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Test taking strategies and 
prioritization for 2026. 

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Let's get into prioritization 
big time because this is your 

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analyze and recognize cues. 
This is that taking action, 

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prioritizing your hypotheses. 
This is clinical judgement. 

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Part of the the test is critical
thinking, a logical deduction, 

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and we have to have those 
skills. 

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It's one of the skills that the 
boards are going to be testing 

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and it is one of the five types 
of questions. 

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And I talk about the five types 
of questions in a different 

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lecture. 
So look out for that because 

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there really are only five ways 
I can ask you a board question. 

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This is a second type of 
question, prioritization. 

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These are the ones that I 
literally want you to look at 

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these four clients that you 
have, 4 patients that you have 

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and say which one am I freaking 
out about? 

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Now? 
I know every person that comes 

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to me or is watching is probably
at least been exposed to AB, CS 

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or airway breathing circulation 
at this point. 

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And if that works for you, stick
to it. 

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It's a great tool if you 
understand airway breathing 

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circulation. 
I found a little bit more of a 

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specific pattern that worked for
me and it's worked well for our 

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students. 
And that is Ask Graf. 

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But we have to be able to 
recognize and analyze cues 

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first. 
That's one of the the things 

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that the boards are testing. 
Look at your CPR report. 

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And when we look at these four 
different patients, we're 

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looking at ones that were 
freaking out about. 

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So look for those questions that
ended first. 

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Initial priority, urgent, most 
concerning, immediate report to 

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HCP. 
These 7 words are cues. 

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You must recognize them and be 
able to analyze that. 

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These are 4 situations that you 
are freaking out about. 

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Which one do you have less time 
with and what more can you do? 

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And in this situation, AB CS 
didn't work for me. 

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For my students, it got a little
too unclear on who to choose. 

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Yet we were able to find ask 
Graph. 

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It leads us to the nine ways 
that we can find one of the 

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patients that we're going to 
prioritize, the one that we're 

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freaking out about. 
And Asgraf starts with airway, 

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airway, airway, airway above all
else. 

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The remainder of them, they 
don't go in order. 

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So look for sepsis, changes in 
potassium, glucose, less than 70

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in pediatric patients that let 
RG or grunting, altered mental 

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status, peritonitis, hemorrhage 
and heart attack. 

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Asgraf Airway again, above all 
else, the remainder of them find

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them for me. 
But remember, the boards are not

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going to just tell you that hey,
this patient is septic, they may

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and that'd be great. 
However, it's going to be a lot 

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harder than that. 
And that's where that critical 

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thinking, logical deduction 
comes in. 

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And that latter part of your 
CPR, especially moving forward 

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in 2026, is finding trends, 
finding clue words that that 

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will indicate to you that this 
is in fact a patient that we are

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freaking out about. 
It is our person that we're 

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going to prioritize and we're 
going to take action with. 

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So look for these clue and 
keywords that the boards love 

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throwing at you when it comes to
airway. 

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Look at drooling, strider nasal 
flaring, accessory muscle use, 

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irritability, that tripod 
position where they got their 

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hands on their knees, 
angioedema, especially when 

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you're thinking about ACE 
inhibitors, pulmonary embolism, 

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which may derive from a DVT, our
attention, pneumothorax, 

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sustained tachypnea, smoke 
inhalation or singed facial hair

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and look for those other ones 
that may not scream airway. 

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But how about overdose things 
like insulin, benzos, opioids 

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where respiratory rate drops 
below 12? 

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Or how about aspiration that 
emesis all over the face? 

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Those are telling you that this 
patient is one that we're 

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freaking out about. 
You're going to see that patient

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first, initial priority, urgent,
most concerning, immediate 

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report to HCP because they don't
have a lot of time. 

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Then the remainder of them find 
them sepsis. 

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Now, sepsis has a triad 
hypotension, tachycardia, along 

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with being either hypothermic or
febrile below 96.8 or above 

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100.4. 
Remember for the boards, every 

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single lab value is concrete. 
There's no like it's kind of 

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low. 
No, it's either low or it's not.

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So you have to make that 
decision. 

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It is concrete. 
The boards are not going to be 

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in this ambiguous state. 
Well, it's 59 of a heart rate 

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and 60 is normal. 
So it's right there. 

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That's how the boards work. 59 
is Vadycardia, 60 is normal. 

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So again, look for those lab 
values and now look more so in 

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2026 for trends. 
Patient went from 98.8 to 99.6 

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and now is 100.5. 
And that trend tells you that 

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something is going on. 
Their blood pressure went from 

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1:00 20 / 75 to one O 5 / 65 to 
86 / 42. 

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But the trend is going towards 
wait a minute, this patient is 

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becoming septic. 
OK, maybe this is the one that 

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I'm freaking out about. 
This is Asgraph, but there's 

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subtle situations that the 
boards are going to throw at you

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to see if you actually can 
recognize and analyze these 

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cues. 
Can you use your clinical 

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judgment to tell me that this 
patient is septic? 

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How about purulent discharge at 
the incision site, tachypnea and

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the one that the boards love, 
elevated lactate. 

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But what are we going to do 
first? 

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What is our most appropriate 
action to take? 

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And then there's a drop down 
menu and now it's going to say, 

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well, I could do antibiotics, I 
can give them supportive 

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measures, I can monitor them, or
I can start IV fluids. 

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Well, that goes back to the 
concept of nipa and POIV fluids.

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Pain if they need it, PPI if 
they need it, anti emetic if 

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they're nauseous, and 
antibiotics as needed. 

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So again, one of those concepts 
that I teach you watch that 

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video as well too. 
And the ones that may not seem 

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obvious are that transfusion and
transplant patient is post op 

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post procedure when we get into 
ash of ASGRAF and now they've 

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received blood products or they 
received an organ, can we 

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transmit infection, a viral 
infection or blood products are 

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left out too long and bacterial 
infection? 

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Absolutely. 
So look for this patient to 

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become septic. 
The key is changes in potassium.

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With changes in potassium, high 
or low hyper or hypokalemia. 

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When potassium has a big role in
the heart as an electrolyte and 

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that electrolyte becomes 
imbalance, we're worried about 

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that heart becoming unstable. 
And when it becomes unstable, 

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we're worried about that 
dysrhythmia. 

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And the most lethal dysrhythmia 
that we're concerned about is in

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fact ventricular fibrillation. 
Now the boards may give you 2.8,

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5.66 point O as a lab value, but
what if they don't? 

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How are they going to see if you
can analyze or recognize these 

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cues? 
Well, they may give you a 

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hypokalemia, muscle cramps. 
Well think about that. 

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Why does that make sense and how
do you spot it? 

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Well, let me give you an 
example. 

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Let's say an athlete, those of 
you that watch my videos about 

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me knocking out my tooth, how 
about when I was practicing out 

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in the heat here in Vegas and 
I'm running, running, running, 

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sweating, sweating, sweating, 
sweating. 

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And I'm like, oh, coach, I got a
cramp. 

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I got a cramp and coach tells me
to go do what? 

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Eat a banana, which has 
potassium in it. 

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How about that patient that's on
the loop diuretic and that says,

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hey nurse, I have been sitting 
here all day but my calf is 

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just, it keeps cramping up and 
you're like, whoa, what's going 

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on? 
How about that patient that has 

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hyperkalemia and has that chest 
palpitations or something Feels 

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funny in my chest and on EKG 
they have peaked T waves. 

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Well, that's not telling you 
hyperkalemia directly. 

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It's not telling you a lab 
value, but it is screaming you 

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better prioritize this patient. 
There is an action to take here.

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Remember, when it comes to 
recognizing and analyzing cues, 

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the boards now, especially now 
in 2026, are giving you age, 

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gender, location, meaning, 
anatomical or physical location,

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and gender for a reason. 
If it's in there, pay attention 

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to it. 
It's not just coincidental. 

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They're doing this to see if you
can recognize and analyze why 

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they give it to you. 
Glucose less than 70? 

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Well, when we're having 
hypoglycemia of that magnitude, 

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our body's going to shut off. 
We're going to become comatose 

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and die. 
And the boards will give you 

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specifically a lab value. 
Glucose is 54. 

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OK, what about some signs and 
symptoms that scream 

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hypoglycemia, fatigue, headache,
disorientation, sweating, 

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nausea, coma, shakiness, 
tremors, seizures? 

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And now we're looking at this 
patient saying, wow, I don't 

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have time. 
What more can I do? 

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Is this that patient that has a 
blood glucose of 64, which is 

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low? 
That's concrete and it's telling

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you they would like more fruit 
juice. 

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No, it's not because who do I 
have less time with? 

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Not somebody that's requesting 
analyze that cue more fruit 

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juice. 
So meaning they've already 

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gotten that that sugar, that 15 
grams of sugar that we talked 

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about in the endocrine and 
they're talking to you. 

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Look at those cues and clues 
that live value is low and it is

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screaming hypoglycemia. 
But again, who do I have less 

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time with? 
If they're talking to me and 

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requesting more fruit juice and 
now they're stable, they're 

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talking to me, what more can I 
do? 

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While I would have given them 
fruit juice, am I going to 

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monitor them? 
Absolutely. 

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But in that question, there's 
probably another one of Asgraf 

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that you have to look at. 
Find me that one. 

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And between the two, tell me who
do I have less time with and 

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what more can I do? 
So this is the way that we apply

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Asgraf. 
In a later video, I'll do 

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practice questions. 
So you can actually see how we, 

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one, use the method and two, how
we're able to actually apply 

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Asgraf with pediatric patients. 
I love the words let RG or 

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grunting and the emphasis on the
R there in Asgraf because in 

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pediatric patients, how do you 
tell? 

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How do you how do you express 
that a patient that is young, 

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five years or younger typically 
could be older, but how do you 

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say that they're in dire need of
treatment? 

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Well, call them lethargic or say
that they're grunting or maybe 

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they have a high pitched crying 
or they're in severe hypoxia to 

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having respiratory distress, 
which is airway, but they're 

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also going to be lethargic. 
They're going to be grunting. 

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So look for things like 
meningitis or infection, Look 

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for abusive head trauma. 
Altered mental status is a 

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second a in Asgraf and look for 
the cure words, seizures, 

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hallucinations, confusion, 
psychosis. 

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Especially when we're talking 
about that psychosocial 

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integrity. 
This is a big deal because we 

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don't think about things like 
suicidal ideation as altered 

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mental status, but it is or 
homicidal ideation. 

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00:12:59,880 --> 00:13:04,640
It is that psychosocial 
integrity, psychosis, bipolar 

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confusion, changes of level of 
consciousness, delusions again, 

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psychosocial integrity, 
disorientation, increased 

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intracranial pressure. 
And again, look for those clue 

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words of time. 
Why did this happen in the last 

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hour? 
What just happened that this is 

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now happening, or it's an acute 
setting, or they're not acting 

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like themselves. 
Pay attention to these Q words 

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and Q words and find them. 
Peritonitis. 

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For what is a peritoneum? 
It is a lining that encases a 

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good majority of the GI tract 
and parts of the female 

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reproductive organs. 
And with the peritoneum, if 

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something is wrong in any of 
those areas, it is going to get 

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inflamed. 
So look for those peritoneal 

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signs. 
Look for things like rigidity, 

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guarding, rebound, tenderness 
board like abdomen, diffuse 

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abdominal pain, severe abdominal
pain. 

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00:14:06,680 --> 00:14:10,840
Look for those quadrant pains 
that are screaming that this 

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patient is actually developing. 
Maybe like we talked about GI 

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perforation leading to 
peritonitis leading to sepsis. 

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Look at those concepts that I 
teach you in other sections. 

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The first H in ASCA is 
hemorrhage. 

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00:14:27,360 --> 00:14:30,000
Again, we're losing volume, so 
our blood pressure goes down. 

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Our hearts trying to compensate 
for it because we don't have the

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volume, so it beats faster. 
So hypotension, tachycardia, 

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when they become hemodynamically
unstable and they're not pushing

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out that warm, red oxygenated 
blood, then look for a weakened 

227
00:14:46,440 --> 00:14:49,400
or diminished pulses. 
Look for cold and clammy or 

228
00:14:49,400 --> 00:14:51,320
pale. 
Look for the places where 

229
00:14:51,320 --> 00:14:55,000
they're losing blood, things 
like saturated pads or 

230
00:14:55,000 --> 00:14:58,400
dressings. 
Look for that capillary refill. 

231
00:14:59,880 --> 00:15:03,920
Continuous drainage. 
Is that that Sarah Sanguinous 

232
00:15:04,120 --> 00:15:05,560
drainage? 
No. 

233
00:15:06,000 --> 00:15:08,960
And if you don't know what Sarah
Sanguinous, that light pinkish 

234
00:15:10,000 --> 00:15:16,640
type of a drainage that is 
expected, then look up the word.

235
00:15:17,400 --> 00:15:20,840
Don't just breeze through them. 
Again, every single word in 

236
00:15:20,840 --> 00:15:23,520
these exams is there for a 
reason. 

237
00:15:23,720 --> 00:15:26,280
When you're practicing and you 
see words like this, write it 

238
00:15:26,280 --> 00:15:30,120
down so that way when you do see
it, you're able to identify it 

239
00:15:30,360 --> 00:15:34,480
or recognize that cue. 
But what are we going to do in a

240
00:15:34,480 --> 00:15:37,400
situation where hemorrhage, 
again, get them hemodynamically 

241
00:15:37,400 --> 00:15:42,000
stable, Ivy fluids, Ivy fluids. 
And the last one is heart attack

242
00:15:42,000 --> 00:15:45,200
or myocardial infarction. 
Again, look for that chest pain,

243
00:15:45,400 --> 00:15:48,160
that pressure tight. 
It's like somebody's they're 

244
00:15:48,160 --> 00:15:51,360
going to tell you that I feel 
like an elephant is sitting on 

245
00:15:51,360 --> 00:15:54,720
my chest. 
Look for that pain that radiates

246
00:15:54,720 --> 00:16:00,560
to the left jaw, left neck, left
arm, that epigastric pain that 

247
00:16:01,000 --> 00:16:04,800
will be a differential when it's
GERD or acid reflux. 

248
00:16:06,200 --> 00:16:09,160
Look for that costochondritis as
a differential diagnosis. 

249
00:16:10,080 --> 00:16:13,040
And now we've got or maybe even 
some sort of pleuritic pain 

250
00:16:14,120 --> 00:16:17,040
differential diagnosis. 
If things present similarly, 

251
00:16:17,920 --> 00:16:21,840
rest assured, one, they could be
a prioritization question. 2. 

252
00:16:21,840 --> 00:16:24,480
They could be differential 
diagnosis, meaning a bow tie 

253
00:16:24,480 --> 00:16:28,760
question or the signs of 
symptoms that are similar or 

254
00:16:28,760 --> 00:16:31,640
that are different. 
Compare and contrast these 

255
00:16:31,800 --> 00:16:35,760
columns that make up your matrix
or grits.