Kind of a late reply I know, But maybe this answer will help someone else. I'm a first semester student in an ADN program and I have not had Med Surg 1 yet and I am level 3 on all of adaptive quizzing. This is mostly because I did the questions over and over and over.. each subject bank only has 30-60 questions (i felt like GI had the most) My suggestion if you are grinding out levels is to do them individually by systems. It took me about 6000 questions to get level 3 on everything. As far as adaptive learning..that requires time. You have to come back when it tells you to come back. You can do it all day long and you can only advance so much. Just be sure when it says to come back to study in 3 hours that you do it...you will advance quickly.