Student activity
The case, a patient snapshot, a recognize-cues worksheet and every item with space for reasoning, in Word.
Curriculum
33 cases that build clinical judgment, step by step
A complete, ready-to-teach clinical judgment curriculum. Each case gives students a patient who feels real, competing needs to sort by urgency and decisions to make, with the documents and scored items faculty need to teach and assess it.
33Cases
6Units
228Clinical judgment items
32Patient charts
BedsideLab · Activity library
What’s in a case
Everything you need to teach it, in one package
No preparation from scratch. Assign a case and students can start in minutes.
Faculty answer key
The keys, rationales and model answers for every item, visible to staff only.
A full patient chart
The training EHR the case is built on, starting with the handoff report.
Auto-scored items
Objective items are scored when students save; open responses are graded by faculty.
The full case list
Six units, from noticing cues to leading care
Cases build from communication and noticing cues to acting in emergencies and working in teams. Each names its level, its number of items and its patient.
Communication and noticing cues
Therapeutic communication, hard news, culturally responsive teaching, interpreters and de-escalation.
Perinatal Loss: Therapeutic Communication After a Stillbirth
Review the chart and handoff report of a 39-year-old patient who delivered a stillborn son overnight. Decide how to respond verbally and non-verbally as her primary nurse, while still watching for postpartum complications.
Apply/Analyze8 itemsHana Kareem, 39 yInpatientReproductivePsychosocial
Hard News: Responding to a New Lung Cancer Diagnosis
A 58-year-old man has just been told he has metastatic lung cancer. Respond therapeutically to his questions, and notice the new physical complaint that could be an oncologic emergency.
Apply/Analyze7 itemsDaniel Okafor, 58 yInpatientRespiratoryOncology
Faith, Fasting and Diabetes: Culturally Responsive Teaching Before Ramadan
A 52-year-old man with type 2 diabetes on insulin and a sulfonylurea plans to fast during Ramadan. Assess his risk, respect his decision, and build a safe fasting plan with him.
Evaluate/Create7 itemsKhalid Al-Harbi, 52 yOutpatientEndocrineCultural care
Lost in Translation: Discharge Teaching with an Interpreter
A 71-year-old Spanish-speaking woman with new atrial fibrillation is going home on warfarin. Use a professional interpreter, find the medication and safety risks in her chart, and confirm understanding with teach-back.
Apply/Analyze7 itemsRosa Delgado, 71 yInpatientCardiovascularOlder adult
Calm in the Storm: De-escalation in Alcohol Withdrawal
A 46-year-old man admitted with pancreatitis becomes agitated, tremulous and frightened on day 3. Use de-escalation, recognize alcohol withdrawal delirium, and act on the withdrawal protocol safely.
Apply/Analyze7 itemsMark Jensen, 46 yInpatientNeurologicalMental health
Analyzing cues and prioritizing
Recognizing deterioration early: sepsis, heart failure, DKA, stroke and hyperkalemia.
Spinal Cord Injury: Prioritizing Care for an Adolescent with Tetraplegia
Review the chart and handoff of a 17-year-old with a C6 spinal cord injury in inpatient rehabilitation. List and prioritize her nursing problems, find the concerns in the admission assessment, and respond when she develops a pounding headache.
Apply/Analyze7 itemsEmily Tran, 17 yInpatientNeurologicalMusculoskeletal
The Quiet Slide: Recognizing Early Sepsis After Surgery
On postoperative day 2 after a colectomy, a 63-year-old man is "just a bit off." Connect subtle changes in vital signs, mentation, urine output and labs, escalate, and start the sepsis bundle.
Apply/Analyze7 itemsAhmed Siddiqui, 63 yInpatientGastrointestinalInfection
Breathless at Night: Acute Decompensated Heart Failure
A 74-year-old man with heart failure is admitted after a family wedding and running out of his diuretic. Prioritize his problems, catch a medication safety issue on day 2, and evaluate his response to diuresis.
Apply/Analyze7 itemsPeter Novak, 74 yInpatientCardiovascularOlder adult
Fruity Breath: Diabetic Ketoacidosis in a Teenager
A 15-year-old with type 1 diabetes stopped his insulin during a stomach virus. Recognize DKA, prioritize fluids, insulin and potassium safely, and watch for cerebral edema.
Apply/Analyze7 itemsEthan Park, 15 yEmergencyInpatientEndocrine
Time Is Brain: Acute Ischemic Stroke in the Emergency Department
A 68-year-old woman arrives with sudden right-sided weakness and trouble speaking. Use the last-known-well time, screen for thrombolysis, lower her blood pressure to a safe range, and protect her airway.
Apply/Analyze6 itemsMargaret O'Neill, 68 yEmergencyNeurologicalOlder adult
A Dangerous Combination: Acute Kidney Injury and Hyperkalemia
A 79-year-old man on an ACE inhibitor and spironolactone took ibuprofen for gout during a bout of diarrhea. His potassium is 6.8 with ECG changes. Find the causes, give treatment in the right order, and evaluate the result.
Apply/Analyze7 itemsGeorge Mitchell, 79 yInpatientRenalCardiovascular
Taking action in acute situations
Hemorrhage, magnesium safety, opioid-induced respiratory depression, transfusion reactions, anaphylaxis, hypoglycemia, asthma and PE.
The First Hour: Postpartum Hemorrhage
Forty minutes after delivering a 4.3 kg baby, a 31-year-old mother has a boggy uterus and heavy bleeding. Act in the right order, choose uterotonics safely for her history, and evaluate the response.
Apply/Analyze7 itemsAna Ferreira, 31 yInpatientReproductiveMaternal
Preeclampsia with Severe Features: Magnesium Sulfate Safety
A 28-year-old at 34 weeks has severe-range blood pressure, a headache and low platelets. Recognize the severe features, give antihypertensive treatment and magnesium safely, and catch magnesium toxicity.
Apply/Analyze7 itemsAisha Bello, 28 yInpatientReproductiveMaternal
Too Quiet at 03:00: Opioid-Induced Respiratory Depression
On the night after surgery, a 58-year-old woman with sleep apnea on a hydromorphone PCA is hard to wake with slow, shallow breathing. Identify the risk factors, rescue her, and prevent recurrence.
Apply/Analyze7 itemsLinda Thompson, 58 yInpatientRespiratorySurgical
Fifteen Minutes In: Acute Transfusion Reaction
A 45-year-old woman with a GI bleed develops chills, fever, back pain and hypotension 15 minutes into a red cell transfusion. Stop the reaction, recognize the type, and find the safety failure.
Apply/Analyze7 itemsFarah Haddad, 45 yInpatientHematologicGastrointestinal
Minutes Matter: Anaphylaxis to an IV Antibiotic
Five minutes into his first dose of ceftriaxone, a 34-year-old man develops hives, throat tightness, wheezing and hypotension. Give epinephrine first, support him, and plan for a biphasic reaction.
Apply/Analyze7 itemsJamal Washington, 34 yInpatientImmunologicRespiratory
Shaky and Confused: Hypoglycemia in a Hospitalized Older Adult
An 81-year-old woman who was NPO for a procedure is found sweaty and confused at 10:15. Treat severe hypoglycemia correctly when she cannot swallow safely, then trace the system causes.
Apply/Analyze6 itemsDorothy Evans, 81 yInpatientEndocrineOlder adult
Every Breath Counts: Asthma Exacerbation in a School-Age Child
An 8-year-old arrives in the emergency department with wheezing and retractions after a cold. Assess severity, give treatment in order, recognize the danger of a "quiet chest," and teach an asthma action plan.
Apply/Analyze7 itemsLeo Martinez, 8 yEmergencyRespiratoryPediatric
Sudden Breathlessness: Pulmonary Embolism After Hip Replacement
On postoperative day 3 after a hip replacement, a 66-year-old woman who refused her anticoagulant injections suddenly becomes short of breath. Recognize a pulmonary embolism and act, and plan how the refusal should have been handled.
Apply/Analyze7 itemsHelen Carter, 66 yInpatientRespiratoryCardiovascular
Patient-centered care and teaching
Shared decision-making, ostomy teaching, polypharmacy and falls, and newborn jaundice.
Shared Decision-Making in Hypertension and Kidney Disease, Part 1: Understanding the Person
A 61-year-old taxi driver has uncontrolled blood pressure and newly diagnosed stage 3b chronic kidney disease. Using the QSEN competency of patient-centered care, uncover his values, preferences, health literacy and barriers before any plan is made.
Evaluate/Create7 itemsSamuel Mensah, 61 yOutpatientCardiovascularRenal
Shared Decision-Making in Hypertension and Kidney Disease, Part 2: Building the Plan Together
Return to Samuel Mensah's chart. Recreate his encounter with the health care team using a patient-centered approach: weigh options against his priorities, write SMART goals with him, and evaluate the plan at follow-up.
Evaluate/Create6 itemsSamuel Mensah, 61 yOutpatientCardiovascularRenal
A New Ileostomy: Teaching Self-Care Before Discharge
A 41-year-old woman with Crohn's disease has a new ileostomy. Assess the stoma, notice the early signs of dehydration from high output, and plan teaching that addresses her readiness and her body image.
Apply/Analyze7 itemsMegan O'Brien, 41 yInpatientGastrointestinalMid-adult
Too Many Pills: Polypharmacy and Falls in an Older Adult
An 84-year-old woman admitted after a fall takes 13 medications. Find the medicines that raise her fall risk, interpret orthostatic vital signs and her low sodium, and lead a patient-centered deprescribing conversation.
Evaluate/Create7 itemsEdith Kowalski, 84 yInpatientOlder adultNeurological
Yellow on Day 3: Newborn Jaundice and Breastfeeding Support
A 3-day-old exclusively breastfed newborn has rising bilirubin, 9% weight loss and few wet diapers, and his first-time mother has sore nipples. Interpret the findings, deliver phototherapy safely, and support breastfeeding.
Apply/Analyze7 itemsBaby Boy Okoro, 3 daysInpatientNewbornPediatric
Mental health, safety and ethics
Suicide risk, lithium toxicity, dementia care without restraints, goals of care and intimate partner violence.
Asking the Hard Question: Suicide Risk After an Intentional Overdose
A 22-year-old student is in the emergency department after an intentional acetaminophen overdose. Treat the medical emergency, assess suicide risk directly and compassionately, and keep her safe.
Apply/Analyze7 itemsSara Lindqvist, 22 yEmergencyMental healthPsychosocial
Narrow Margin: Lithium Toxicity in Bipolar Disorder
A 49-year-old man stable on lithium for years develops vomiting, coarse tremor and confusion after a new diuretic, an NSAID and a stomach bug. Recognize toxicity, act, and teach to prevent it.
Apply/Analyze6 itemsThomas Reid, 49 yInpatientMental healthNeurological
Person-Centered Dementia Care: Agitation Without Restraints
An 86-year-old man with Alzheimer's disease and a urinary tract infection becomes agitated every evening, tries to leave "to go to work," and strikes out during care. His son asks for restraints. Find the unmet needs and create a person-centered plan.
Evaluate/Create7 itemsArthur Bennett, 86 yInpatientNeurologicalMental health
Honoring Her Wishes: Goals of Care at the End of Life
A 77-year-old woman with metastatic pancreatic cancer is dying. Her advance directive declines life support, her daughter is her health care proxy, and her son wants "everything done." Recognize the dying process, manage symptoms, and support an ethical family conversation.
Evaluate/Create7 itemsMiriam Feldman, 77 yInpatientOncologyPalliative care
Behind Closed Doors: Recognizing Intimate Partner Violence in Pregnancy
At a 24-week prenatal visit, a 27-year-old woman has bruises at different stages of healing, a partner who answers for her, missed appointments and a positive depression screen. Create a private space, ask, document and plan for safety.
Apply/Analyze7 itemsNatalie Brooks, 27 yOutpatientReproductiveMaternal
Transitions, teams and systems
Medication costs after discharge, early warning scores and SBAR, delegation, and infection prevention.
Can He Afford to Recover? Medication Costs After a Heart Attack
A 56-year-old rideshare driver with a high-deductible plan is going home after a stent with six new prescriptions. Estimate his monthly costs from the chart, find resources, decide which medicine he must never stop, and plan for adherence.
Evaluate/Create7 itemsRafael Gomez, 56 yInpatientCardiovascularMid-adult
Speaking Up: Early Warning Scores, SBAR and the Chain of Command
A 70-year-old man with pneumonia is deteriorating at 02:00. Calculate his NEWS2 score, write an SBAR, and know what to do when the on-call physician says to "keep an eye on him."
Evaluate/Create7 itemsWalter Brooks, 70 yInpatientRespiratoryInfection
Five Patients, One Shift: Delegation and Prioritization on a Busy Unit
You have five patients on a medical-surgical unit, an LPN and a nursing assistant. Decide whom to see first, what to delegate to whom, and how to communicate a clear delegation.
Apply/Analyze7 itemsGloria Mendes, 68 yInpatientMusculoskeletalTeamwork
Breaking the Chain: Clostridioides difficile and Infection Prevention
A 72-year-old man on antibiotics and a proton pump inhibitor develops profuse diarrhea and tests positive for C. difficile. Implement the right precautions, catch an unsafe practice, and teach his family.
Apply/Analyze7 itemsVincent Russo, 72 yInpatientGastrointestinalInfection
The final unit
From one patient to the whole unit
The course ends where nursing practice gets most complex: transitions of care, speaking up, delegating across a full assignment and protecting every patient on the unit.
Case 30 · Can He Afford to Recover? Medication Costs After a Heart Attack
A 56-year-old rideshare driver with a high-deductible plan is going home after a stent with six new prescriptions. Estimate his monthly costs from the chart, find resources, decide which medicine he must never stop, and plan for adherence.
Case 31 · Speaking Up: Early Warning Scores, SBAR and the Chain of Command
A 70-year-old man with pneumonia is deteriorating at 02:00. Calculate his NEWS2 score, write an SBAR, and know what to do when the on-call physician says to "keep an eye on him."
Case 32 · Five Patients, One Shift: Delegation and Prioritization on a Busy Unit
You have five patients on a medical-surgical unit, an LPN and a nursing assistant. Decide whom to see first, what to delegate to whom, and how to communicate a clear delegation.
Case 33 · Breaking the Chain: Clostridioides difficile and Infection Prevention
A 72-year-old man on antibiotics and a proton pump inhibitor develops profuse diarrhea and tests positive for C. difficile. Implement the right precautions, catch an unsafe practice, and teach his family.
Make it yours
Adapt every case to your syllabus
The built-in cases are a starting point, not a limit. Review each key against your local policies, and change anything you need with the activity builder.
- Edit the scenario, items, keys and rationales
- Write your own items of all eight types
- Replace activity documents and answer keys with your own
- Edit or duplicate any patient chart, or build a new one
- Assign the same case to different sections at different times
- Use practice mode, and individual or team work
Ready to run these cases with your students?
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