What's new in September 1–5, 2026

Two nutrition questions were reworded after student reports this week. The weight-management question that asked what a realistic, sustainable weekly loss looks like gave its rate only in pounds. It now gives the rate in kilograms first, about half a kilogram to one kilogram a week, the way it is taught here and the way our other weight-loss question already read, and its explanation opens by saying why that rate is the standard instead of only repeating the choice. The question about why a patient takes chewable or liquid vitamins for the first months after a sleeve gastrectomy had a choice that ended mid-thought, carry a tablet through undissolved, which a student rightly flagged as reading like a missing word. It is now a full sentence: the small, fast-emptying stomach can move a tablet along before it dissolves. No correct answer changed, so past attempts keep their score.

Three flashcards were rebuilt on student suggestions. The pancreatitis card that asked for the name of the bruising around the umbilicus also printed Grey-Turner on the front, so only one sign was left to recall; both signs are now blanks and you name each one. The T-tube card that asked how much bile normally drains in the first day now says mL after the blank, so it is clear the card wants a volume and not a colour, and the back adds how the output should fall over the next days and the amount worth reporting. The postpartum mood card that packed blues, depression and psychosis onto one card with a paragraph on the back is now a focused blues-versus-depression comparison, the shape that has measurably worked best in our decks.

Two flashcards were added to the Postpartum Complications deck so that each mood disorder also has its own card: one on the postpartum blues, when they appear and how long they are expected to last before they count as something more, and one on postpartum depression and the Edinburgh scale used to screen for it. Postpartum psychosis already had its own card on the priority nursing action.

Every practice question in classification of surgery was rewritten in one pass. The scenario is cut to the point, with the average stem down from fifty-three words to twenty-four, so you read the finding and the ask, not a story. The four choices are now equally plausible on one axis, with one wrong choice that a well-prepared nurse could genuinely argue for, and the explanation names that choice and says what separates it from the answer. Each explanation opens by saying why the correct answer is correct, then gives the rule you can carry to the next question, then takes the other choices one by one without ranking them or commenting on how they sound. No sentence runs past twenty-eight words, and no explanation is longer than the one it replaced. One question that repeated a hernia repair six other questions already covered now asks about a paracentesis instead, a procedure the bank had never tested. Answer keys did not change, so past attempts keep their score.

The gastrostomy question used to label the operation supportive care, a purpose class that no nursing text we could find actually lists. It now asks only what the procedure name says the surgeon will do, and every choice sits on the word endings a nurse reads: -ectomy, -ostomy, -otomy and -plasty. The correct answer letter is unchanged.

Ninety-six practice questions across thirty-three topics have new explanations. Most of them are in community health nursing: the Philippine health laws and the workforce laws, the national programs, immunization, nutrition, sanitation and environmental health, health education and research, epidemiology and vital statistics, and school and occupational health. The rest are single questions scattered through the clinical topics, from autonomic dysreflexia and seizure precipitants to insulin storage and bisphosphonate dosing. Each explanation now opens by saying why the correct answer is correct, in plain clinical or legal terms, then gives the rule you can carry to the next question, then walks through every other choice one by one, saying what it gets right before saying why it still loses. No sentence runs past twenty-eight words. The old sentence that compared the wrong choices to each other is gone from all ninety-six. Where an explanation names a Republic Act, a section or a year, it is the one the question already taught, and we checked every statute name against the rest of the bank in both its long and short form. Two explanations were also corrected on the way through. One had read as if the Magna Carta for Disabled Persons itself granted the twenty percent discount, when it is the 2016 amendment that does. One had narrowed the HIV law's confidentiality exception to a court order, when the law, a neighbouring question and the Nurse Law cram sheet all say a court order or subpoena. No question, no choice and no correct answer changed, so past attempts keep their score.

Nurse Law and Patient Rights is on the Foundations shelf. It is the sheet for the legal and ethics items that turn up in every part of the exam, written for Philippine law. It starts with how one careless act can become a crime, a damage suit and a case before the Board of Nursing at the same time, and what has to be proved in each. It gives you the four elements of negligence the Supreme Court requires, with the Philippine cases that carry them, including the hospital that paid because it could not show how it supervised its nurses, and the operating room where the nurses' charted sponge count put the missing gauzes on the surgeon. Then assault, battery, false imprisonment, invasion of privacy and defamation, with the law that makes holding a patient over an unpaid bill a crime. Consent gets its own part: who may decide for whom, from the emergency that needs no consent to the refusal that always stands, what the nurse's signature as a witness actually confirms, and what the 2014 Supreme Court ruling did to the rules on minors and spouses. After that, what a do-not-resuscitate order is and is not, who may be told a diagnosis under the Data Privacy Act and which reports the law compels, the chart as evidence, the incident report, telephone orders, the ethical principles as the exam writes them, and the duty to report an impaired colleague. Twenty-two pages, closing with a table that reads the stem and names the wrong.

One question changed with it. The item about a seventeen-year-old mother who supports herself asked who may consent to her own care, and its explanation treated her as an emancipated minor, a category that exists in United States law and not in ours. In the Philippines a person comes of age only at eighteen, and a marriage under eighteen has been void since 2021. The question now asks about her own family planning, and the correct answer is that she consents for her infant as its parent while her own family planning still needs a parent's or guardian's written consent, because the Supreme Court struck the law's exception for minor parents in 2014. The answer letter did not change, so past attempts keep their score.

The PH Health System, UHC and Primary Health Care cram sheet has been rebuilt in the newer layout, growing from eighteen pages to twenty-one. Every teaching box now opens with a short label on the left and then gives the claim, the reason, what to do, the trap and what the exam is really asking, and every list is set out as bullets instead of one long line. The four half-empty pages are gone. It also carries content the shelf did not have before: the inter-local health zone beside the health care provider network and the province-wide health system, so you can tell the three apart in a stem; who counts as a PhilHealth dependent and the two numbers behind lifetime membership; the Ottawa Charter with its five action areas and its three strategies; Doctors to the Barrios, the nurse deployment program, community health teams and the barangay health emergency response team; and a closing table that reads eight typical stems and names the answer. Two small errors were corrected on the way: the FHSIS is the Field Health Services Information System, and the barangay assembly is not the Katarungang Pambarangay, which settles disputes.

The Perioperative Nursing cram sheet has had the same rebuild, growing from twenty-five pages to thirty-one. The teaching boxes now read in the label, claim, reason, action, trap and exam-point pattern, every long table cell is a short list, and the near-blank last page is gone. It also gained sections the sheet never had: the continuum of sedation from minimal sedation to general anesthesia, with the exam point that a patient can slide one level deeper than intended; the four surgical wound classes from clean to dirty, with the infection rate each one carries; closed versus open gloving and when each is used; how the skin is prepared before the incision, working outward and never back over a prepared area; the numbers for the operating room itself, its temperature, humidity, air pressure and air changes, the neutral zone for passing sharps, and the tourniquet pressures and time limits; and captions under the two figures so that the semi-restricted zone and the Sign In, Time Out and Sign Out pauses can now be found by the sheet's search.

The Postpartum, Newborn and Family Planning cram sheet is the third, growing from eighteen pages to twenty-four. The three labelled diagrams, the postpartum danger signs, caput versus cephalhematoma and where each family planning method works, have been re-drawn with labels large enough to read on a phone. The new content is the part of this topic the exam asks about and the sheet did not carry: the Filipino postpartum customs of binat, hilot and suob and how a nurse honors the rest while redirecting what harms; how to feed the breastfeeding mother; the mother-baby friendly hospital rules and the Ten Steps; hand expression and cup feeding for the baby who cannot suckle; that a mother with hepatitis B can breastfeed once her baby has had the immune globulin and the vaccine; how to prepare formula safely when it must be used; how to dry up milk, which medicines pass into milk and which stop breastfeeding, and what to do about flat or inverted nipples; Sheehan syndrome after a severe hemorrhage; the newborn resuscitation ladder, from the first minute to compressions; the weight classes of the small baby, the WHO grades of a cold baby and kangaroo mother care; the birth injuries behind an uneven Moro reflex; the TwoDay Method, the patch and the ring, and how the CycleBeads are read; the GATHER counseling steps and the rule against quotas; what to do after a missed pill; and the four WHO categories that say who may use which method.

If you had highlights on an earlier edition of any of those three sheets, they are exactly where you drew them. Tap the small clock icon in the sheet's toolbar to open the edition you marked up, and tap it again to come back to the new pages.

Yesterday we took the ranking commentary out of two hundred and eighteen explanations. Checking our work afterwards turned up the same habit wearing a different sleeve, in fifty-two more. Thirty-five of them judged a wrong choice by how it comes across rather than by what it does: the equipment and the extra staff make this look safe, stopping to feel for a pulse sounds like careful reassessment, an oil-based ointment feels protective. Those now say the clinical thing instead. The slide board and the second person are the correct equipment for a transfer, but nothing has established that this client may be moved at all. Same verdict, and now you can see the reasoning. Fourteen more delivered a verdict on the nurse instead of on the choice, saying a nurse could reasonably start there or could fairly defend it. In almost every one of those the sentence already gave you the real clinical reason right beside it, so the comment about the nurse simply went and everything else stayed. As before, no question, no choice and no correct answer changed. Only the explanation underneath.

The last three were select-all questions whose closing line still ranked the wrong statements against each other, calling one the easiest of the wrong steps to trust or the one that raises the most alarm of the wrong entries. Those closings now do one job only: they name which statements are true, so you can see which combination follows. The reasoning has moved onto the statement itself, where it is useful, so the wrong statement tells you what is genuinely right about it and then where it goes wrong. These three had survived our earlier passes because of how the sentence was built, not because anyone judged them acceptable: our checks looked for a closing that counted the choices, and these named the wrong ones instead. We have taught the check to see that wording, so the next one gets caught the first time.

Two hundred and eighteen explanations have stopped commenting on the exam and gone back to teaching the nursing. The habit we removed was ranking the wrong choices for you: telling you which one was the closest competitor, which was the runner-up, which was the most tempting, which one a careful reader would fall for. None of that is nursing, it tells you how a question was built rather than how a patient is cared for, and it quietly trains you to hunt for the trap instead of thinking through the case. Every one of those explanations now does the same job the honest way. It grants what is genuinely right about each wrong choice, in clinical terms, and then says exactly what defeats it. Nothing about the questions themselves moved: the same wording, the same choices, the same correct answer. Only the explanation underneath changed, and only where it was talking about the test.

One answer has changed. The question about Aling Norma, the market vendor with no employer and irregular income, asked which PhilHealth membership category she belongs to, and it was marked as indigent or sponsored. That is not what the law says. Under the Universal Health Care Act a person only sits in the government paid category once they have actually been assessed and listed as poor, through the DSWD listing, a 4Ps record, or an assessment by a social worker, and nothing in her situation says any of that happened. Earning little does not by itself put anyone in that category. She is a self earning member who carries her own premium, which the app calls an individually paying member, and the correct answer is now that one. Two other things in the app already agreed: a twin question about a tricycle driver with the same profile is answered self earning, and the last question in Aling Norma's own set says her payments have been on and off, which only makes sense if she is the one paying them. Your past attempts keep the score they were given. Only new attempts are marked against the corrected answer.

Sixty four of those explanations were on select all questions, where the change is easier to see. Those used to end by picking out which wrong statement was the most tempting of the set, a line that judged how a statement feels rather than what it says. The closing line now does one thing only: it names which statements are true, so you can see which combination follows. The reasoning that used to sit in that closing line has moved to where it is actually useful, onto the statement itself, so the wrong statement now tells you what is genuinely right about it and then where it goes wrong. Every numbered statement is still quoted exactly as it appears in the question.

Thirty new questions have been added to the two pregnancy topics, six to Normal Pregnancy and twenty-four to Complications During Pregnancy. They are short and direct: they ask you one thing and expect one fact back. That is a shape the real exam leans on far more than our bank did, and these two topics are among the most heavily practised in the whole app, so they are where it was worth starting. The facts came from a coaching workbook, but every question, every choice and every explanation was written fresh to our own standard rather than lifted. Twenty of the fifty facts we started from did not become questions at all. Seventeen were already the answer to a question sitting in the bank, sometimes one you have met, so writing them again would only have handed you the same fact twice under a different heading. The other three we could not ask fairly: on each one a second choice turned out to be just as defensible as the one we would have marked correct, and rather than reword it until it looked clean we left it out.

Fifty-four questions in those same two topics have had their wording cut down, from about sixty-two words to about thirty-five. Nothing else about them moved: the same choices, the same correct answer, the same explanation. What went was the story around the question, the scene-setting you had to read through before the actual question arrived. Every clinical detail that any choice depends on is still there, and that is not a promise, it is the thing we checked hardest. Each shortened question was read by someone who had not written it, whose only job was to confirm that it still has exactly one best answer and that nothing a choice relies on had been cut away. A handful came back where the explanation still mentioned a detail the shortening had removed, and every one of those was put right before any of this went live.

The fourteen new questions added to the liver, gallbladder and pancreas topic earlier today have had their explanations reworked. Two things were off. First, each one spent a line restating that the correct choice was correct, which every other question in the bank does in its own section already, and which our own quality checker rejects. That line is gone. Second, and more useful to you, none of them did the thing our explanations are supposed to do: take the wrong choice you were most likely to pick, admit what is genuinely right about it, and then give you the one fact that rules it out. All fourteen now do. So instead of the lipase question simply saying amylase is wrong, it grants that amylase does rise in pancreatitis and then tells you why lipase is the one that settles it. That is the part worth reading twice.

Two questions and two flashcards presented a big protein meal as the thing that tips a client with liver disease into confusion. We checked it against the guidelines and it does not hold up. The recognised triggers are infection, bleeding in the gut, too much diuretic, an electrolyte problem and constipation; a meal is not on any of those lists, and its absence is deliberate rather than an oversight. Leaving it in would have taught the trigger version of the rule we retired this morning, which is a short step from cutting protein. All four now name a real trigger instead. One thing was deliberately kept: bleeding into the gut genuinely is a protein load, and an odd one, because blood is missing an amino acid the body needs; that teaching is correct and stays. Nobody reported any of these four. They came out of a sweep of every question, flashcard and cram sheet for the same idea, run after the first one turned up.

Four hundred and twenty-seven practice questions across forty-five subtopics, with about twenty-four thousand recorded answers between them, now carry rewritten answer explanations. They cover asthma in children, diabetes, shock and sepsis, critical care equipment, electrolyte imbalances, laboratory values, blood disorders, skin conditions, the bowel and its absorption, the sick child's kidneys, crisis intervention, personality disorders, community mental health, family nursing, nutrition programmes, disease reporting law, nursing research, cancers by site, postpartum complications, the operating room, and more. Sentences that ranked the wrong choices against one another, calling one the most tempting or the closest competitor or the runner-up, are gone from every one of them. In their place each wrong choice is granted what it genuinely gets right and is then met with the clinical fact that rules it out. Questions, choices and answer keys are unchanged, so every result you have already recorded still stands.

Something we did not expect turned up while we were doing it, and it is worth telling you about. On most of these questions the ranking sentence was not merely clumsy, it was the only thing standing in for an explanation of the wrong choice at all. On one batch of items it was six out of eight, on another eight out of nine, on another eleven out of twelve. Those questions had a sentence telling you which wrong answer was the closest, and nothing telling you what was right about it or why it still fails. So for well over a hundred of these, this is not a rewrite of an explanation you already had. It is the first time the question explains its runner-up to you at all.

We also went looking for the ones our own checks could not see, and fixed them. Every sweep so far has found questions by matching a list of phrases, which means a question could carry exactly the wording we were removing in a form the list did not cover and stay untouched while every check reported itself clean. We measured that gap and it was real: one hundred and twenty-eight questions across sixty-two topics were carrying words like tempting, runner-up or distractor where no sweep could ever have selected them. Some had already been through an earlier rewrite and kept the wording because it was invisible to us at the time. All one hundred and twenty-eight have now been rewritten, which is why this is the last of them rather than a promise. Ninety-six of those questions used the word tempting, and on forty-five of them that word was doing the work of explaining the wrong choice, so each of those needed a real clinical reason written in its place rather than a word deleted. While checking, we also found three words on our internal list that we deliberately left alone, because reading the questions showed they were ordinary clinical language and not exam commentary: trapping air, trapping ammonia and the Wolff-Chaikoff trap are nursing, not jargon about answering questions.

Three questions in the bank told you that once a client with liver disease develops encephalopathy, protein is cut back. That is the rule most Philippine review books still print, and it is the rule we were taught. It is not what the guidelines say any more. We checked it against the joint European and American liver guideline, the European nutrition guideline for liver disease, the American college's 2025 guideline and the current StatPearls chapter, and all four say the same thing: protein is not restricted in hepatic encephalopathy, not even during an acute episode. The target is about 1.2 to 1.5 grams per kilogram a day. The old rule was dropped after a 2004 trial found that cutting protein gave no benefit at all and actually increased protein breakdown, and because the muscle loss it causes is itself one of the things that makes encephalopathy worse and more likely to come back. One of the three had the retired rule inside its correct answer, so that answer has been rewritten; the answer letter did not change on any of them. Because so many of you will have been taught the old rule and would think we had made a mistake, the explanation now says the old rule out loud and says when and why it was retired, instead of quietly stating the new one. Plant and dairy protein are still preferred over red meat. Two of the three questions were not reported by anyone: we found them by sweeping the whole bank, the flashcards, the situations and the cram sheets for the same claim after the first one turned up.

One gallstone question was giving away its own answer. The question described pain that came on after fatty food and spread to the right shoulder, then asked which finding best supported gallstones, and the correct choice simply said the pain was triggered by fatty meals. You could match the wording and be right without knowing anything about gallbladders. The question now describes the attacks without naming what brings them on, and asks which extra detail from her history would support gallstones; the four choices are now four different patterns of what sets a pain off or settles it, one for gallstones, one for an ulcer, one for a bowel cause and one for reflux. The answer letter did not change. Along the way we removed two things the old version implied that are not true: night pain does not argue against gallstones, and biliary pain is steady rather than cramping despite the word colic.

The liver, gallbladder and pancreas topic now has fourteen new questions of a kind it did not have a single one of before. Every question in it used to be a patient story, and several of you have told us the real exam asks a great many short, direct questions as well, especially on basic concepts and medicines. So these fourteen are short and direct. They ask where gallbladder pain is felt and where pancreatic pain is felt, which enzyme actually points at the pancreas, why the clotting time stretches out in liver disease, what a blocked bile duct does to the colour of the stools, what to do first when a balloon tube used to stop bleeding veins slips, and what a client may and may not lift after the gallbladder comes out. The four choices on each one come from the same page of the same textbook, so they all look right and one fine fact decides between them. Every fact was checked against a source before the question went in, and two of them were rebuilt after that check disagreed with the first draft.

Thirty questions in the same topic have been shortened. The typical one ran fifty-eight words and now runs thirty-four. What came out was the story around the question: the admission background, the family at the bedside, the ward being short of staff, and the vitals that no choice actually turns on. What stayed is every fact you need to answer: every age, temperature, pulse, blood pressure, oxygen reading, pain score, drug, dose, timing and finding, in the same values as before. The four choices, the correct answer and the explanation on all thirty are untouched, so anything you have already answered still stands and your results are unaffected. Three of the thirty needed a second pass, because a clause that looked like background turned out to be the one thing ruling out a wrong answer, and those clauses are back in. One question was left long on purpose: shortening it would not have fixed a problem it already had, and that one needs its choices rewritten instead, which is a separate job.

Forty-five practice questions had one thing in common: the correct choice was the only one carrying a note in parentheses, such as a second name for a drug, an acronym, or a short explanation of the term. Some of you told us the same thing about a few flashcards last month, and you were right: a reader who spots the pattern can pick the answer without knowing the nursing. We measured it across the whole bank and found the pattern on forty-five questions in thirty-three subtopics, with about six thousand seven hundred recorded answers between them. In forty of them the note was simply removed from the correct choice, so "Vitamin K (phytonadione)" now reads "Vitamin K" and "Electroencephalogram (EEG)" reads "Electroencephalogram". In four, the note was reworded into plain words so the choice stays about as long as its neighbors, and on the Rh incompatibility question the drug is now called anti-D immune globulin, the same medicine under its name without parentheses. The second names and acronyms still appear in the explanations, where they teach rather than tell. Questions, wrong choices, answer keys and explanations are otherwise unchanged, so every result you have already recorded still stands. No question in the bank now has a note in parentheses on its correct choice alone.

There is a new cram sheet in your Resources library, Sick Child B, on the NP2 shelf. It is the second of the two sick child sheets and it takes the blood, the brain, the kidney, the skin and the bones of a child who is already ill. The blood part puts the four sickle cell crises in one table with the crisis care in the order you give it, fluids first and never meperidine, then sets hemophilia, ITP and von Willebrand disease side by side by the one lab that tells them apart, and follows acute lymphoblastic leukemia from the first blood count through the four phases of chemotherapy, the neutropenic room and the bleeding plan, before Wilms tumor, neuroblastoma, the bone tumors and retinoblastoma are sorted by age and by the one thing you must not do. The brain part reads raised pressure inside a skull that can still stretch, the fontanel, the shrill cry, the shunt and its alarm signs by age, then takes meningitis with its droplet clock, seizure first aid and the febrile seizure, Reye syndrome, cerebral palsy, the three neural tube defects with the care of the sac, the head injury from the sofa and the child pulled from the water. The kidney part covers the urinary tract infection and reflux, nephrotic syndrome against glomerulonephritis in one table of two children, hemolytic uremic syndrome, bedwetting, the undescended testis and the urethral openings in the wrong place. The skin part fits kuto, galis, buni, an-an, impetigo, candida and eczema in one table with the burned child after it, and the bones part runs from the hip that dislocates and the clubfoot through scoliosis, the limping child by age, juvenile arthritis, brittle bones, Duchenne, the child's fracture, traction, cast care and the fracture that must be reported. It closes with a first action table, five precautions and a one page list of every number on the sheet.

There is a second new cram sheet in your Resources library today, Reproductive Health, on the NP2 shelf. It carries what no other sheet does. The two tracts are named part by part: the vulva from front to back, the vagina with its acid and its fornices, the uterus in three layers with its ligaments and positions, the tube in four segments with the one that is tied and the one where the egg is met, the ovary and the breast; and on the male side the two cell types of the testis, the seven stops a sperm passes on its way out, and which gland adds what to semen. The cycle is told four ways, as the axis, the ovary, the lining and the signs you can read on the body, with the fixed fourteen day rule that answers every question about cycles of different lengths, and every menstrual disorder from amenorrhea to toxic shock has its definition and its first move. Menopause is dated the way the exam dates it and placed at about forty-eight for Filipino women. The prostate is sorted into benign and cancer, the after-surgery irrigation scenario is walked through, and six scrotal swellings are told apart in one table. Then conception day by day, the three inheritance patterns with their odds, the karyotype notation, the syndromes a nurse must recognize at the cot side, screening against diagnosis, and newborn screening. The subfertile couple gets the year rule, the three basic tests, what each test needs from you, ovulation drugs and every assisted route, and the last part is the ethics of maternal care as the exam scores it: the principles named for maternity scenarios, consent and refusal, the spouse, the minor, the objecting nurse, and who does what on a short-staffed unit.

A question in the maternal and child health programs topic asks why a sick 14-month-old who is under weight and still mostly breastfed gets feeding counseling at her visit. Its explanation opened by admitting that the question did not say which kind of reason it wanted, so more than one answer could be argued. An explanation should never leave you with that. We went back to the WHO IMCI chart booklet and the WHO training module on counseling the mother, and the answer is not ambiguous at all: IMCI puts feeding counseling into the sick-child visit because good feeding after illness makes up for weight loss and helps prevent malnutrition, and good feeding when the child is well helps prevent the next illness, which is why the chart has the nurse assess feeding for every child under two and for any child with acute malnutrition or anaemia. The explanation now says that, in the booklet's own terms. The wrong choice that sounded most procedural, that feeding problems are something the booklet classifies, is now answered precisely: the booklet classifies nutritional status and anaemia, and feeding is assessed and counseled as a treatment step under that classification, with a return visit in seven days if a feeding problem is found. The question, the four choices and the answer letter did not change, so any result you already recorded still stands. Nobody reported this one; it was found while reading through a list of explanations that used the word arguable.

The Department of Health has a new vision and mission, and page 5 of the PH Health System, UHC and Primary Health Care cram sheet was still printing statements from before 2017. The page now carries the current wording, checked against the DOH Citizen's Charter 2025: the vision that Filipinos are among the healthiest people in Asia by 2040, and the mission to promote healthy settings and steer the development of an effective, resilient, equitable and people-centered health system for Universal Health Care. The earlier wording that many review handouts still teach is kept underneath as a note, so you can recognize either version if it appears, and the source was added to the reference list on page 18. Nothing else on the sheet moved. If you had marked up the previous edition, your highlights and notes are safe on that edition, one tap away behind the clock icon in the top bar. The practice question on the DOH vision was updated to the same wording.

Three practice questions were revised after student reports. The chain of infection question about dengue, tuberculosis and hookworm used to ask which link the three organisms share, which sent many of you looking for something they have in common; it now asks directly which link of the chain each organism occupies, and its explanation was reworded to match. The informed consent question under the Mental Health Act had an awkwardly worded choice, which now reads the way the law itself does: full disclosure in plain language, and consent given voluntarily. Answer keys are unchanged, so every result you have already recorded still stands.

Three flashcards were corrected. The IMCI card on severe jaundice in a young infant listed its two findings joined by and, as though both were needed. The chart classifies the infant pink when either one is present on its own, jaundice under 24 hours of age or yellow palms and soles at any age, and the card now says so, with the 14-day referral rule added on the back. Two fetal monitoring cards gave away their own answers by printing the last word of the term after the blank; the blank now covers the whole term, and the late deceleration card names the pattern and asks for its cause.

Two hundred and thirteen practice questions across eighteen subtopics, about twelve and a half thousand recorded answers between them, now carry rewritten answer explanations. They cover hearing loss and ear assessment, therapeutic communication, somatic and behavioral therapies, antidiuretic hormone disorders, thyroid and parathyroid disorders, infectious and immunologic disorders, peripheral neuropathies, autonomic dysreflexia, Guillain-Barre syndrome, increased intracranial pressure, oncologic emergencies and cancer treatment, the normal puerperium, tuberculosis, and health education in the community. Sentences that ranked the wrong choices against one another, calling one the most tempting or the closest competitor, are gone from all of them. In their place each wrong choice is granted what it genuinely gets right and then met with the clinical fact that rules it out. Every rewrite was checked line by line so no dose, law or clinical fact was lost, then read end to end by four reviewers who had not written it, and the corrections from that review were re-checked before anything went live. Questions, choices and answer keys are unchanged, so every result you have already recorded still stands.

Seven more explanations that called a wrong choice the closest miss were reworded the same way. That phrase had slipped past the earlier rewrites because it matched none of the wording we were searching for, so it is now on the list, and the whole bank was swept for it. One of the seven had already been revised once and kept the sentence until now.

Ninety-three explanations across forty-six subtopics said the same sentence twice, usually because two different wrong choices had been given one identical reason, copied word for word. Each repeated sentence, one hundred and thirty-six in all, was replaced with a reason true of that particular choice. Because this rewrite added new clinical statements rather than removing words, every item was read by reviewers who had not written it, and the one new statement they found to be wrong, about neck vein distention in pulmonary edema, was corrected before going live. One further question was held back on purpose because its replacement wording needs a closer review, so it keeps its repeated sentence for now. Questions, choices and answer keys are unchanged.

One hundred and sixty-three practice questions across sixty subtopics, about nineteen thousand recorded answers between them, had their explanations reworded to drop one more habit of ours: calling a wrong choice the trap. Phrases like "this is the trap", "the classic trap" or "the strongest trap on the page" described how the question was built rather than the nursing, and every one of them is gone. Where the explanation already gave the clinical reason the choice fails, the label was simply removed; where it did not, the reason now stands in its place. The word trap stays wherever it is real clinical language, such as air trapping in the lungs or the water trap on ventilator tubing, and seven questions were deliberately left alone for that reason. A small follow-up the same day removed three stray phrasings the first pass could not see, including "a closely competing option" and "the closest wrong time point", while keeping the word mistaught in the three explanations where it names a genuine clinical misconception rather than ranking a choice. Every rewrite was checked line by line so no dose, law or clinical fact was lost, then read end to end by reviewers who had not written it. Questions, choices and answer keys are unchanged, so every result you have already recorded still stands.

There is a new cram sheet in your Resources library, Sick Child A, on the NP2 shelf. It is the first of the two sick child sheets and it takes the heart, the airway and the gut of a child who is already ill. The heart half sorts every congenital defect by where the blood goes, so a hole, a narrowing and a swapped vessel stop being a list to memorize and become three stories you can reason through, then walks the tet spell in the order you act on it, the early signs of heart failure in a baby who sweats through a feed, the digoxin rules a parent must be able to recite back, rheumatic fever by the Jones criteria in the version that actually applies to the Philippines, and Kawasaki disease by stage. The airway half sets croup, epiglottitis, bronchiolitis and the aspirated peanut side by side by sound and by first move, then covers pneumonia, childhood asthma, cystic fibrosis, apnea, tonsillectomy, otitis media and safe sleep. The gut half grades dehydration three ways, teaches oral rehydration and zinc the way the health center gives them, and puts the three obstructions of infancy, pyloric stenosis, intussusception and Hirschsprung disease, in one table so the olive, the currant jelly and the ribbon stool stay apart in your head, before the cleft lip, the fistula, the imperforate anus, the wall defects and the poisoned toddler. It closes with a scenario table and a one page list of every number on the sheet.

There is a second new cram sheet in your Resources library today, Infectious, Inflammatory and Immunologic Disorders, on the NP3 shelf. It takes everything the immune system does wrong: too little, too much, and against its owner. It opens with the cast of immune cells on real medical plates and the labs that read them, then puts the four hypersensitivity types on one grid so anaphylaxis, the wrong blood transfusion, serum sickness and the tuberculin skin test finally sit apart by the clock. Lupus and scleroderma are drawn on the body, with the classic four of eleven criteria beside the 2019 score, then Sjogren, polymyositis and the drugs that follow every autoimmune disease. Transplant rejection is told by the clock, hyperacute, acute and chronic, with the immunosuppressant watch list. The HIV part runs from the window period to AIDS: how it spreads and how it does not, the life cycle as the drug map, the two curves over ten years, the opportunistic infections by CD4 count, testing the way the Philippines confirms it, treatment for everyone on the day of diagnosis, PrEP and PEP. Every sexually transmitted infection is set side by side with syphilis by the calendar, then standard precautions, the order you put protective gear on and take it off, the resistant organisms, the needlestick protocol minute by minute, COVID-19 in the words that changed, Crohn against colitis and Guillain-Barre as patterns, and it closes with a first-action table, the numbers, a drug index and the memory hooks.

Our founding beta closed once its seats ran out, but six places in the app still spoke as though it were running. The community card on your dashboard invited you to study alongside the other beta reviewers, your Profile page said your Telegram handle was only used to reach you about your beta access, the free plan note under Daily flashcard goal said beta let you set your own goal, and the popup on a locked study plan said the scheduler was part of BoardPal Beta. Those all now say full access, or simply drop the word. On the Plans page, the gold Beta card marked Sold out used to greet everyone, sitting above the plans that are actually open and showing a lower price nobody could buy any more. It is now shown only to the students who hold that founding pass, where it reads as their plan. Everyone else lands straight on the plans they can choose from. Nothing about anyone's access, price or expiry date changed.

If your boards were split or rescheduled and you only need to sit part of them, your study plan can now cover just those sections. On the Schedule page, the new Sections button next to your dates lets you pick Everything, Day 1 only (NP1 to NP3), Day 2 only (NP4 to NP5), or any custom mix, and the same choice appears when you build a new plan. Your remaining days rebuild around the sections you picked, only the matching mock board day is scheduled, and a plan covering fewer sections may use a shorter window than the usual fourteen days. Everything you have already finished carries over, and your previous plan stays restorable. Two students whose Day 2 was moved asked for exactly this.

When your plan leaves out some sections, the mock boards no longer make you finish the earlier sections first. A student whose plan covers Day 2 only can open NP4 and NP5 on any mock board straight away.