Walkthrough: Reduction of Risk Potential Q1 – NCLEX-RN®

00:01 A client who's diagnosed with myasthenia gravis is prescribed prednisone as a part of the treatment.

00:07 Which statement does the nurse know is accurate about this medication? Okay. Let's unpack this together. I know I have a client with a diagnosis.

00:17 So it's myasthenia gravis. Anytime you see a diagnosis, we think through, "Hey, what is that disease? What are the problems with that?" Just do a quick run-through in your brain.

00:28 Now, if you're working through this question with me and you're thinking, "I don't know anything about myasthenia gravis.

00:33 Write yourself a note in your notebook to review myasthenia gravis later.

00:39 For now, we'll work on this question. So they're prescribed prednisone.

00:44 We know that's a medication and it's part of their treatment.

00:48 So thinking about, is that normal that somebody with myasthenia gravis is prescribed prednisone? Well, that is a steroid, right? So what do you remember about that and myasthenia gravis? Here's where you need to make a decision.

01:06 Are you - is this a normal part of treatment or not? Let's go onto the rest of the question.

01:12 Which statement does the nurse know is accurate about this medication? Okay. I'm looking for accurate statements about prednisone when treating myasthenia gravis.

01:24 So I've put that question into my own words.

01:27 So which statement is accurate about prednisone for a patient who has myasthenia gravis? Now, why am I going up on my toes when I say accurate? The reason I am is because that last question is the one that can catch you.

01:42 See, on these questions, it may ask you which statement is inaccurate about this medication? Which statement requires further education by the patient? Then, I'd be looking for a false, wrong, or unsafe answer.

01:58 But very clearly, this says, "Which statement does a nurse know is accurate about this medication?" So that's what I'm going to ask myself four times. I'm going to look at option number one.

02:10 Let's bring those in. Let's look at the answer choices.

02:21 And I'm going to ask myself that question in my own words.

02:26 Is that statement accurate about prednisone for myasthenia gravis? It increases muscle strength by slowing down the breakdown of acetylcholine.

02:36 Is that what prednisone does in myasthenia gravis? Does prednisone slow down the breakdown of acetylcholine? No. It does not. So we can eliminate that answer.

02:49 Number two, it improves muscle strength by inhibiting the production of autoantibodies.

02:55 Oh, does prednisone work like that in MG? Well, you have to think about what you know about MG, and then prednisone, yeah.

03:03 That's an immunosuppressant. So that might be an answer.

03:07 I'm not ready to eliminate that yet.

03:10 Number three, is it accurate to say that prednisone in MG is reserved for severe cases of the condition? No. Because remember, I've already thought about this.

03:21 And I know that we use prednisone with MG. So that is not accurate.

03:26 It's not reserved for severe cases. I'm going to X that out.

03:31 Number four, using prednisone in myasthenia gravis, does it decrease the muscle atrophy by increasing the production of muscle enzymes? So does prednisone increase the production of muscle enzymes in myasthenia gravis? No. It's an immunosuppressant. Now, the only one we kind of left in was number two.

03:56 Let's go back and see if it makes sense.

03:58 For prednisone in treating myasthenia gravis, will it improve muscle strength? Well, what's the - what's the reason they say it does? Because it inhibits the production of autoantibodies? Absolutely. That's the answer.

04:13 Select that one, read it one more time just to make sure it's correct.

04:18 And then you're ready to go on to the next question.

04:21 Now, some of you are likely saying as I know I would have said as a student.

04:26 You are making this question go extremely long, right? This is going to take forever for me to take the test.

04:33 That's because I am putting us in really slow motion to explain to you the steps on how to raise your test scores.

04:43 So you will do this very slowly at first, but the more questions that you practice, the more adept you'll become at it.

04:51 But the reason I take such care is because I have sat down with many, many, many students in my practice as an educator.

05:00 And when I sit down, I look at a test with them, afterwards I say, "Why did you pick this answer?" And they say, "I have no earthly idea why I picked that answer." Keep in mind, testing makes us feel stressed, right? Can cause anxiety.

05:16 And your brain doesn't work as clear.

05:19 If I was doing brain surgery, I want to be really sure where I was cutting and separating things, right? Look at a test the same way. Think of yourself as a surgeon, and you're going to just try to make the tiniest, most precise incision, so that you get the best answer. That's why you treat each answer choice separately, and make sure that it answers or addresses the question you're being asked.

05:44 Not another question because that's a strategy that's used on these questions.

05:49 They're called distracters. So there might be really great answers, but they don't address the topic of this question.

05:56 All right. So we've talked about some extra rules in here.

05:58 Now, you're ready to try another question with us.