…Our Simulation
Catalog…3rd edition
What is available?
A compendium of Available Scenarios, with descriptions…
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Index of Cases, By Type
NLN Simulation in Nursing Education,
Volume 1 Scenarios:
(1) Surgical Core (a) and Complex (b) Cases
1a. Postoperative Hemicolectomy—Preventing Respiratory Complications
1b. Postoperative Hemicolectomy—Pulmonary Embolism
2a. Lower Leg Fracture –Basic Assessment
2b. Lower Leg Fracture –Compartment Syndrome
3a. Preoperative Bowel Obstruction --Spiritual Needs
3b. Preoperative Bowel Obstruction --Fluid & Electrolyte Imbalance
4a. Immediate Postoperative Abdominal Hysterectomy -- Managing Nausea
4b. Immediate Postoperative Abdominal Hysterectomy -- Opioid Intoxication
5a. Postoperative Hip Arthroplasty --Blood Transfusion
5b. Postoperative Hip Arthroplasty --Blood Transfusion Reaction
(3) Medical Core (a) & Complex (b) Cases
6a. Acute Strep Throat ---Mild Reaction to Antibiotic
6b. Pneumonia -- Severe Reaction to Antibiotic
7a. Mild Asthma
7b. Severe Asthma
8a. Chronic Obstructive Pulmonary Disease -- Oxygen Therapy
8b. Chronic Obstructive Pulmonary Disease -- Spontaneous Pneumothorax
9a. Angina
9b. Acute Myocardial Infarction
10a. Diabetic -- Insulin Administration
10b. Diabetic -- Hypoglycemia
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NLN Simulation in Nursing Education,
Volume 2 Scenarios:
(1) Spinal Cord Injury (SCI)
(1A) Spinal Cord Injury (SCI) -- Skin Assessment
(1B) Spinal Cord Injury (SCI) -- Autonomic Dysreflexia
(2) Cerebral Vascular Accident (CVA)
(2A) Cerebral Vascular Accident (CVA)—Aspiration
(2B) Cerebral Vascular Accident (CVA) – Ischemic Stroke
(3) AICD
(3A) AICD --Malfunction
(3B) AICD --Misfiring
(4) Congestive Heart Failure (CHF)
(4A) Congestive Heart Failure (CHF)—Medication Management
(4B) Congestive Heart Failure (CHF) -- Overload
(5) Sickle Cell Anemia (HbSS)
(5A) Sickle Cell Anemia (HbSS)—Mild Acute Exacerbation
(5B) Sickle Cell Crisis (HbSS) –Acute Chest Syndrome
(6) Altered Renal Function
(6A) Renal Colic – Pain Management
(6B) Acute Kidney Injury
(7) Gastrointestinal Bleeding
(7A) Gastrointestinal Bleeding -- Assessment & Patient Teaching
(7B) Gastrointestinal Bleeding -- Ethical Considerations
(8) Pancreatitis
(8A) Pancreatitis –Assessment & Symptom Management
(8B) Pancreatitis –Hemodynamic & Respiratory Instability
(9) Hip Fracture
(9A) Hip Fracture—Impaired Mobility
(9B) Hip Fracture – Altered Mental Status
(10) Liver Cirrhosis
(10A) Liver Cirrhosis – Patient –Family Teaching
(10B) Liver Cirrhosis –End Stage Disease
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OTHER Simman Scenarios, Synopses
(1) VF 1
ALS Simulator scenarios. Patient had no prior complaints when he suddenly collapsed. In
hospital scenario: A visitor collapses near the cafeteria. When the student arrives, some basic
care has been established. Clinical Signs Immediately Visible: (1) No movement, (2) Appears
unconscious, (3) cyanotic, (4) appears to be in good physical condition, (5) Initial treatment
has included starting an IV, (6) SpO2=74%.
(2) Acute Asthma
This case presents a patient with a history of asthma who is in acute respiratory distress. The
participant must quickly identify the critical nature of this case and initiate appropriate management
strategies. Delayed or incorrect management will result in clinical deterioration up to and including
cardiopulmonary arrest. Appropriate treatment includes administration of oxygen, Bet2 agonists, and
corticosteroids. Given the natural history of severe status asthmaticus, even an appropriately treated
patient might suffer clinical deterioration before treatment takes effect.
(3) NRP Program Scenario: Resuscitation with Bag and Mask and
Oxygen
This case presents a complicated pregnancy (pregnancy-induced hypertension) with fetal
heart rate decelerations. The focus of this case is specifically on the ventilation component of
newborn resuscitation. Learners are expected to be familiar with the setup and proper use of
the type of ventilation device used locally.
(4) Emergency preparedness Scenario: Terrorism: Improvised
Explosive Device
This case presents a 21 year old male trauma casualty secondary to the detonation of an
improvised explosive device at a local café. The casualty is conscious, alert, and responsive, with
a penetrating chest injury in the right midclavicular area. The casualty is complaining of
shortness of breath and chest pain. Responder Personal Protective Equipment (PPE) must be
donned prior to entering the incident area. Responders should provide oxygenation, secure
open chest wound with occlusive dressing, and manage the pneumothorax. The casualty should
be triaged ‘immediate,’ and a trauma alert should be issued, followed by supportive care and
transportation.
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(4) Emergency preparedness Scenario: Terrorism: Nerve Agent
This scenario presents a 16 year old male casualty of a nerve agent attack. The casualty is
found outside a mall entrance and amongst a large group of individuals in a parking lot. The
casualty is conscious, alert, and ambulatory, complaining of running nose and dim vision.
Responder personal Protective Equipment (PPE) (level C or greater) must be donned prior to
entering the incident area. Casualty must be immediately treated with Mark I nerve agent
antidote kit, followed by supplemental oxygen. The casualty should be triaged ‘delayed’ and
moved to an ambulatory decontamination area followed by supportive care and transportation.
NLN Simulation in Nursing Education,
Volume 1 Scenario Synopses:
Surgical Core Case 1A: Lower Leg Fracture -- Basic Assessment
This case presents a patient that has sustained an injury to her left lower leg with a resultant fracture.
The student will be expected to perform a basic assessment including vital signs and pain scale, manage
pain, and communicate findings to the emergency department charge nurse.
Surgical Complex Case 1B: Lower Leg Fracture --Compartment Syndrome
This case presents a post - surgical repair of an open reduction (ORIF) of a left tib-fib fracture. The
student will be expected to conduct a basic assessment including a pain scale, recognize complications
(compartment syndrome), and intervene appropriately.
Surgical Core Case 2A: Preoperative Bowel Obstruction -- Spiritual Needs
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This case presents a preoperative patient who needs to be prepared for impending surgery. The
patient is requesting a spiritual priesthood blessing. The surgeon is anxious to get the patient to surgery
as soon as possible. The student will be expected to provide basic preoperative care, as well as advocate
for the patient’s spiritual needs.
Surgical Complex Case 2B: Preoperative Bowel Obstruction -- Fluid & Electrolyte Imbalance
This case presents a preoperative patient who presents to the Emergency Department with severe
dehydration. The symptoms of dehydration are related to poor intake of fluids by mouth and reflux
vomiting (small bowel obstruction). The student will be expected to demonstrate basic assessment to
detect symptoms of severe dehydration and impending hypovolemic shock, notify the physician
immediately and provide the appropriate treatment.
Surgical Core Case 3A: Immediate Postoperative Abdominal Hysterectomy -- Managing Nausea
This case presents a postoperative patient in the post anesthesia care unit (PACU). The patient has
just arrived in the PACU. The student will be expected to address safety concerns and perform basic
assessment. The patient will be complaining of nausea and pain. The student will be expected to
address these complaints and manage them appropriately.
Surgical Complex Case 3B: Immediate Postoperative Abdominal Hysterectomy -- Opioid Intoxication
This case presents an immediate postoperative patient who develops respiratory depression. The
student will be expected to provide the basic standard care with regard to patient safety and infection
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control, as well as a thorough patient assessment. The student will be required to manage pain and
recognize morphine induced respiratory depression, and manage this potential complication efficiently
and effectively.
Surgical Core Case 4A: Postoperative Hemicolectomy -- Preventing Respiratory Complications
This case presents a postoperative patient. The student will be expected to perform a respiratory
assessment, assess pain level, identify the need for incentive spirometry, and provide patient education
on preventing respiratory complications.
Surgical Complex Case 4B : Postoperative Hemicolectomy -- Pulmonary Embolism
This case presents a postoperative patient that has been noncompliant with ambulation and incentive
spirometry use. This patient unexpectedly experiences respiratory complications associated with
pulmonary embolism. The student will be expected to provide post operative care, recognizing and
managing critical respiratory complications.
Surgical Core Case 5A: Postoperative Hip Arthroplasty -- Blood transfusion
This case presents a day 2 postoperative hip arthroplasty patient who is requiring 2 units of packed
red blood cells. The student will be expected to demonstrate basic care and perform the blood
administration safely.
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Surgical Complex Case 5B:
Postoperative Hip Arthroplasty -- Blood Transfusion Reaction
This case presents a postoperative hip arthroplasty patient who will receive 2 units of packed red
blood cells due to blood loss from surgery. The student will be expected to demonstrate basic care,
perform the administration of blood, recognize reaction to the blood transfusion, and respond
appropriately.
Medical Core Case 6A: Acute Strep Throat -- Mild Reaction to Antibiotic
This case presents a patient with a diagnosed strep throat infection. The patient has an unknown
allergy to penicillin. The scenario calls for the student to administer Penicillin. The patient will develop a
moderate allergic reaction to the Penicillin. The student will be expected to provide the basic standard
care with regard to administration of the medication, as well as evaluation and recognition of signs and
symptoms of an allergic response. Once the allergic reaction is recognized, the student is expected to
promptly notify the primary care provider and treat the patient according to protocol.
Medical Complex Case 6B: Pneumonia -- Severe Reaction to Antibiotic
This case presents a patient that has known allergies to penicillin. The patient will have a severe
anaphylactic reaction to IV Ceftriaxone (Rocephin) that has been ordered to treat pneumonia. The
student will be expected to provide the basic standard care with regard to administration of the IVPB
medication, as well as evaluation and recognition of signs and symptoms of a severe allergic response
with prompt notification to primary care provider and rapid emergency treatment.
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Medical Core Case 7A: Mild Asthma
This case presents a patient in moderate respiratory distress. The patient has a history of asthma.
The student will be expected to demonstrate basic standard care with regard to safety and infection
control, as well as perform a focused respiratory assessment. Student will also be expected to provide
appropriate treatment of respiratory distress.
Medical Complex Case 7B: Severe Asthma
This case presents a patient in acute respiratory distress. The patient has a history of asthma. The
student will be expected to quickly recognize acute respiratory distress with impending respiratory
arrest. The student needs to communicate effectively, and promptly initiate a coordinated team
approach to patient management and care.
Medical Core Case 8A: Chronic Obstructive Pulmonary Disease -- Oxygen Therapy
This case presents a patient with chronic obstructive pulmonary disease, who is in moderate to severe
respiratory distress. The student will be expected to provide the standard of care related to patient
safety and infection control, communicate appropriately, initiate a respiratory assessment, and provide
appropriate interventions.
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Medical Complex Case 8B: Chronic Obstructive Pulmonary Disease –
Spontaneous Pneumothorax
This case presents a patient admitted to a medical unit for chronic obstructive pulmonary disease
(COPD). He has been stable for several hours following administration of bronchodilators. He suddenly
experiences profound respiratory distress due to spontaneous pneumothorax caused by a ruptured
bullae. The student will be expected to recognize this potential complication, notify the physician, and
provide appropriate interventions, including preparing to assist with chest tube insertion.
Medical Core Case 9A: Angina
This case presents a patient in the Emergency Department, who is complaining of chest pain. The
student will be expected to follow the local facility protocol for the treatment of chest pain suggestive of
ischemia.
Medical Complex Case 9B: Acute Myocardial Infarction
This case presents an angina patient that is being monitored on the telemetry unit. The patient
suddenly develops increasing pain which progresses to cardiac arrest with a presenting rhythm of
ventricular fibrillation (VF). The student will be expected to follow local facility protocol for the
treatment of cardiac arrest (VF) within their scope of practice.
Medical Core Case 10A: -- Insulin Administration
This case presents an adolescent male who has been newly diagnosed with diabetes type 1. He has
been treated for diabetic ketoacidosis in the Intensive Care Unit. He was managed for rehydration,
restoring electrolytes and managing blood glucose levels. He is now stable and has been transferred to a
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Medical Unit for continued blood glucose control and diabetic education before discharge to home. The
student will be expected to administer his morning insulin and reinforce diabetic teaching.
Medical Complex Case 10B: -- Hypoglycemia
This case presents a recently diagnosed type 1 diabetic adolescent that presents to the Emergency
Department with symptoms of hypoglycemia. The student is expected to recognize symptoms of
hypoglycemia and treat appropriately. The student is also expected to maintain confidential patient
information.
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NLN Simulation in Nursing Education,
Volume 2 Scenario Synopses:
Scenario 1A: Spinal Cord Injury: Skin Assessment
This case presents a patient admitted eight days ago to the Progressive Care Unit from the Neuro
Intensive Care Unit. The patient experienced a complete C5 injury 18 days ago. The student is expected
to perform a focused neurological assessment including skin assessment, demonstrate correct
positioning and recognize signs of a potential pressure ulcer.
Scenario 1B: Spinal Cord Injury: Autonomic Dysreflexia
This scenario presents the student(s) with a spinal cord injury that recently transferred to a
rehabilitation facility. The patient has a kinked urinary catheter and is now presenting with signs and
symptoms of autonomic dysreflexia (AD). The student(s) is expected to perform rapid assessment
recognizing signs and symptoms of autonomic dysreflexia caused by a distended bladder and implement
emergency treatment in a timely manner.
Scenario 2A: Cerebrovascular Accident -- Aspiration
This case presents the student(s) with a patient 24 hours post cerebral vascular accident (CVA). The
patient experiences aspiration related to dysphagia because of inappropriate feeding by family member.
The student(s) is expected to recognize the potential complication, conduct a rapid focused assessment
and provide emergency treatment.
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Scenario 2B: Cerebral Vascular Accident -- Ischemic Stroke
This case presents the student(s) with a patient who has recently experienced a cerebral vascular
accident (CVA). The student(s) will be expected to perform a rapid assessment recognizing signs and
symptoms of an acute ischemic stroke. The student(s) will also be expected to obtain a focused patient
history, perform a complete neurological assessment, implement emergency care, and identify if patient
is a candidate for thrombolytic therapy treatment in a timely manner.
Scenario 3A: AICD -- Malfunction
This case presents the student(s) with a patient with an internal pacemaker / defibrillator (AICD) that
is presenting to the emergency department with sudden onset of syncope. The student will be expected
to obtain a patient history, perform a focused cardiac and pulmonary assessment, recognize pacemaker
malfunction then prepare the patient for pacemaker replacement including obtaining informed consent.
Scenario 3B: AICD -- Firing
This case presents the student with a patient who came to the emergency room with intermittent
severe pain because of misfiring of her internal pacemaker / defibrillator. The pacemaker defibrillator
has fired 6 times in the last 2 hours. The student is expected to obtain a detailed history, perform an
assessment, initiate cardiac and respiratory monitoring, reassure and calm the patient, and provide
proper management and care.
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Scenario 4A: Congestive Heart Failure -- Medication Management
This scenario presents a patient with a history of congestive heart failure (CHF). The patient has been
admitted to the medical unit and is now in hospital day 2. The student will be expected to perform
cardiac assessment, recognize orthostatic conditions, hold medication, communicate findings to primary
care provider and provide proper management and care.
Scenario 4B: Congestive Heart Failure -- Overload
This scenario presents a patient with a history of congestive heart failure (CHF). The patient has been
admitted to the intensive care unit directly from his physician’s office this a.m. because of severe
dyspnea and orthopnea. The student will be expected to perform a cardiac and pulmonary assessment,
evaluate lab data, recognize lack of response to treatment, communicate findings to the primary care
provider, and provide proper management and care including administration of Natrecor.
Scenario 5A: Sickle Cell Anemia -- Mild Acute Exacerbation
This case presents a sickle cell anemia (HbSS) patient in acute pain. The student will be expected to
perform a general assessment, perform pain assessment and observe for potential complications. The
student will be expected to provide education on alternative pain management strategies, identify the
need for incentive spirometry, and provide patient education on preventing respiratory complications.
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Scenario 5B: Sickle Cell Crisis -- Acute Chest Syndrome
This case presents a sickle cell anemia (HbSS) patient admitted with acute pain episode who has had
difficulty controlling pain. He unexpectedly develops a fever of 38.4*C (101.2*) orally and hypoxemia on
day 3 of his hospitalization. The student will be expected to provide acute assessment and care
recognizing a deteriorating patient requiring nursing and medical intervention.
Scenario 6A: Renal Colic --Pain Management
This case presents the student with a patient presenting to the emergency room with severe pain
related to renal colic. The student will be expected to obtain a detailed patient history, perform a pain
assessment, and manage pain appropriately.
Scenario 6B: Acute Kidney Injury
This case presents the student with a patient admitted to the medical unit for pain management
related to renal colic. The patient will display signs of acute kidney injury with symptoms of sudden
onset of oliguria. The student will be expected to promptly recognize oliguria as a sign of acute kidney
injury and implement correct treatment to minimize kidney damage.
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Scenario 7A: Gastrointestinal Bleeding -- Assessment and patient teaching
This case will present the student with a patient who presents with severe epigastric pain, tarry stools,
and coffee ground emesis. The patient is self medicated with ibuprofen and aspirin. The student will be
expected to obtain patient history, recognize gastrointestinal bleeding, manage patient care and provide
patient teaching.
Scenario 7B: Gastrointestinal Bleeding -- Ethical considerations
This case presents the student with a patient with acute upper gastrointestinal bleeding. The student
will be expected to perform an assessment, evaluate lab data, recognize the need for blood transfusion,
obtain informed consent , and manage a patient refusing to receive blood because of religious faith.
Scenario 8A: Pancreatitis -- Assessment and Symptom Management
This case presents the student with a 46 year old female patient admitted to the progressive care unit
for acute pancreatitis. The patient has no history of alcohol use / abuse and a biliary tract disease is
suspected. The patient is in acute pain and is nauseated. The student is expected to perform an
assessment, evaluate lab data, manage acute pain and nausea, and perform patient care.
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Scenario 8B: Pancreatitis -- Hemodynamic and Respiratory Instability
This case presents the student with a 46 year old female patient admitted 2 days ago to the
progressive care unit for acute biliary pancreatitis. The patient has no history of alcohol use / abuse. The
patient is treated with fluids, antiemetic, and opiate analgesics for pain. Patient is complaining of
respiratory difficulty. The student is expected to perform a patient assessment, evaluate drawn labs,
notify primary car provider of patient symptoms and lab values. And initiate correct treatment
Scenario 9A: Hip Fracture -- Impaired Mobility
This case presents the student with an 80 year old female who suffered a femoral neck fracture as a
result of a trip and fall injury in her home. Surgry is planned for the following day and the patient is
awaiting a medical evaluation. The student will be expected to perform an assessment, provide pain
management, assist the patient on the bedpan, and conduct a thorough skin assessment.
Scenario 9B: Hip Fracture -- Altered Mental Status
This case will present the student with an 80 year old female who has suffered a femoral neck fracture
as a result of a trip and fall in her home 3 days ago. She has been alert and oriented since admission.
She has been placed on a PCA analgesia pump for pain management. She is now confused, with periods
of combativeness. The student will be expected to perform an assessment, recognize misuse of the PCA,
initiate correct action, and provide family teaching regarding use of the PCA pump.
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Roseman University of Health Science | South Jordan Campus March 2011
Scenario 10A: Liver Cirrhosis -- Patient-family teaching
This case presents the student with a patient with chronic liver disease admitted to the unit with
complaints of bleeding from the gums, and confusion. The patient has a long history of alcohol abuse
and has been disabled. He appears jaundiced, with mild ascites. The student will be expected to conduct
a complete history, perform a neurological examination, evaluate lab data, and provide appropriate care
including patient and family teaching.
Scenario 10B: Liver Cirrhosis -- End Stage Disease
This case will present the student with end stage liver disease. The patient’s wife is present and
questioning liver transplant options. The student is expected to provide information and manage
different options regarding organ transplant as well as quality of life issues to a non-compliant patient.
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