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How to PASS the NCLEX [7 Day Training] Day #2 NCLEX CATEGORIES PART I — Transcript

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0:01All right. So, let's begin. This is the
0:04agenda for our 7-day training.
0:07Yesterday, we did our first day of the
0:10training and basically we focused on
0:14understanding the ENLEX world and we
0:17talked about pillars, pillars of success
0:21that will help you and aid you into
0:24passing the ENLEX. On day number two,
0:28we're going to talk about ENLEX
0:31category. So today, tomorrow, and day
0:36four, we're going to be talking about
0:39ENLEX categories.
0:42Okay? You're going to know each
0:44category.
0:46What do you need to show the ENLEX in
0:50order to prove that you're a safe nurse
0:52in each one of those categories? And the
0:55best of all, we're going to practice
0:57enclelex style questions. All right, so
1:00it's going to be very very interesting.
1:05Day two agenda, we're going to talk
1:07about the distribution of ENLEX content.
1:11We're going to talk about how to master
1:14physiological integrity
1:17and the subcategories included in
1:20physiological integrity which includes
1:23basic care and comfort, pharmacological
1:26and parental therapies and reduction of
1:30risk potential. And in each category
1:33today we are going to practice enclelex
1:37style questions. So we're going to
1:39practice about two question for each
1:41category and then tomorrow we will
1:44continue with the other enclelex
1:47categories.
1:49All right, thank you for everyone that
1:52showed up yesterday supporting our
1:54channel. Thank you for that. And today
1:57we're going to get into uh deeper waters
2:00and we're going to start developing that
2:03critical thinking and your ability to
2:06answer ENLEX style questions. When we
2:09talk about the distribution of content
2:11for the ENCLEX, we have several
2:15categories and subcategories.
2:19And each one of these categories has a
2:22percentage of questions that you can see
2:25on the ENLEX. For example, if we look on
2:28the upper left, physiological
2:31adaptation, you can see about 14% of the
2:35ENLEX questions related to physiological
2:39adaptation.
2:41What does this represent? Basically if
2:44you do a 100 question enlex you could
2:48see about 14 questions on the enlex on
2:52physiological adaptation
2:55we see that reduction of risk potential
2:58is 12% pharmacological and parental
3:02therapies 15% basic care and comfort 9%
3:07psychosocial integrity 9% health
3:11promotion and maintenance
3:139%
3:14safe and infection control or safety and
3:18infection control 12% and management of
3:22care 20%. So as you can see the biggest
3:26categories are management of care,
3:30physiological adaptation and
3:32pharmarmacological and parental
3:35therapies. But do not worry, we are
3:37going to discuss each one of them and
3:40we're going to practice questions
3:42together. So no more delays. Let's begin
3:46with basic care and comfort.
3:49So Rey, what do you what do I have to
3:52show the ENLEX
3:55in order to prove them that I I am a
3:58safe nurse when it comes to basic care
4:01and comfort? Basically, you have to show
4:04the ability to provide comfort and
4:08assistance with activities of daily
4:12living. Now guys, this comes directly
4:16from NCSBN. My wife and I, we have been
4:20to several yearly meetings for NCBN and
4:24we've had the opportunity to sit there
4:27and ask questions and it has been very
4:31very useful for us in order to prepare
4:35our content to teach our students
4:38and basically accordingly to the NCSBN
4:42ENLEX these topics are included in basic
4:47care and comfort. Thank you Mr. Mixel
4:52Linarees for supporting our YouTube
4:55channel. We appreciate it. So these
4:58subtopics or topics are included in
5:02basic care and comfort. Assist the
5:05client to compensate for physical and
5:09sensory impairment.
5:11These type of questions deals with
5:13assistive devices,
5:16positioning and compensatory techniques.
5:20Also, you're going to see assessment and
5:23manage management of client with
5:25alteration in elimination,
5:28performing irrigations,
5:31apply, maintain and remove orthopedics
5:34devices, implement measures to promote
5:37circulation and so on. I'm not going to
5:42read each one of this because you can
5:44read by yourself. But what I want you to
5:46do is write this down. And as you use
5:50your resources to study for the ENLEX
5:53like the Sanders book for example like I
5:56shared with you guys yesterday
5:58what I encourage is that each one of you
6:01use the Sanders book or whatever other
6:03book that you have nursing book and
6:06review and study each one of these
6:10topics. Now remember the key is not to
6:16memorize it but understand it. Um the
6:21photo is a little bit small. I don't
6:23know if you have like a tablet or or a
6:26phone you can zoom in and see it a
6:29little bit better. But also this is not
6:32something that I created. You can find
6:34it on ncsbn.org
6:37or if you type on Google
6:41Enclelex test plan the last revision was
6:45done in 2019
6:48so use that Google and go NCSBN enclelex
6:53test plan download it and you're going
6:56to see what is included in each one of
7:00those categories
7:02guys everything is out there I'm not
7:05making this up is information that NCSBN
7:09provides to professors and every
7:13candidate that is presenting to the
7:16ENLEX.
7:18Okay. So what I want to do next I want
7:21to practice some questions. Okay. So
7:24let's practice two questions about basic
7:28care and comfort. So this is question
7:31number one. And as I am reading this
7:34question and highlighting or indicating
7:38specific keywords which you learned
7:41yesterday, remember the five key factors
7:44of an enclelex question. If you don't
7:46know what I'm talking about, find day
7:49one, day one training of our 7-day
7:52training and you're going to hear the
7:55five key factors of an ENLEX question.
7:59So as I review this question, think
8:02about the question and comment on the
8:06comment section what you think is the
8:08answer. Okay? And why why do you think
8:11that is the answer? That is the most
8:14important thing to do. That way I can
8:16read and I can see what is your thinking
8:20process. Okay. So the male client is
8:23diagnosed with Gileian Beret syndrome
8:26and is in the intensive care unit on a
8:30ventilator. So in this question we don't
8:34have a lot of information about our
8:37client. The only thing we know that is a
8:40male client. We have a diagnosis which
8:44is Gileian Beret
8:47and the patient is in the intensive care
8:50unit on a ventilator.
8:54This is important
8:57because knowing that the patient is on a
9:00ventilator can tell you about the
9:03seriousness of this patient's condition.
9:08Thank you, Mr. Jorge Martinez, for
9:10supporting our channel. I appreciate it.
9:14Now read the next question. It says,
9:17"Which cardiovascular
9:21rationale explains implementing passive
9:26range of motion exercises.
9:31Cardiovascular
9:33rationale.
9:35So the answer that you're looking for
9:38needs to have a relationship with card
9:43the cardiova cardiovascular system.
9:47So if you're looking at the answer and
9:49it's not related to the cardiovascular
9:52system is the wrong answer. The mistake
9:55that student make in this question here
9:59is that they automatically go and think
10:02about passive range of motion exercise.
10:06And yes, that is a an important factor
10:09of the question. But the answer that
10:12we're looking for, the rationale has to
10:15do with the cardiovascular system.
10:18So let's review answer number one. It
10:20says passive range of mo passive range
10:24of motion exercises will prevent
10:27contractions from developing.
10:31And yes, answer number one is a good
10:35answer because it is true passive range
10:39of motion exercise help prevent
10:42contractions from developing. However,
10:45this is a muscularkeeletal complication,
10:49not a cardiovascular
10:52complication.
10:53So, we can eliminate answer number one.
10:56And once again, I am using the process
10:59of elimination.
11:02Answer number two, the client will feel
11:05better if he is able to exercise and
11:10stretch his muscles.
11:13Well, let's think about this one here.
11:17The patient is on a ventilator.
11:21What this means is that you know in
11:23Gileiam we have ascending paralysis. So
11:28if a patient is on a ventilator the
11:32ascending paralysis reach the
11:36respiratory muscles.
11:38So we're looking at a serious condition.
11:41So this patient will not be able to
11:44exercise and stretch his muscles. That
11:48will be active range of motion and we're
11:52talking about passive range of motion.
11:56So answer number two, we can eliminate.
12:01Answer number three,
12:04range of motion exercise will help
12:08alleviate the pain associated with
12:12Gileian Beret. Well, as in number three,
12:16we can eliminate for two reasons. One,
12:19it would not alleviate the pain and two,
12:24it has nothing to do with the
12:26cardiovascular system. So answer number
12:29three is eliminated.
12:33Answer number four passive range of
12:36motion help to prevent
12:40DVTs
12:42deep vein trombosis
12:45by movement of the blood through the
12:48veins. So are we talking about the
12:53cardiovascular system? Is number four a
12:57cardiovascular rational of why we will
13:01be implementing passive range of motion?
13:05The answer is yes. So answer number four
13:10is the correct answer.
13:14I don't know if you are paying attention
13:17from day one from since yesterday you
13:20have been listening to me on how I
13:24analyze enclelex question and you're
13:27going to see something very important. I
13:30analyze the question the same way. It
13:35doesn't matter if it's a content
13:37question. It doesn't matter if it's a
13:40prioritization question. The most
13:42important thing for you to do is first
13:46identify the key factors of an enclelex
13:49question and then start analyzing answer
13:53by answer using the process of
13:56elimination. So you are not looking for
13:59the correct answer, you're looking for
14:01an incorrect answer to eliminate. Would
14:05you agree that is not the same selecting
14:08the right answer in four answer choices?
14:11Then if you eliminate two of them and
14:13now you're in between two answer
14:15choices. Now what is the usual problem?
14:20Students analyze eliminate and then they
14:24get to two possible answers and most
14:28times they choose the wrong answer. And
14:32that is okay. It's one step at a time.
14:35Throughout the training you will
14:37continue to develop your critical
14:38thinking and you will you will select
14:42the correct answer more often. Okay. So
14:48answer number four is the correct
14:50answer. Let's look at another question.
14:56This question says after a prostatectomy
15:01a client is diagnosed with a major
15:03complication of hemorrhage and hypoalmic
15:08shock. Which of the following is the
15:11initial nursing action? There's a few
15:15keywords here that are extremely
15:17important. The condition prostatctomy.
15:21There's not a lot of information about
15:23the client.
15:25The client was diagnosed with a major
15:27complication of hemorrhage and
15:30hypovalmic shock. So we know that this
15:33patient is bleeding. This patient has a
15:36physiological need regarding airway,
15:41breathing, circulation as specifically
15:45circulation. So we know that the
15:47client's problem is a circulatory
15:50problem.
15:52Which of the following is the initial?
15:55The word initial tells me that I'm
15:58looking for the first answer. We have
16:03monitor vital signs, administer a vaso
16:07dilator to improve the client's blood
16:09pressure, administer intravenous fluids,
16:13and record intake and output.
16:17What an interesting scenario. And answer
16:20number one or a monitor vital signs is
16:24an answer that I see very often. Okay.
16:28Now, are we going to be doing an
16:31assessment like answer number one or are
16:36we going to be doing an implementation
16:39like answer number or letter C
16:43administer IV fluids?
16:46What is the priority action? What is the
16:49initial nursing action? Let's use the
16:53critical thinking.
16:56If you analyze this scenario, you have
16:59determined that this is an emergency.
17:02And in emergency scenarios, are you
17:06thinking about doing an assessment or an
17:08implementation?
17:11If your patient is in distress, do not
17:15assess, implement. in most cases. So I'm
17:20looking for an implementation. So answer
17:23A I can eliminate because this is an
17:25assessment.
17:27Recording the intake and output,
17:30administering IV fluids and
17:32administering a vaso dilator. They are
17:34implementation answers. Now I can
17:38continue using
17:40critical thinking and we have two
17:43answers that are related to another.
17:48For example, the administration of vasod
17:51dilator and the administration of IV
17:55fluids.
17:57Each one of these answers is going to do
18:00a different effect on the circulatory
18:03system. For example, if I administer a
18:08vessel dilator,
18:10what is that going to do to the blood
18:13pressure? Is it going to increase the
18:17blood pressure or is it going to
18:20decrease the blood pressure? And
18:23remember that the patient is in
18:26hypoalimic
18:27shock. So the patient is going to be
18:31hypotensive.
18:33The patient is in shock. So I need to do
18:36something that increases the blood
18:39pressure.
18:42A vessel dilator
18:44will decrease the patient's blood
18:47pressure further and will cause more
18:51problem.
18:53B is eliminated.
18:56Now, administering IV fluids, is that
19:01going to help with hemorrhage? Yes. Is
19:05that going to help with hypoalmic shock?
19:08Yes.
19:10So, letter C is a very good answer.
19:15And D, recording the intake and output.
19:19Do we record intake and output in a
19:21patient that is in a hypoalmic shock?
19:24Yes. Is it the priority? Well, very
19:27simple. Ask this question.
19:31Between letters C and D, which answer
19:35helps the patient's condition?
19:39Administering fluids or documentation?
19:44Obviously, administration of fluids is
19:47going to help the patient more. Remember
19:51documenting is your last action to take.
19:56You document once you have done
19:59everything
20:00that you can do to help the patient.
20:05Does it make sense? Okay. Are you
20:09learning? Is that critical thinking
20:12improving?
20:13Are you starting to see different things
20:16that you were not seeing before?
20:19I hope the answer is yes. And this is
20:22only the beginning, day two of a whole 7
20:27day training. You will learn a lot. And
20:30like I said, on the first day, you will
20:33never think about an endless question
20:35the same way. Thank you, Miss Betty
20:38Delgado, for supporting our our channel.
20:42And thank you, Miss Alejandra Alexandra
20:45Tronoso for supporting our YouTube
20:49channel. I appreciate it.
20:56All right, Lester Lester asks a great
21:00question.
21:01Professor,
21:03can I administer IV fluids without a
21:07doctor's order? Excellent question. And
21:11here's the answer. Remember this for the
21:14ENLEX.
21:16It is assumed that you have a doctor's
21:20order. In other words, you do not have
21:24to say, "Well, let me call the doctor
21:26first to ask the doctor if it is okay to
21:30administer IV fluids." You have an order
21:33already. What you have to do is say does
21:37administering IV fluids is it going to
21:39help my patient with this condition yes
21:43or no. If the answer is yes go ahead and
21:46do it. You have the right order. That is
21:49a very important question and I am glad
21:53Lester that you asked that question.
22:03Mercy, you make Enkllex seem simple.
22:06I wouldn't say it's simple. It's just
22:09that it is easier for you to
22:13analyze the question. Because if you
22:16think about what is easy or hard, simple
22:20or difficult, it depends on who's
22:22analyzing it. If you're prepared, if you
22:26study, if you develop your critical
22:28thinking, you're going to say, "Ah, this
22:30is very simple." But if you're not
22:32prepared, you don't know how to
22:34prioritize, you don't know how to think
22:36critically, you're going to see it very
22:38difficult. So, it depends on who's
22:41analyzing.
22:43Thank you, Miss Loose Rodriguez, for
22:46supporting our channel with that uh
22:50super chat, super sticker. Excellent.
22:54All right. Well, that's a little bit
22:57about basic care and comfort. Let's go
23:00to
23:02pharmarmacology.
23:04Pharmarmacological and parental theapy.
23:08You have to show the enlex that you have
23:10the ability to provide appropriate care
23:15in relationship to the administration of
23:19medications.
23:21What are the topics that are included in
23:25pharmarmacological and parental therapy?
23:28We have adverse effect, blood products,
23:32blood transfusion, centravenous access
23:36devices, dosage calculation,
23:39expected versus side effect, medication
23:42administration guidelines and rights,
23:45parental and intravenous therapies,
23:48pharmacological actions and agent,
23:51pharmarmacological interactions,
23:53pharmarmacological pain management and
23:56TPN or Toro Parental Nutrition.
24:01Thank you, Mr. Ismael
24:04Ramirez. Thank you for supporting our
24:07YouTube channel.
24:11Very good, Jasmine.
24:14Thank you, Miss Auka.
24:17You're an amazing teacher. I appreciate
24:19it. Very humble. I am very glad that you
24:23guys are enjoying this uh training.
24:26Okay.
24:28Very good. So why is pharmarmacology so
24:33difficult? Pharmarmacology is one of the
24:36most difficult nursing content areas to
24:39master.
24:41The reason is that there are an enormous
24:45number of medications available.
24:49A vast amount of information to know
24:53about each medication.
24:57And this is what I think.
25:01I don't think it's possible to learn all
25:05the medications, to learn all the side
25:08effects, all the adverse effects, the
25:11intended effect of every medication.
25:15It's impossible to learn all that. And
25:18that is the problem.
25:20But what can we do to deal with this
25:24problem?
25:26Because if we focus on the problem,
25:28we're done. If we try to find the
25:31solution, then we have a chance.
25:34So what can we do? And very often
25:39student ask me, professor, is there a
25:42list of medications
25:46that appears on the anklex? The answer
25:50is no.
25:52Don't spend money buying a list of
25:55medication guide that comes up on the
25:58ENLEX because you know what nobody
26:01knows. Nobody knows exactly
26:05what questions are going to appear on
26:07your ENLEX exam. However, there are
26:11certain medications or medication
26:14categories that appear very often. For
26:17example, emergency drugs.
26:21Emergency drugs that you give when a
26:23patient is having airway, breathing,
26:26circulation problem. If the patient is
26:29on cardiac arrest, what medications do
26:31you give? anti anti-coagulants,
26:34antibiotics,
26:38medications like heperin, medications
26:41like couadin,
26:44insulin
26:46and on other trainings we will go a
26:48little bit more in depth about
26:50pharmarmacology because I tell you I can
26:53do a seven day training just on
26:57pharmarmacology and it will probably not
27:00be enough.
27:02So we will continue to discuss that in
27:05future trainings. But understand this,
27:09focus on the emergency drugs. Focus on
27:14medications that you use in emergency
27:16situations and also known high risk
27:21medications.
27:23Okay. Also antidotes. They're very
27:26important for the enklex.
27:29So another question that I see students
27:32asking is what do I have to study
27:37generic or brand names? Do I have to
27:41know the generic names or brand names of
27:46medication? And that is a very very
27:50frequent and common question that I see
27:53in students. Thank you Mr. Lester
27:57Pinata.
27:59for that uh super sticker. I appreciate
28:01it. Thank you, Miss Yolanda Pantoas for
28:05supporting our YouTube channel. Thank
28:08you.
28:12H Areli, you should do professor a 7day
28:15training on pharmarmacology. That would
28:17be amazing.
28:19Hey, maybe we can do that. If everybody
28:22wants to do that, we'll do it. We'll
28:24find another time to do another seven
28:27day training. Like I said, I really want
28:31to help you guys out. I think that
28:34you all of you need a lot of help. And
28:37if I can do something to to support and
28:40help the community, I am willing to do
28:43that here in our in our YouTube channel,
28:47help other people at the same time. my
28:50channel grows as well and the academy
28:53grows. So, I think we help each other
28:56out. So, we will we will do that. No, no
28:59problem.
29:00Thank you, Miss Elizabeth Salana, for uh
29:04supporting our YouTube channel. So, what
29:07do I have to learn, Professor Generic
29:11or brand drug names? Well, accordingly
29:15to the NCSBN
29:18at this time,
29:20they will use generic medication names
29:25only.
29:27However, in certain scenarios, they
29:30could use a brand name, but if they do
29:34use a brand name, they will give you the
29:38generic name as well.
29:42So if I if I were you, I would study the
29:46generic medications. And the reason is
29:49because for one generic medication, you
29:52could see five 10 different brand names.
29:56And you're not going to have time to
29:59learn all those brand names. So I am
30:02glad that the NCPN the ENLEX made that
30:06decision to only include generic names
30:09and not brand names.
30:14All right. So let's talk about
30:17assessment when it comes to
30:19pharmarmacology
30:20because as you know accordingly to the
30:24nursing process assessment is the first
30:27step of the nursing pro process. Do not
30:30confuse that with that assessment is the
30:32priority all the time. That is a big
30:35mistake. Assessment is the first step of
30:39the nursing process but is not always
30:42the priority. That is an assumption that
30:45you cannot make. It depends on the
30:48scenario. But let's talk about
30:50assessment
30:51and pharmarmacology.
30:54One of the most important assessment to
30:56do is assessment of allergies and hyper
31:00sensitivity to medications.
31:03Many medications
31:05clients can develop allergic reactions.
31:09So this it is very important to ask and
31:12determine in the client's clinical
31:14record if the patient has an allergy to
31:18a certain medication group.
31:21It is important to assess the client for
31:24any existing medical disorders that
31:27would be contraindicated in the
31:30administration of a certain medication.
31:36Assess for potential interactions
31:39related to medication. In other words,
31:42if the patient takes over-the-counter
31:44medication, does it interact with a
31:48prescription medication?
31:51Is there any contraindications
31:53or potential interactions between a
31:57prescribed medication and let's say uh a
32:02tea that a patient takes or herbal
32:05remedies
32:08assessment of laboratory results.
32:12For example, if you're giving potassium,
32:15if you're giving magnesium,
32:18you need to check the laboratory results
32:21because otherwise you can give a patient
32:24a medication that you can cause damage
32:28to that patient. You can injure that
32:31patient. For example, there are certain
32:34medications like let's mention one of
32:37them heperin
32:40kumadin. you have to check certain lab
32:44values and I don't know if you know the
32:46answer to that. So what is the lab value
32:49that you have to check if you will
32:53administer or you are administering
32:56heperin to a patient that is a good and
33:00clicks question.
33:02What is the lab value that you have to
33:07assess if you're giving a patient
33:10warerin or kumadin?
33:14Let me see the chat. What do you think?
33:19Let me see if if I have a sharp group
33:23today, tonight.
33:29See, Janette says PTT
33:35and PT INR.
33:42Okay. Jaspine says PTT for heperin,
33:46PTIR
33:47for kumadin.
33:53All right. Excellent. So you have to
33:56know the relationship between laboratory
33:59results and medication. Also vital
34:03signs. For example, if you are
34:06administering an anti-hypertensive drug,
34:09you're giving a medic a medication for
34:11high blood pressure. So, what is a vital
34:15sign that I have to assess? Well, I have
34:19to assess the blood pressure. If I am
34:22giving a medication that uh interacts
34:25with the heart rate of the patient, for
34:27example, if I'm giving a beta blocker, I
34:30have to assess the patient's pulse. If
34:33I'm giving dioxin, I have to assess the
34:37patient's pulse. So you have to know the
34:40relationship between vital signs that
34:43you have to assess and a medication
34:47administration.
34:50You have to assess for intended effect,
34:54side effect, adverse effect and toxic
34:57effect of medication. And there is a
35:01difference between these subjects.
35:05Intended side effect, adverse effect and
35:08toxic effect are not the same. We will
35:11talk about that in the next few minutes.
35:15Thank you Miss Beverly Kalana
35:20for
35:21that super sticker. Thank you for
35:24supporting
35:26our YouTube channel. I appreciate it.
35:29All right. So you have to read the
35:32question carefully and identify first
35:36the key factors of an enclelex question
35:39but also you have to think about
35:42something very particular to medication.
35:46Okay we know about
35:49reviewing and identifying demographic
35:52information such as age and gender. Who
35:55is your patient? What is your patient's
35:58medical history, family history? But now
36:03with medication administration, we have
36:05to add something else.
36:07Allergies to medications.
36:10And we're going to add something else.
36:13Do I have information on the stem of the
36:16question that talks about vital signs?
36:20That talks about laboratory results.
36:24Remember if you see that on the stem of
36:27the question you see a medication
36:31is there for a reason. Now you have to
36:34think a little bit more in depth. When
36:37you are reviewing and identifying the
36:41key factors of the ENLEX question it's a
36:44little bit more advanced in
36:46pharmarmacology.
36:47Look for keywords such as intended side
36:51effect or adverse effect. But watch out.
36:55Sometimes it does not include intended
36:59side effect or adverse effect or toxic
37:01effect. But this sentence describes an
37:06intended side effect, adverse effect or
37:08toxic effect. And most important,
37:12continue to use the process of
37:15elimination and critical thinking
37:17strategies to answer the question. I
37:20will tell you when I took the anklex
37:23I had a lot of difficulties in
37:26pharmarmacology. I had three problems
37:30and maybe somebody can uh can relate to
37:34me. I had pharmarmacology problem. I had
37:37maternity problem and I had nutrition
37:40problem. I don't know why but I
37:44struggled greatly with each one of these
37:47topics that I just mentioned. I'm
37:49talking several years ago.
37:53What did I do? I knew that I couldn't
37:57develop content overnight and I didn't
38:01have much time to prepare for the ENLEX.
38:03I had a family that I had to support and
38:05I needed to pass the ENLEX quickly. So,
38:08I studied for a month, that's it. I
38:10didn't have more time and I did the best
38:13I could to develop the critical thinking
38:16and the critical thinking and
38:18prioritization strategy helped me
38:21overcome the lack of knowledge that I
38:24had in certain areas.
38:27Like I said yesterday, I'm not saying
38:30don't study, throw the book away. What I
38:33am saying is that if you develop this
38:36that I'm telling you critical thinking
38:37and strategies you will do okay but you
38:41have to use both in combination
38:45content and the application of nursing
38:48knowledge with critical thinking.
38:51So let's go into further detail about
38:54intended effect toxic effect adverse
38:57effect and side effect.
39:03If you know the difference between these
39:06four
39:08subjects, you will learn to respond most
39:13of pharmarmacology and cllex question.
39:17And I'll tell you this,
39:19if you develop this strategy that I'm
39:22going to teach you next, you will be
39:25able to answer some pharmarmacology
39:28questions even without knowing the drug
39:33because sometimes the drug is irrelevant
39:37to the question and the reason of why
39:41the question was created.
39:44For example, if I'm talking about what
39:47is the most important action to take and
39:51one of the answers says ask the patient
39:54for allergies,
39:57does it really matter what the
39:59medication is? If one answer says call
40:04the doctor, the other answer says give
40:06the medication in the morning. The other
40:09one says h check the pulse. And the last
40:12answer says, ask the patient for
40:15allergies of this medication.
40:18Do you really need to know the drug
40:21category? Do you really need to know
40:23everything there is to be known about
40:25that medication to answer that question?
40:28No. Because the question is a safety
40:30question. The question is you have to
40:33ask the patient for allergies to
40:36medications. Because guess what? If the
40:39patient has allergy to that medication,
40:42I will not be giving that medication.
40:45So, is it relevant to call the doctor
40:47first? Is it relevant to check for the
40:49pulse? Is it relevant to check for the
40:52blood pressure or whatever? So, what I'm
40:55saying is if you are reviewing an ENLEX
40:59question that has to do with
41:00pharmarmacology and you look at the
41:04medication and you say, "Oh my god, I
41:06don't know that medication." Do not give
41:08up. Continue reading. Continue using
41:12your critical thinking and see where you
41:15get because it is better to use critical
41:18thinking than to say I don't know A B C
41:20D C. Okay? Don't do that the day of your
41:24exam.
41:26So let's learn about the difference
41:30between intended side effect and adverse
41:33effect. An intended effect is the
41:36desired
41:37and expected effect of a medication.
41:43For example, if I give a patient
41:46morphine sulfate,
41:49the intended effect that I want out of
41:52this medication in a patient that has
41:55pain is to relieve the pain. that is the
42:00intended effect or reason of why I'm
42:05giving a medication.
42:08On the other hand,
42:11when we talk about a side effect
42:15is a physiological effect of the
42:17medication that is unrelated to the
42:21intended medication effect.
42:25It is something that the patient
42:27[clears throat]
42:28sorry could experience
42:32after administering a medication.
42:38Okay. So a side effect is a
42:42physiological effect of a medication
42:44that is unrelated to the intended
42:48medication effect. An example of this,
42:51let's say you're giving a patient an
42:53antihistamine medication. What is a
42:57known side effect? Drossiness.
43:00You're not giving the antihistamine to
43:03produce drossiness. That is a side
43:06effect.
43:08Now when we talk about side effects and
43:10I see books making these mistakes all
43:13the time
43:15they confuse side effect and adverse
43:18effect. It's not the same thing.
43:22side effect
43:24is usually not lifethreatening
43:30and usually
43:33you can relieve or alleviate
43:36the discomfort associated with that
43:39medication very easy. In other words, a
43:43side effect is a an effect of the
43:47medication that is unwanted,
43:50but that effect does not cause okay is
43:55not going to injure my patient greatly.
43:59It's not going to cause a lifealtering
44:03condition.
44:06And I'll give you an example.
44:09Let's say you give a patient morphine
44:12sulfate. We talked about morphine
44:14sulfate already.
44:16We talked about the intended effect
44:18being to relieve pain.
44:22But what is a common and expected side
44:25effect? Constipation.
44:30Can you treat constipation rather easy?
44:33Yes. Increase fiber and more water
44:36intake.
44:38So yes is a expected side effect of the
44:42medication an unwanted one but does not
44:46cause lifealtering injuries to the
44:49patient. It can be taken care of easily.
44:54On the contrary, an adverse effect
44:59is more severe side effect and always
45:05has an undesirable effect. For example,
45:09let's talk about sulfanomide.
45:13A an adverse effect is hyper sensitivity
45:17to that medication. If a patient is
45:19allergic to it, the patient can have
45:22rash, fever, and shortness of breath.
45:26Another example is anaphilaxis.
45:29It's an adverse effect and it cannot be
45:32treated easily.
45:34A side effect can be treated easily. An
45:37adverse effect cannot be treated easily.
45:42And we probably need a health care
45:44provider, a nursing intervention to help
45:48the patient with that adverse reaction
45:52otherwise the patient could die very
45:56very soon.
45:58So, as you're reviewing a
46:00pharmarmacology question and they tell
46:03you which of the following
46:05um side effects is expected in this
46:09medication,
46:10you're going to be thinking, okay, a
46:12side effect is something common that a
46:15patient can experience,
46:18but it's something that can be treated
46:20easily and is not going to cause
46:24lifealtering situations on the patient.
46:27On the contrary, if it says which of the
46:30following is an adverse effect of the
46:32medication, then you're looking at
46:34something serious, something that if you
46:37don't treat very quickly, the patient
46:40could experience a lifethreatening
46:42condition.
46:44Thank you, Miss Jel Nunes, for the super
46:51chat sticker. Thank you for supporting
46:54our channel.
46:58All right.
47:02So, this is getting very interesting.
47:04We're going to continue practicing a few
47:07more questions. I hope that you are
47:09excited about day two of our past the
47:13Enclelex step-by-step 7day training.
47:17What do you think so far? If you've
47:20liked what have you heard so far, what
47:22have you seen so far? Go ahead and click
47:25the like button on this video. Help me
47:30with YouTube algorithm. Show YouTube
47:33that this training is beneficial to you
47:36and to other nurses. Help me by liking
47:40this video. And also share this video
47:43with other nurses. But don't go
47:45anywhere. We're not done. We're going to
47:48continue practicing some questions
47:51together. We're going to take everything
47:53that I've said so far about
47:55pharmarmacology and see it on an
47:58enclelex style question.
48:01Uh S. Awesome. Mr. Patel, yes. Thank
48:06you, sir.
48:08H best one ever. Darlene, I'm learning a
48:12lot. Excellent.
48:15Luis Brown, I love it.
48:19Awesome. Thank you for the support.
48:24Miss Mara, very beneficial. Thank you so
48:27much.
48:31Miss Ariana Morales, thank you for the
48:34donation. Thank you for supporting our
48:36YouTube channel. I appreciate it.
48:41Miss Deborah, h thanks a lot. Thank you,
48:44too.
48:47All right. Excellent. So, let's
48:49continue. Let's review a question
48:52together.
48:54It says, "The nurse notes that the
48:57primary healthc care provider has
48:59prescribed sulfamethasol
49:02and trimetrop
49:04for a client. Which priority action
49:07should the n should the nurse take
49:10before administering
49:12this medication?
49:15Which priority action?"
49:18So which priority action means that this
49:21is a priority question should the nurse
49:25take before
49:27administering this medication.
49:30So there's not a whole lot of
49:33information about the patient. All we
49:35know is a medication that was prescribed
49:38and we have to take an action before
49:42giving the medication.
49:47So, ask the client about an allergy.
49:52Call the pharmacy to obtain the
49:54medication.
49:56Inform the client about the need to
49:58increase fluid intake.
50:00Check the medication supply room to find
50:03out whether the medication needs to be
50:05obtained from the pharmacy.
50:07Wow, what an interesting scenario.
50:12So, what is my priority action in this
50:15scenario? Answer number one
50:18says ask the client about allergy. So
50:21what is answer number one has to do with
50:24one the patient.
50:27Two safety
50:31medication
50:33safety.
50:36What about answer number two? Call the
50:38pharmacy to obtain the medication. This
50:41deals with the medication. Answer
50:46number three, inform the client about
50:49the need to increase fluid intake. Wait
50:52a second.
50:54So, we have a situation.
50:57The stem of the questions says, "What is
51:00the priority before giving the
51:02medication? Do I really have to be
51:04teaching the patient about increasing
51:06fluid intake now? Can I do that later
51:09on?" Yes. So, that's not my priority.
51:13Answer
51:15number four, check the medication supply
51:18rooms. In other words, check the room,
51:21find out about the medication. So, we
51:24have answer number one, the focus is
51:28patient and safety. Answer number two,
51:32the medication. And answer number four,
51:35the supply room and the medication.
51:38So, what is the priority? The priority
51:41is my patient and whether the patient
51:45has an allergy to this medication or
51:48not.
51:51If you look at this question and this is
51:54the scenario that I was telling you
51:56about
51:57the medication is irrelevant.
52:00It could be Tylenol. It could be
52:04acetaminophen.
52:06Whatever
52:07the focus of this question is safety
52:12and my priority nursing action is to
52:15determine if the patient has allergies
52:19to this medication,
52:22but it could be any medication. But
52:25maybe you're reviewing this question and
52:27and you don't know about sulfamethasol.
52:31You don't know that this medication is
52:33given to treat bacterial infections.
52:37But in reality to answer this question,
52:41you don't really need to know a whole
52:43lot about sulfa at least in this
52:46scenario.
52:48Okay.
52:49All right.
52:52Let's review a select all that apply.
52:57I know a lot of you have been
52:59communicating with me in our telegram
53:02group about seleto that applies and
53:06although I'm not going to go into into
53:08indepth about seleto that apply I want
53:11to share with you this scenario and I
53:15want you to start thinking about the
53:18proper steps to follow in a select all
53:21that apply however I'll tell you this
53:26most select Like all that apply
53:27questions, they are content related.
53:32In other words, many of them are content
53:34style questions or recall and
53:36recognition style questions. There's
53:39usually not a whole lot of critical
53:41thinking that take in place in a select
53:44apply question. However, in this
53:46scenario, we can use some critical
53:49thinking in this selector that apply. So
53:53read this question with me. Analyze this
53:55question with me.
53:56Tell me in the chat, comment on the chat
54:00what is your answer
54:03and let me talk about SATS or select all
54:07that apply. The first misconception that
54:10I have heard on with my students about
54:14select that applies.
54:18Select that apply is a right and all or
54:22nothing scenario. Meaning if the ENLEX
54:26determines that there are three correct
54:30answers and you select two correct
54:33answers is wrong.
54:36If the ENLEX determines that that there
54:39are three correct answers and you select
54:42four is wrong. You have to select
54:47exactly
54:48the right amount of answers in order for
54:53the question to be answered correctly.
54:57Now
54:59taking that into consideration, let's
55:02review this scenario.
55:05The nurse is caring for several clients
55:07on the respiratory unit who are
55:10receiving
55:11B beta aduric agonist broncoilator
55:16aluterol
55:18in the prescribed nebulizer treatments.
55:22Which side effects?
55:27Important keyword.
55:30Which side effect will the nurse expect
55:33to assess following administration?
55:38Select that apply. So remember what I
55:42taught about side effects versus adverse
55:47effect. So, a side effect is an
55:51undesired
55:53expected effect of a medication
55:56that can be treated
55:59and usually
56:01is not going to cause a life-threatening
56:04condition.
56:06So, let's review answer number one. And
56:10I see several of you selected answer
56:13number one.
56:17increase
56:18tacipia.
56:20So increase the rate of breathing.
56:25If we're giving a bronco dilator
56:28albuterol, you have to think of first
56:32before we think of the side effect. What
56:34is the intended effect? Why am I giving
56:38aluterol?
56:40in many cases could be to treat wheezing
56:44difficulty breathing
56:47is given in many conditions it's given
56:51in COPD chronic obstructive pulmonary
56:54disease
56:56so what is the expected therapeltic
56:59effect of a bronco dilator
57:03if a patient is having difficulty
57:05breathing and we give a bronco dilator a
57:08medication that is going to dilate the
57:10bronchioles,
57:12the patient is going to be able to
57:14breathe better.
57:17So we are not expecting a higher
57:21respiratory rate or typnia. We are
57:24expecting a decrease in the rate of
57:30breathing.
57:33So answer number one does not make sense
57:37to the intended effect of the
57:39medication.
57:42Now irritability
57:44and nervousness, shakiness,
57:47we see that as a side effect of aluterol
57:53of a bronco dilator. So answer number
57:56two is a definite correct answer.
58:01Now what do we see in patients that take
58:06aluterol a bronco dilator? We see that
58:10the heart rate goes up. So we see
58:15tachicardia.
58:17This is why in patients that are already
58:20tachicardic
58:22we have to be careful when we're giving
58:24this medication.
58:27So tachicardia
58:29is a side effect of this medication
58:35increase sumance. And I want you to
58:38compare answer four and five
58:43because they are opposite to each other.
58:47And this is a strategy that I use in
58:49selectto that applies. I try to find if
58:52there are answers that are similar or
58:55opposite to each other.
58:57So what can this medication cause?
59:01Somnolence
59:03or insomnia.
59:06And look at the other answers.
59:09Irritability,
59:11nervousness.
59:13You think the patient is going to be
59:15with some or insomnia.
59:19If you see irritability,
59:22nervousness and tachicardia and answer
59:25number six,
59:27anxiety.
59:29So if you think about this,
59:34irritability and nervousness,
59:38tachicardia,
59:40insomnia, and anxiety, they're kind of
59:44related to each other.
59:47Think about it.
59:49And it is opposite to answer number four
59:54somnance which is the opposite of a
59:58patient that is right a wide awake or
1:00:02very awake.
1:00:05Therefore answer number two three five
1:00:10and six are the correct answers. we
1:00:14eliminate answer number one and answer
1:00:18number four. And this is the scenario
1:00:22that I was giving you. Let's say in your
1:00:25answers you selected 2, three, and five.
1:00:30And you forgot answer number six is
1:00:32wrong.
1:00:34Let's say that you selected two, three,
1:00:37five, six, and one.
1:00:40wrong answer because you selected an
1:00:43incorrect answer. So it is an all or
1:00:48nothing scenario.
1:00:50Starting April 2023
1:00:54is going to change. The ENLEX will be
1:00:57different and the the way they're going
1:01:01to calculate if a question is right or
1:01:03wrong is different than the way they do
1:01:06it now. But we cannot worry about 2023
1:01:11yet because we're in 2022.
1:01:14So let's continue.
1:01:20Reduction of risk potential. And this is
1:01:23the last category that I want to share
1:01:26with you on day two training.
1:01:31Reduction of risk potential refers to
1:01:34the nurse's ability to decrease the
1:01:37potential for clients to develop
1:01:40complications or health pro or health
1:01:44problems related to treatments,
1:01:48procedures or existing condition.
1:01:53Now
1:01:55what are the topics that are included
1:01:58accordingly to the test plan on
1:02:01reduction of risk potential? Diagnostic
1:02:04test monitoring conscious sedation
1:02:08potential for alteration in the systems
1:02:11of the body or in body systems. Tests
1:02:15treatments procedures uh pro potential
1:02:18complications related to a diagnostic
1:02:20procedure. system specific assessment,
1:02:23therapeutic procedures, vital signs and
1:02:27lab values.
1:02:29So all of these topics are included in
1:02:33reduction of reduction of risk
1:02:36potential. Now let's review a priority
1:02:40question related to this category.
1:02:45Here's the question.
1:02:49Uh, Crystal, guys, isn't today supposed
1:02:52to be day two? Yes. Yes. Uh, Crystal, it
1:02:56is day two. I just had issues with the
1:03:00technology at the beginning and for
1:03:02whatever reason, the video that I had
1:03:05originally created for day two didn't
1:03:08work on YouTube. So, I had to use the
1:03:12day one link in order to to start live.
1:03:16Otherwise, you guys were going to be
1:03:18waiting the whole afternoon and I did
1:03:21the best thing I could to start the live
1:03:24as soon as possible. So, that is why you
1:03:27see on the title day number one.
1:03:30However, I will change that after the
1:03:33live uh YouTube training and it will say
1:03:38the right title uh day number two. Okay.
1:03:42So to confirm, we are on day number two
1:03:46of our 7day training. Okay,
1:03:51I hope that uh clarifies
1:03:55Crystal.
1:03:58Okay, perfect. So the nurse is caring
1:04:01for clients on a medical floor. Which
1:04:04client is the highest priority?
1:04:08A strategy that I like to use when I see
1:04:12a question that gives me four different
1:04:15patients.
1:04:17I try to identify
1:04:21which patient is stable versus unstable.
1:04:26I try to identify if there is a patient
1:04:29that has an acute condition
1:04:33versus a chronic condition.
1:04:36I try to identify if there is a patient
1:04:40that has some kind of airway, breathing,
1:04:44circulation compromise.
1:04:48So as I review my answers, I try to
1:04:52think about that.
1:04:54So patient A, 84 year old exhibiting
1:04:59uncontrolled atrial fibrillation.
1:05:04Letter B 60 year old 60 year old
1:05:08exhibiting asymptomatic
1:05:10sinus bradic cardia so let's compare A
1:05:14and B and I like to do that I like to
1:05:17compare one patient with the other and
1:05:20start eliminating remember I always use
1:05:24the process of elimination
1:05:26so if I compare A and B
1:05:31who is worst
1:05:33uncontrolled called atrial fibrillation
1:05:36or asymptomatic
1:05:40sinus bradic cardia.
1:05:43So the word asytomatic
1:05:46tells me that the patient is not
1:05:49experiencing any symptoms.
1:05:53So I think B we can eliminate.
1:06:00Notice I'm not looking for the right
1:06:03answer yet. The only thing that I do was
1:06:05compare A and B.
1:06:08So now B is out of the way. I will
1:06:13compare A and C. Now A says
1:06:1884 uncontrolled atrial fibrillation.
1:06:22C says 53 year old exhibiting
1:06:26ventricular
1:06:28fibrillation.
1:06:30Oh, we got a problem
1:06:33because we know that ventricular
1:06:36fibrillation is a deadly disriythmia.
1:06:41This patient needs CPR
1:06:45and defibrillation
1:06:48soon.
1:06:49So A and C C is in a work worse
1:06:54condition or a more unstable condition.
1:07:00So I so I eliminate letter A.
1:07:04Now I'm going to compare C and D.
1:07:10D 65year-old exhibiting supra
1:07:14ventricular tachiardia.
1:07:17This is a big problem as well. But
1:07:20notice the word supra ventricular or
1:07:24above the ventricles.
1:07:28So what is a worst scenario?
1:07:31Ventricular fibrillation or supra
1:07:35ventricular tachiardia. Ventricular
1:07:37fibrillation
1:07:39is the worst condition. So the answer is
1:07:43C.
1:07:46Now
1:07:47you may look at this question and say oh
1:07:51professor this this is easy I know
1:07:54ventricular fibrillation is the answer
1:07:57over supra ventricular tachicardia over
1:08:00asymptomatic suspicardia over
1:08:02uncontrolled atrial fibrillation.
1:08:05However, I am teaching you thinking
1:08:08process.
1:08:10Use the same process in whatever the
1:08:13topic or situation.
1:08:16The problem that I see many of you have
1:08:19is that you do not have a system.
1:08:23You fail to analyze questions the right
1:08:27way and the only thing that you're using
1:08:29is content. When the questions get gets
1:08:33more difficult, when the scenario is not
1:08:36as clear, you don't know what to do. I'm
1:08:40teaching you the steps first.
1:08:43I want you to improve the critical
1:08:46thinking process. I want you to have a
1:08:48system at your side and then we will
1:08:53review harder questions,
1:08:55a more difficult scenario.
1:08:58But this is the starting. This is the
1:09:01beginning steps because if I start
1:09:04giving you super difficult scenarios,
1:09:07you'll be like, I don't know what I'm
1:09:09doing. I'm lost.
1:09:11And we got to take baby steps. Okay.
1:09:16So, let's review the next question.
1:09:24The nurse is caring for a seven-year-old
1:09:26child who has undergone a cardiac
1:09:28caization two hours ago. So, they're
1:09:32giving us information about the child,
1:09:35sevenyear-old.
1:09:37The procedure was a cardiac calf two
1:09:40hours ago, so
1:09:42pretty recent.
1:09:45And when the nurse
1:09:48goes to see the patient, when the nurse
1:09:51checks on the patient, she finds
1:09:55the dressing and the bed saturated with
1:09:59blood.
1:10:03So we have a bleeding problem.
1:10:07Saturation or saturated with blood means
1:10:11bleeding.
1:10:14What is the first
1:10:17action to take?
1:10:19Once again, we have assessment,
1:10:23we have implementation,
1:10:26we have implementation in letter C and
1:10:30implementation. Calling the D.
1:10:34See many students
1:10:37they take the approach of calling the
1:10:39doctor. It's the easiest thing to do.
1:10:44However, learn this.
1:10:47If you have a scenario
1:10:51that you have an option to call the
1:10:53doctor, ask this first.
1:10:56Is there something that I can do?
1:11:00Is there something within my scope of
1:11:02practice that as a nurse I can do to
1:11:07help the patient?
1:11:09If your answer is yes, there is
1:11:11something that you can do to help the
1:11:14patient, do it before calling the
1:11:17doctor.
1:11:19In other words, in this scenario, if I
1:11:23do A, B, or C,
1:11:27does those answers help the patient? Yes
1:11:31or no?
1:11:32And yes, there is an answer that helps
1:11:36the patient. So therefore, calling the
1:11:39doctor is not my first intervention.
1:11:46So I have A, B, and C.
1:11:50I have an assessment answer that says
1:11:52assess bioscience and I have two
1:11:55implementation
1:11:57answers.
1:11:58And let's think about the
1:12:01process of critical thinking. I told you
1:12:06if it's [clears throat] an emergency do
1:12:08not assess, you need to implement.
1:12:11This is an emergency. The patient is
1:12:13bleeding. There is saturated blood on
1:12:16the dressing and on the bed.
1:12:19We have to do something to
1:12:23assist the patient with bleeding.
1:12:24Therefore,
1:12:26I will eliminate assessment of vital
1:12:29signs. Now I have B and C.
1:12:34Which answer B or C is going to help
1:12:38stop the bleeding?
1:12:42Letter C will help stop the bleeding.
1:12:46Apply pressure to the catheter site will
1:12:49help stop the bleeding. Therefore,
1:12:53answer C is my first action over A, B,
1:13:00and D.
1:13:02All right, guys. If you haven't
1:13:05subscribed to our channel yet, it is
1:13:07very important that you do so. As you
1:13:10could tell, I had technical difficulties
1:13:14today. So, if you weren't subscribed to
1:13:16the channel and you didn't have you
1:13:18didn't have the right link, you couldn't
1:13:20see the training today. So, it's very
1:13:22important that each one of you is
1:13:24subscribe to our YouTube channel so you
1:13:27don't miss any information.
1:13:31That is the most important action to
1:13:34take today. So, you don't miss future
1:13:38training. Okay, other trainings that I
1:13:41will be doing in the future and the
1:13:43other training days that we will have
1:13:46for the remainder of the week.
1:13:50Also, I have created a telegram channel
1:13:55group.
1:13:57I see that a lot of you are not in this
1:14:00telegram group. If you have the telegram
1:14:03application,
1:14:05go ahead and go to the comment section
1:14:07on this video and find the link to the
1:14:10telegram group and join our telegram
1:14:13group because in this group every day I
1:14:17put information.
1:14:19I put the link of the videos so you
1:14:21don't miss any of the valuable
1:14:23informations that I will be sharing with
1:14:25you during the training and after the
1:14:27training. Thank you Mr. Martinez. for
1:14:31the donation and helping our YouTube
1:14:34channel. Are you ready for day three?
1:14:40Remember, we will start tomorrow
1:14:435:00 p.m.
1:14:45Same YouTube channel tomorrow morning in
1:14:49the Telegram group. I will share the
1:14:52agenda for tomorrow and I will share the
1:14:55link with all of you guys.
1:15:00All right. Well, 6:22. So, it took us a
1:15:04little bit longer than expected, or like
1:15:07I told you at the beginning, it was
1:15:08going to be like that. It could take us
1:15:10a little bit longer because I want to
1:15:12make sure I finish the whole
1:15:14presentation. It doesn't matter if it
1:15:16takes me an hour and a half or two
1:15:18hours. I will give you the whole
1:15:20presentation and I'll do the best I can
1:15:24to help you uh with your ENLEX
1:15:27preparation. Remember that you can see
1:15:30this video recorded later on. Listen a
1:15:34little bit more in detail, okay?
1:15:38And really learn this uh critical
1:15:40thinking that I'm trying to teach you.
1:15:42Thank you uh God loved for the donation
1:15:46for our YouTube channel. I appreciate
1:15:48it.
1:15:50Thank you. Thank you. Thank you.
1:15:54Uh Crystal, you can find the group in
1:15:56the comment section on the video. Find
1:15:59the comment section. It will be there on
1:16:02the description. I think it's on the
1:16:03description.
1:16:07Julie, yes, we will do more selector
1:16:10that applies.
1:16:15Um I don't know if my advisor is here.
1:16:18Can you share on the on the comment
1:16:20section the the link for the telegram
1:16:23group? So the students that are not
1:16:25there they can join please.
1:16:32Thank you Miss Aeli Monttero for the
1:16:36donation. Thank you for supporting our
1:16:38YouTube channel.
1:16:57Marita SATA is it stands for select all
1:17:02that apply. It's just an abbreviation
1:17:05that student use.
1:17:12Erh
1:17:14Senate is there enough time to think
1:17:16critically before answering the question
1:17:18when taking the ENLEX? Yes, there's more
1:17:20than enough time. Remember that it seems
1:17:23that you're taking a long time now first
1:17:26because I'm explaining it. So, it takes
1:17:29longer to explain than to apply. And
1:17:32also, as you develop your critical
1:17:35thinking and you practice, you will do
1:17:38it rather quickly. For example, a
1:17:41prioritization question, I can analyze
1:17:43it the right way with critical thinking
1:17:46in two minutes, less than two minutes.
1:17:48depends on the question, but it can be
1:17:50done. And remember, you have several
1:17:54hours to take the ENLEX, so you don't
1:17:56you don't need to be rushing. Okay,
1:18:01Miss Bonita Vlet, thank you for your
1:18:05donation. Thank you for supporting our
1:18:07YouTube channel.
1:18:10Loise Brown, I don't really know how
1:18:13it's done. I just see the students doing
1:18:15it. I think there's like a there's like
1:18:19a icon like a money icon or something
1:18:22like that if you are connected to
1:18:24YouTube. I don't I don't know if they
1:18:26ask for your payment information. Like I
1:18:28said, I've never done it, but I see the
1:18:31students doing it all the time. Maybe if
1:18:33somebody can explain on the on the chat
1:18:35how to do it. That way the other
1:18:38students that want to donate to the
1:18:41channel, they can do it cuz I don't
1:18:43really know how the process is to be
1:18:45honest with you.
1:18:52Yes. Everybody, please don't forget to
1:18:54like the video. It's important. And
1:18:57share the video with other nursing
1:18:59students. Okay? Don't forget to do that.
1:19:06All right, guys. So, I'm gonna take off.
1:19:07Thank you for being here. See you
1:19:09tomorrow at 5:00 PM Eastern Standard
1:19:12Time. Day three of our ENLEX training.
1:19:16God bless you. Take care. Bye-bye.

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