Backwards and Forwards

Rina’s NCLEX Study Plan 2026

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Outline

Overview

Show the student the big picture of what you are talking about…
Then go backwards through the steps that cause the condition…
Then go forward one more time to bring it all together.

Key Points

Example
1. BIG PICTURE
  1. The heart is a big muscular pump. Heart failure is effectively pump failure in the circulatory system.
2. GO BACKWARDS
  1. Anything that can cause the heart to not pump as effectively could cause heart failure – for example, damage to the heart muscle from a myocardial infarction, or prolonged high blood pressure making the heart have to work harder
3. GO FORWARDS
  1. When the pump fails, blood flow forwards is decreased – showing signs of poor perfusion in the extremities and to other organs. The other thing that happens is that blood begins to back up in the system, so you’ll either see pulmonary congestion or systemic congestion. . . etc. etc.

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Transcript

For this next half I titled it backwards and forwards, but the full title is big picture, go backwards, go forwards.

That probably doesn’t make sense to you right away so let me show you what I’m talking about. This is referring to the general process when presenting a topic. This can work for a super broad topic like heart failure or for a more specific topic like the use of a diuretic. So you’re going to give them the big umbrella big picture of the topic. Then you’re going to go backwards and talk about what causes it or more foundational ideas of that topic. And then you’re going to bring them forward again like you’re bringing them on a journey through the topic.

So to help you understand what this looks like, let me show you an example.

If we are talking about heart failure. The big picture of heart failure is that the heart is a big muscular pump and that heart failure is effectively pump failure in the circulatory system. that is the big picture, umbrella understanding of heart failure. You can use a general image like this one to show the circulatory system, and just give that big picture idea of heart failure.

Then you’re going to go backwards. So anything that can cause the heart to not pump as effectively can cause heart failure. This could include damage directly to the heart muscle from a myocardial infarction, or prolonged high blood pressure can make the heart have to work harder against that extra pressure. So you’ll notice I drew directly on the image and gave them a foundational understanding of what causes heart failure.

Then we want to go forward again. Now that we know the big picture of heart failure and what can cause it, let’s take them through that Journey. So when the pump fails blood flow forward is decreased and the blood backs up in the system. Because of the decreased blood flow forward, you will see signs of poor perfusion in the extremities and two other organs. Because of the congestion backwards, you can see congestion in the lungs or in the systemic circulation depending on which side of the heart is failing. So we gave them the big picture, we took them backwards to see what caused it, then we took them for words to see what would happen to the patient. So big picture, go backwards, go forwards.

Keep checking out these practical application tips to know how to implement the Core Content Mastery Method in practice. Now go out and be your best self today. And, as always, happy nursing!

Backwards and Forwards

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Included In This Lesson

NURSING.com students have a 99.25% NCLEX pass rate.

Outline

Overview

Key Points

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Rina’s NCLEX Study Plan 2026

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