Each case presents a real patient scenario with 6–7 linked clinical-judgment questions — exactly the NCSBN April 2026 NGN format. Bow-tie, matrix, cloze, trend, and extended-response items across all 6 CJMM layers.
The nurse is performing an assessment on Mr. Jennings, a 71-year-old male on post-operative day 2 following emergency bowel resection. Which clinical FINDINGS from the nurse's assessment are most consistent with acute kidney injury (AKI) and require immediate intervention?
The nurse is assessing a 38-year-old female with known Graves' disease following appendectomy. She stopped taking propylthiouracil (PTU) 3 weeks ago. Which clinical findings are MOST consistent with thyroid storm (thyrotoxic crisis)?
James Washington is a 67-year-old male with 12-year history of CKD from T2DM and hypertension, on three-times-weekly hemodialysis. He missed Wednesday and Friday sessions and presents Sunday with dyspnea and bilateral leg swelling. Medications: amlodipine 10 mg, carvedilol 25 mg BID, sevelamer 1600
Priya Patel is a 34-year-old with autoimmune Addison's disease on hydrocortisone 20 mg AM/10 mg PM and fludrocortisone 0.1 mg daily. She presents via EMS after her husband found her unresponsive. She had nausea, vomiting, and diarrhea for 3 days and could not keep any medications down. She did NOT f
Derek Williams is a 22-year-old male found unresponsive at a party where friends report he used alcohol and MDMA and danced intensely for hours in a warm room without adequate water. Alert but confused on EMS arrival. Severe diffuse muscle pain, unable to walk. Vital signs: BP 92/60, HR 126, RR 20,
Miriam Goldstein is a 72-year-old female who presents to the ED with severe pain in her right eye for 4 hours, blurry vision, and a horrible headache with nausea. She vomited twice at home. PMH: Hypertension (metoprolol 50 mg daily), hyperopia corrected with +4.5 OD lenses. Currently taking OTC diph
Josephine Carter is a 29-year-old G3P2 female at 34+4 weeks gestation admitted for painless vaginal bleeding. She reports waking from sleep with 'a gush of bright red blood' that soaked two pads within 15 minutes. No contractions, no pain, no rupture of membranes. Prior two cesarean deliveries (both
Tobias Freeman is a 41-year-old male construction worker brought in by EMS after a partial building collapse entrapped his bilateral lower extremities under heavy concrete debris for approximately 3.5 hours before rescue. EMS: BP 88/52 pre-extrication; HR 128; 2 large-bore IVs placed; 2L NS bolused.
Mr. Washington, 61-year-old male with CKD Stage 4 (GFR 22 mL/min), T2DM, and HTN, presents to the nephrology clinic for his quarterly visit. He reports fatigue, decreased appetite, leg cramps at night, and difficulty concentrating. Labs: creatinine 4.2 mg/dL (up from 3.8 three months ago), BUN 68, K
Mrs. Walsh, 78F with gastroenteritis-induced AKI on ACEi/HCTZ/metformin. Fluid resuscitation, medication holds, dilutional hyponatremia.
Mr. Rivera, 54M with alcoholic cirrhosis, SBP, encephalopathy. Ceftriaxone, IV albumin, dilutional hyponatremia.
Ms. Ng, 38F with ACTH-secreting microadenoma. Surgery, post-op cortisol replacement, sick-day rules, adrenal crisis.
The preoperative client is visibly anxious 2 hours before surgery and expresses fear about not waking up from anesthesia.
Case studies + traditional questions + full rationales — $29 one-time, 30-day access.
Get Full Access — $29