. We have our regular once a month immigration Q&A with the expert legal panel, everything you need to know about immigration questions coming up on the 18th. We have the Lefora talk show and here we are talking specifically about the Philippine Nurse Association in the United States and what great work they do for the community. On the 21st. We did a poll for our stateside segment, and North Carolina where Dr. James lives was the number one state that people wanted to know more about. So learn more about North Carolina on the 21st. And on the 28th. We're going to be talking about your spouse, if you're married and coming to the United States, how do you help support your spouse in making a smooth transition. Also, don't forget the Connetics College. We have upcoming shows on the 10th. We have Pearson PTE with Swoosh on the 17th. We have NCLEX plus with J from IPOs. And on the 24th we have the IELTS with Ervin and Brian from Niners every Monday 5am pacific time these are free classes, please tag your friends, join in the Connetics College we have 1000s of people that are watching every week. Now these are free classes. And Dr. Paul and Dr. James also do free classes on the Connetics college.

So we encourage everybody to watch and learn the skills that you need to know about coming to live in the United States. And also just a shout out to Dr. Paul. I will be on his show tomorrow morning. And we're going to be talking about the challenges in chasing the American dream. And we'll be screening that on the on the Connetics page as well. Thank you everybody for joining us. Thank you to our panel, Dr. James and Dr. Paul. We also have Dr. James and Dr. Paul have agreed to put some of it to answer some of the questions that we have in the chat. And then we will be doing another bonus class on the next generation NCLEX. So there's going to be a lot more information coming on onwards and upwards. Connetics initiatives before we finish, we have free English a scholarship for all Connetics nurses free NCLEX scholarship for selected nurses, our $1,000 referral fee extended to November. And there's a link on our website for you to put in anybody who's passed the NCLEX watch or listen to our podcast nursing in America we have direct hire for nurse aides onwards and upwards show every Friday Canadians college every Monday and if you are a med tech medical lab technician or other allied needs, we have positions for you too. Thank you everybody for joining us. See you next week. Onwards and upwards. Thank you bye bye