NCLEX-RN®: Next Gen Questions

by Rhonda Lawes, PhD, RN

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    00:01 I'm going to walk you through the NGN questions.

    00:04 Okay? I want you to see some quick strategies on how you can take a look at these from a big view and then show you how to take the next steps and break down the question. So I'm not going to spend a lot of time finding the right or wrong answer here.

    00:17 I just want you to get the big picture now.

    00:20 We have lots of videos that will walk you through exactly how to work through this question, find the topic, pick the best answer.

    00:27 But in this one, I just want you to get familiar with the format.

    00:31 See, this looks different than what you see on your regular nursing school exams.

    00:35 On the left hand side, you've got a lot of information about the patient.

    00:39 On the right hand side, you've got a type of question that you have to respond to.

    00:44 Now see what's different about this one.

    00:45 Look at the right hand side.

    00:47 Select the four client findings that require immediate follow up on some questions.

    00:52 You'll be told exactly how many answers are correct.

    00:56 It's kind of a relief and then yet sometimes kind of bittersweet when you're still working through those questions. But use your strategies and walk through them.

    01:03 Now look at this format.

    01:05 You see, here's what the clinical findings are, and then they give you three different diagnoses. This is where that checking, that clinical judgment and that critical thinking for you, you see fever, you'd have to know, does that happen in pneumonia? You'd say yes or no.

    01:19 If it's yes, you check the box.

    01:20 Same thing with UTI.

    01:21 Yes or no? Check the box.

    01:23 If it's yes. Influenza, yes or no, check the box.

    01:26 If it's yes, leave it blank.

    01:27 If it's no. And then you would work through each one of those client findings.

    01:32 So remember, the first one told me exactly how many answers I was looking for.

    01:37 I was looking for four.

    01:38 This format tells me you've got to think of this System the symptom client finding, and then think through the three diagnoses and check in or out.

    01:47 Yes or no.

    01:49 Now, this is a drop down.

    01:50 You've seen this all over the Internet.

    01:52 So you see the little drop down box when you click on it.

    01:55 Look what's going to happen.

    01:56 It gives you the answer option.

    01:58 So you'll notice all the way through the left hand side of the screen has stayed the same. I've got all the patient information.

    02:06 The question changes on the right hand side of the screen.

    02:10 If you're looking at a case study, there's six of these questions that refer to the same client. So on this one, you hit the dropdown arrow and you select the answer that you think is most correct.

    02:22 Now, in this version, you see, look at the left hand side.

    02:26 We've got another tab that it's appeared.

    02:28 So on most of these you'll see three tabs, you might see two tabs, but you've just got that as a reminder.

    02:34 You have the ability to click in between those and read the information any time you want to. Now this is asking you to figure out what's the best thing to do.

    02:44 You've got potential nursing interventions all the way down the left side.

    02:48 Should you do it or not? That's really what the question is asking you Should you do it or not? And if you think about it, it's just like a select all that apply.

    02:57 Question Right? Because you take each question with each option one at a time and decide yes or no, in or out, true or false.

    03:05 So that's all you're doing here.

    03:06 It's just presented in a little different way.

    03:09 Now you're looking at orders and it's asking you to click to highlight the order that the nurse should consider a priority.

    03:16 Ready When I first heard about these, I was kind of tripped out.

    03:19 I'm like, Oh, it just seemed like too many options on the NCLEX exam.

    03:24 It will limit what can or cannot be highlighted so you'll know what you're picking from on the exam.

    03:30 So don't panic. It'll be very clear what's even possible to highlight.

    03:34 You just have to choose the best answer.

    03:38 This is the last type of question that we're going to talk about that could show up in a case study.

    03:43 Remember, a case study has six different questions about the same patient.

    03:48 So you'll see things that are happening to the patient over time, orders that are changing. But this is the last one we're going to talk about.

    03:55 So we saved the best for last on this one.

    03:58 You have three options for each one of the assessment findings, so don't let that panic you. This is going to happen, but you can do it.

    04:06 This is where you recognize cues, analyze cues, prioritize hypothesis.

    04:12 This is how you'll be tested on that.

    04:14 Take it one assessment finding at a time.

    04:17 Check the boxes, make sure you're thorough, and then you can move on.

    04:21 And that are all the different types of questions that could show up on a clinical case study on next gen.

    04:29 This has been labeled a bow tie question because of the shape of the question on the right. You see that it kind of looks like a bow tie.

    04:36 The name isn't as important as you processing.

    04:39 What's the most efficient way for you to get the best answer? On the left hand side is all the information about the patient.

    04:47 Read it slowly and thoroughly.

    04:50 Make sure you're paying attention to any numbers.

    04:52 Are they high, low or normal? Make sure you know what's normal or abnormal.

    04:56 So as you spend thoughtful, focused time reading through those questions.

    05:00 Now, when you move over to the right hand side, you see this is where it starts to test your knowledge. So you'll see there's essentially three columns.

    05:07 The one on the left of the bow tie has two boxes.

    05:11 In the middle you have one box and on the last two you have two boxes.

    05:15 Now you can change your answers after you pick them.

    05:18 But let's talk about strategies.

    05:20 Some people are starting with the middle first.

    05:23 They want to start with that and then they work both the sides.

    05:26 That can be a little tricky.

    05:29 You can do it that way, but make sure you're very clear, because if you put the wrong answer in the middle, you're going to get the wrong answers on either side.

    05:38 So I prefer to start for me on the left hand side, match that up.

    05:43 I go through each one of those options where it says action taken, right? So each one of those potential actions, I look at that and see which one makes sense for this particular patient.

    05:55 Then I do.

    05:56 Oh, the potential condition.

    05:57 Yes. Does that line up? And then I know what I need to monitor, which is the third column.

    06:03 So my best recommendation for this is I start at the left.

    06:06 I work through each one of those options, say yes or no.

    06:09 I'm keeping them in Then.

    06:11 I'm rock solid on What the middle and the last pieces are.

    06:14 Once I've filled out all five boxes, I'll go back and make sure that all makes sense.

    06:19 Like everything matches three columns across.

    06:22 Then I'll read the question one more time to make sure that I answered the right question because they write really good distractors on this question.

    06:30 So make sure you're thorough and take your time.

    06:35 This question is a trend.

    06:37 Question. I'm going to show you two types of these as we walk through them.

    06:41 But what makes it a trend question is that you see information over time.

    06:46 So look at this. You've got a weekly visit, one weekly visit, two weekly visit, three.

    06:50 It might be just the same patient in the same day, but this is telling us what's happened over a period of weeks.

    06:57 Timing matters when you're reading the information, but this tells you what is a trend. Question Now, over on the right hand side, that's where we do the work of answering the question.

    07:07 You'll see that you're going to have to click and drag your answers to the boxes.

    07:11 That's how this type of trend question works.

    07:14 This type of trend question is a little bit different.

    07:17 You'll see you have the flow sheet.

    07:19 This is one patient you're working through a time things are happening during the day and then you have a select all that apply.

    07:26 Question On the right, this question addresses what's happening on the left hand side. So just use the same strategies go through, make sure you notice what things are normal or abnormal things you would expect, things you would not expect.

    07:38 Then go to the question and treat each one of those options on a select apply as a true false. Yes, no question.

    07:47 And you'll have those knocked out.

    About the Lecture

    The lecture NCLEX-RN®: Next Gen Questions by Rhonda Lawes, PhD, RN is from the course NCLEX-RN® Introduction to the Exam.

    Author of lecture NCLEX-RN®: Next Gen Questions

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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