Dorothy Chen, 68
☆☆☆☆☆Pneumonia Assessment
Productive cough, fever, and increasing shortness of breath.
Scenarios
100+ scenarios at launch. 5 new ones added every month.
Med-Surg22 scenarios
Tyler Moore, 22
☆☆☆☆☆Appendicitis Triage
Worsening abdominal pain migrating to the lower right side.
Ashley Rivera, 29
☆☆☆☆☆Anaphylaxis Response
Throat tightening and hives after taking an antibiotic.
Frank Kowalski, 71
★★★☆☆COPD Exacerbation
Acute onset severe shortness of breath with increased sputum.
Robert Hayes, 58
★★★☆☆Acute Myocardial Infarction
Chest pressure radiating to the left arm with diaphoresis.
Linda Park, 44
★★★☆☆Post-Operative Wound Infection
Wound site redness and fever two days after surgery.
Walter Thompson, 74
★★★☆☆Acute Heart Failure Exacerbation
Increasing dyspnea on exertion and bilateral ankle swelling.
Marcus Johnson, 19
★★★☆☆Traumatic Brain Injury Assessment
Altered consciousness after a fall from height.
Emma Patel, 24
★★★☆☆Bacterial Meningitis Assessment
Severe headache, photophobia, and neck stiffness.
Carol Bennett, 52
★★★☆☆Post-Op DVT and Pulmonary Embolism
Sudden-onset dyspnea and chest pain 4 days post-surgery.
Jerome Williams, 28
★★★☆☆Sickle Cell Vaso-Occlusive Crisis
Severe bone pain and fatigue in a patient with known sickle cell.
David Kim, 35
★★★☆☆Burn Wound Assessment
Partial and full-thickness burns across the arm and torso.
Marcus Lee, 59
★★★☆☆Acute Kidney Injury
Rising creatinine and decreased urine output following IV contrast administration.
Eduardo Reyes, 52
★★★★☆GI Bleed — Hematemesis
Hemodynamic instability after vomiting bright-red blood in the emergency department.
Patricia Osei, 44
★★★★★Thyroid Storm Recognition
Tachycardia, high fever, and agitation two days after thyroid surgery.
Ryan Callahan, 31
★★★★☆Hypovolemic Shock
Trauma patient with falling blood pressure and altered mental status after a motor vehicle crash.
Darren Moore, 36
★★★★★Autonomic Dysreflexia
Sudden severe headache and hypertension in a patient with a T4 spinal cord injury.
Edna Kowalski, 79
★★☆☆☆Urosepsis in Older Adult
Acute confusion and low-grade fever in a catheterized patient — atypical sepsis presentation.
Jasmine Carter, 27
★★★★★Tension Pneumothorax Recognition
Absent breath sounds and tracheal deviation after central line placement.
Anthony Russo, 47
★★☆☆☆Acute Pancreatitis
Severe epigastric pain radiating to the back with elevated lipase after alcohol use.
William Greene, 61
★★★☆☆Liver Failure with Encephalopathy
Confusion, asterixis, and rising ammonia in a patient with end-stage liver disease.
Deja Thompson, 22
★★★☆☆Rhabdomyolysis
Dark urine and diffuse muscle pain after a prolonged seizure and positioning injury.
Pediatric16 scenarios
Maria Torres (for son Liam), 6
☆☆☆☆☆Pediatric Dehydration
Six-year-old with vomiting and diarrhea for two days, refusing fluids.
Sofia Nguyen (for baby), 0
★★★☆☆Neonatal Jaundice Assessment
Yellowing skin in a 3-day-old at the well-baby visit.
Aiden Reyes, 9
★★★☆☆Pediatric Asthma Attack
Audible wheezing and respiratory distress during an asthma exacerbation.
Rachel Martinez (for Maya), 2
★★★☆☆Pediatric Febrile Seizure
Parent in distress after witnessing a first febrile seizure.
Tyler Warren, 17
★★★☆☆Opioid Overdose Recognition
Unresponsive teen with pinpoint pupils found by parent.
Amanda Lee, 29
☆☆☆☆☆Gestational Diabetes Education
Newly diagnosed gestational diabetes at 26 weeks.
Tanya Brooks, 26
★★★☆☆Preterm Labor Management
Regular uterine contractions at 32 weeks gestation.
Parent of Tyler (age 4), 4
★★★☆☆Suspected Child Abuse
Inconsistent story about injuries in a 4-year-old requiring mandatory reporting.
Sandra Kim (for son Noah), 0
★★★★★Pediatric Sepsis — Infant
Fever, lethargy, and poor feeding in a 3-month-old — sepsis workup and early escalation.
Luisa Flores (for Mia), 1
★★☆☆☆RSV Bronchiolitis — Toddler
Wheezing, nasal flaring, and poor oral intake in an 18-month-old during RSV season.
Keanu Makoa, 13
★★★☆☆Pediatric Meningitis
Headache, stiff neck, and photophobia with fever in an adolescent.
Oliver Pham, 8
★★★☆☆Anaphylaxis — Pediatric
Hives, vomiting, and throat tightness minutes after eating peanuts at school.
Isabella Reyes, 6
★★★★☆Post-Tonsillectomy Hemorrhage
Swallowing blood and restlessness eight hours after tonsillectomy — post-op bleeding.
Baby of Maria Gonzalez, 0
★★★★★Newborn Resuscitation — NRP
Limp, apneic newborn at delivery requiring positive pressure ventilation and team coordination.
Baby of Kara Walsh, 0
★★★☆☆Substance-Exposed Newborn
High-pitched cry, tremors, and poor feeding — NAS scoring and non-pharmacologic comfort.
Amara Okafor, 28
★★★★★Eclampsia — Acute Seizure
Tonic-clonic seizure at 38 weeks in a patient with known severe preeclampsia.
Mental Health18 scenarios
Jordan Taylor, 34
☆☆☆☆☆Major Depressive Disorder Assessment
Patient describing persistent sadness, loss of interest, and sleep disruption.
Alex Morgan, 22
★★★☆☆Suicide Risk Assessment
Patient in the ED expressing hopelessness and passive suicidal ideation.
Brian O'Sullivan, 47
★★★☆☆Alcohol Withdrawal Assessment
Tremors and agitation in a patient 24 hours after last drink.
Sam Okonkwo, 29
★★★☆☆Acute Psychosis — De-escalation
Disorganized thinking and paranoia requiring a calm, structured approach.
Claire Donnelly, 19
★★★☆☆Restrictive Eating Disorder
Assessing a patient with restricted intake, distorted body image, and medical instability.
Thomas Huang, 51
★★★★★Lithium Toxicity Assessment
NP managing a patient on lithium presenting with tremor, confusion, and GI symptoms.
Helen Walsh, 81
★★★☆☆Dementia with Behavioral Crisis
Redirecting and calming an agitated patient with advanced dementia.
Raymond Peters, 83
★★★☆☆Geriatric Polypharmacy Assessment
Confusion and falls in an elderly patient on multiple medications.
Patricia Green, 58
★★★☆☆Chemotherapy-Induced Nausea
Supporting a patient experiencing severe nausea during chemotherapy.
James Porter, 45
★★★★★Febrile Neutropenia
Oncology emergency in an immunocompromised patient with fever.
Marcus Reyes, 34
★★☆☆☆PTSD — Trauma-Informed Care
Combat veteran with hypervigilance and flashbacks triggered by wound care procedures.
Danielle Frost, 29
★★★☆☆Opioid Withdrawal — COWS Protocol
Sweating, cramping, and agitation 24 hours after last opioid use — COWS-guided care.
Nina Shapiro, 26
★★★☆☆Manic Episode — Bipolar I
Grandiosity, pressured speech, and three nights without sleep on the psychiatric unit.
Harold Briggs, 55
★★★★★Serotonin Syndrome Recognition
Fever, clonus, and agitation after starting a second serotonergic medication.
Kyle Donovan, 31
★★★☆☆Psychiatric Emergency — Involuntary Hold
Patient threatening self-harm and refusing voluntary admission — 5150 hold process.
Renata Polk, 43
★★★☆☆Aggressive Patient — Verbal De-escalation
Patient shouting and refusing medication on the psychiatric unit — de-escalation required.
Sandra Williams, 58
★★☆☆☆Adjustment Disorder — Acute Grief
Newly diagnosed with terminal illness — expressing hopelessness and requesting discharge.
Dylan Park, 20
★★★☆☆First-Episode Psychosis — Young Adult
Family brings in a college student with disorganized speech and paranoid delusions.
End of Life10 scenarios
Margaret Sullivan, 78
★★★☆☆Goals of Care Conversation
A palliative care conversation about prognosis, values, and care goals with a patient and family.
George Fletcher, 72
★★★★★End-Stage Heart Failure
Managing symptom burden and LVAD decisions in advanced heart failure.
Mary Chen, 64
★★★☆☆Cancer Pain Management
Assessing undertreated pain in a patient with metastatic cancer.
Victor Santos, 67
★★★★★Malignant Hypercalcemia
Recognizing a life-threatening oncologic emergency with confusion and weakness.
Frances Bell, 56
★★★★★Status Epilepticus
Managing prolonged seizure activity and preventing secondary injury.
Arthur Klein, 82
★★★★★Advance Directive Conflict — Family Override
Son insisting on full code despite the patient's clearly documented DNR — ethics and advocacy.
Rosa Jimenez, 71
★★★☆☆Transitioning to Hospice
Family meeting to discuss stopping curative treatment and goals for comfort-focused care.
Clarence Davis, 88
★★★☆☆Last Hours of Life — Active Dying Signs
Cheyne-Stokes breathing, mottling, and decreased responsiveness — family support at bedside.
Family of Tyler Grant, 24
★★★★★Organ Donation Conversation
Approaching the family of a brain-dead trauma patient about organ donation — sensitive communication.
Betty Nakamura, 77
★★★☆☆Comfort-Focused Pain Management
Titrating an opioid infusion for a hospice patient with refractory cancer pain.
Difficult Families14 scenarios
Evelyn Brooks, 61
★★★☆☆Advocating with a Dismissive Team Member
Escalating a clinical concern when the provider is dismissive.
Family of Raymond, 75
★★★☆☆Delivering Difficult News
Telling a family their loved one's condition has worsened significantly.
Howard Miller, 43
★★★☆☆Redirecting an Inappropriate Patient
Setting a boundary and de-escalating with a patient who is acting out.
Susan Walsh, 55
☆☆☆☆☆Asking for Help When You Don't Know
Communicating uncertainty to a supervisor while keeping the patient safe.
Diana Torres, 48
★★★☆☆Recovering After Saying the Wrong Thing
Repairing trust after a communication misstep.
Noah Garcia, 7
★★★☆☆Calming an Agitated Pediatric Patient
De-escalating a scared and combative 7-year-old before a procedure.
Kevin Walsh, 69
★★★☆☆Difficult Family at the Bedside
Managing a demanding family member while maintaining care focus.
Cheryl Nguyen, 52
★★★☆☆Scope of Practice Boundary
Responding to a family requesting actions outside nursing scope.
Carmen Diaz, 74
★★☆☆☆Delegating to UAP
Assigning appropriate tasks to unlicensed staff across a four-patient med-surg assignment.
Dorothy Evans, 67
★★☆☆☆SBAR Handoff — Overnight Team
End-of-shift handoff with an unexpected change in patient condition requiring clear SBAR.
Mark Huang, 50
★★★☆☆Near-Miss Medication Error — Disclosure
Caught a wrong-dose error before administration — disclosing the near-miss to the patient.
Unit 4C — Night Shift, 0
★★★☆☆Charge Nurse — Staffing Shortage
Making safe assignments with one RN calling out and no float pool — prioritizing patient safety.
Fatima Al-Rashid, 39
★★☆☆☆Interpreter Services — Language Barrier
Non-English-speaking patient needing informed consent — navigating interpreter services and cultural humility.
Gerald Walsh, 72
★★★☆☆Reporting Up — Ignored SBAR Call
Provider dismisses the nurse's clinical concern — escalating through chain of command to protect the patient.
NCLEX20 scenarios
Daniel Wright, 66
★★★☆☆Sepsis Recognition
SIRS criteria and early sepsis recognition with clinical judgment focus.
Barbara Allen, 71
★★★☆☆Acute Stroke Assessment
Rapid NIHSS assessment and thrombolytic decision in the ED.
Jessica Collins, 31
★★★☆☆Postpartum Hemorrhage
Recognizing and responding to excessive bleeding after delivery.
Carlos Mendez, 23
★★★☆☆Diabetic Ketoacidosis
Recognizing DKA and initiating the insulin and fluid protocol.
Denise Hammond, 54
★★★★★Hypertensive Emergency
Differentiating hypertensive emergency from urgency and managing end-organ damage.
Carolyn Reed, 48
★★★☆☆Pulmonary Embolism Recognition
Sudden pleuritic chest pain and tachycardia three days after total knee replacement.
Louise Martin, 63
★★★★☆Transfusion Reaction — Anaphylactic
Hives, hypotension, and dyspnea 10 minutes into a blood transfusion — stop and respond.
Harold Beck, 69
★★★☆☆Atrial Fibrillation — RVR
Palpitations, near-syncope, and an irregular heart rhythm on telemetry monitoring.
Phillip Grant, 55
★★★☆☆Chest Tube Management
Air leak assessment and drainage monitoring after chest tube insertion for pneumothorax.
Beverly Carr (primary), 64
★★★★☆Prioritization — Four-Patient Assignment
Determine safe sequencing of care for four patients of varying acuity at shift start.
Rosario Vega, 58
★★★☆☆Critical Lab Value — Panic Potassium
Potassium of 2.9 in a patient on digoxin — critical value protocol and immediate interventions.
Phillip Adams, 61
★★★★★SIADH vs. Diabetes Insipidus
Differentiating the two sodium disorders using urine and serum values after pituitary surgery.
Hannah Brooks, 18
★★★★☆Acetaminophen Overdose — N-Acetylcysteine
Intentional overdose — applying the Rumack-Matthew nomogram and initiating N-acetylcysteine.
Veronica Chao, 39
★★★☆☆Neutropenic Precautions — Oncology
Post-chemotherapy neutropenia with fever — protective isolation and sepsis bundle.
Taylor Scott, 25
★★★★☆Postpartum Preeclampsia
BP of 160/110 appearing 24 hours after uncomplicated delivery — magnesium and escalation.
Owen Larson, 4
★★★★☆Pediatric Airway Obstruction
Sudden choking with audible stridor — distinguishing partial from complete obstruction.
Sandra Ortega, 66
★★★★☆Acute Respiratory Failure — NIV
Worsening hypoxia unresponsive to supplemental oxygen — determining when to escalate to BiPAP.
Irene Watson, 84
★★★☆☆Medication Reconciliation — Polypharmacy
Screening 12 home medications on admission for duplicates, interactions, and high-alert drugs.
Donald Brooks, 77
☆☆☆☆☆Fall Risk Assessment and Intervention
Post-op patient with a high Morse Fall Score — implementing the fall bundle and communicating the plan.
Evelyn Harris, 91
★★☆☆☆Wound Assessment — Pressure Injury Staging
Staging a coccyx wound and implementing a prevention bundle in a bedbound patient.
All scenarios are available in the app.
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