Open Education Resources for Nursing
These scenarios are licensed under a Creative Commons CC BY 4.0 license so are free and openly available for faculty to use, adapt or modify. They can be used in Acadicus or adapted for all types of simulation learning experiences. When using or adapting an Open RN VR Scenario Plan for use at your institution, please include an attribution statement according to CC BY licensing.
Administering Cardiac Medications to a Patient with Dementia
Miles Johnson is an 87 year old resident of Shady Acres rehabilitation facility. He has a past medical history of dementia, hypertension, atrial fibrillation, and chronic renal failure. Students must perform appropriate assessments prior to safely administering cardiac medication while also communicating therapeutically with a patient with dementia.
Addressing Safety Hazards
Miles Johnson is an 87 year old resident of a rehabilitation facility who was admitted for daily physical therapy after undergoing surgery for a hip fracture. He has a past medical history of dementia, hypertension, atrial fibrillation, and chronic renal failure. He walks with the assistance of one with a walker and requires assistance with ADLs. Students must identify and resolve safety hazards in Miles’ room while also communicating therapeutically with him.
Caring for a Pediatric Patient Experiencing Pain
Ella Peterson is a 7 year-old patient who underwent a tonsillectomy this morning. She tolerated the surgery well but was unable to swallow fluids during the post-op recovery period so has been admitted for overnight observation. Her mother was at Ella’s bedside all day, but recently went home. The student should assess and safely manage Ella’s pain while communicating therapeutically with her.
Caring for a Client with Chronic Heart Failure
Hector Fernandez is a 62 year-old Hispanic male recently admitted to a long term care facility due to recent falls. He has a history of chronic heart failure. Students must assess Hector while communicating therapeutically regarding his concerns. Any new or unexpected findings should be communicated to the provider and cardiac medications administered safely.
Administering Nitroglycerin to a Client with Chronic Angina
Students assess a newly admitted resident of a Long-Term Care (LTC) facility who reports feelings of chest pressure and use clinical judgment regarding administration of prescribed forms of Nitroglycerin.
Students provide comfort for a client receiving hospice care including insertion of a Macy catheter.
This scenario has been designed for maximum flexibility for use in the classroom or in a simulation center. Students perform appropriate pre-assessments to determine if a medication can be safely administered to a VR patient. Students may also perform post-assessments after administration of medication to determine if side/adverse effects are occurring or if desired therapeutic outcomes are being met. A formulary of available medications for administration is aligned with the classes of medications in the Open RN Nursing Pharmacology, 2e OER text book.
Students assess a virtual patient withdrawing from alcohol in a Medical Surgical hospital unit and appropriately administer medication based on a CIWA protocol.
OB – Routine Active Labor
Students will care for a multifunction OB virtual patient that progresses routinely through the stages of active labor to the transitions stage then pushing. Simulated EHR forms are provided.
OB Complication: Preeclampsia
Students will care for a multifunction virtual OB patient experiencing pre-eclampsia. Cecelia Roberts is a 22-year-old African-American, G1P0 at 33 weeks gestation. She is admitted to the maternity unit for complaints of a frontal headache, seeing spots before her eyes and RUQ pain. Her boyfriend, Jack, and mother, Sarah, are with Cecelia. Students perform a focused antepartum assessment, apply the nursing process, and use clinical judgment to provide safe, effective care.
Transgender Male – Vaginal Delivery With Nuchal Cord
Students will care for a multifunction, transgender male virtual OB patient presenting to the hospital in active labor experiencing contractions at 39 weeks 6 days gestation. They are 5 cm dilated and have been progressing well. However, during the course of labor, variable decelerations in fetal heart rate are observed, requiring careful monitoring and interventions. Despite this, Anthony expresses a strong desire for a natural labor and birth experience. Students will provide routine intrapartum care throughout all three stages of the scenario, ensuring that the patient’s unique needs and preferences as a transgender individual are respected and supported.
Gen 2 Multi-function patient: Atypical Chest Pain Level 1
Students perform a focused subjective and objective assessment for a female multifunction VR patient in an Emergency Department setting who is experiencing chest pain that she relates to “indigestion.”
Gen 2 Multi-function Patient: Atypical Chest Pain – Level 2
Students perform a focused subjective and objective assessment for a female multifunction VR patient in an Emergency Department setting who is experiencing chest pain that she relates to “indigestion,” then analyze lab results, prioritize orders, and appropriately administer medications.
Gen 2 Multi-function Patient: Atypical Chest Pain Level 3
In this scenario, students perform a focused assessment for a female multifunction virtual patient experiencing chest pain, analyze lab results and ECG results, and implement interventions based on a STEMI protocol.
Gen 2 Multi-Function Patient: Asthma Level 1
Millie is a 57-year-old multifunction virtual female patient who presents to the clinic in stable condition for a follow-up appointment related to worsening of her asthma. Students should perform a focused respiratory assessment and analyze her current respiratory status according to the Asthma Severity protocol provided.
Gen 2 Multi-Function Patient:
Asthma Level 2
Maria is a 57-year-old multifunction virtual female patient who presents to the clinic for a follow-up appointment related to worsening of her asthma. She is in stable condition but in the “yellow zone” according to her Asthma Action Plan. Students should perform a focused subjective and objective respiratory assessment, analyze her respiratory status according to her Asthma Action Plan and Asthma Severity protocol, report abnormal findings to the provider, perform patient education, and accurately document findings.
Gen 2 Multi-Function Patient:
Head to Toe Assessment – Level 1
Students perform a head to toe assessment on a virtual multifunction patient and appropriately document their findings.
OB – Routine Postpartum Care: Vaginal Delivery
Students will provide postpartum care for a multi-function OB virtual patient after a routine vaginal delivery.
OB – Postpartum Care: Emergent C-section
Students will provide postpartum care and interact therapeutically with a multifunction OB virtual patient after an emergent C-section following a motor vehicle accident. The newborn was admitted to NICU with hypoxic ischemic encephalopathy Technician prompts and a Spanish-version handout are provided for an optional feature of a patient who only speaks Spanish.
OB Complication: Placental Abruption
Students will care for a multifunction OB virtual patient in an ED setting after experiencing a motor vehicle accident. The client develops vaginal bleeding and is diagnosed with a partial placental abruption.
Gen 2 Multi-Function Patient: Opioid Overdose
Phoebe James, is a 38-year-old female with a recent history of left total knee arthroplasty, three weeks ago. She presents to the emergency department accompanied by her husband with initial complaints of difficulty breathing and left knee pain. These developments require comprehensive assessment and communication to manage her respiratory distress and pain. The case emphasizes the challenge of managing a patient’s care in an acute care setting through a patient-centered approach.
OB Active Labor With Adoption
Students will care for a multifunction OB virtual patient portraying a young mother presenting to the hospital in active labor experiencing contractions at 38 weeks 6 days gestation, whose pregnancy was discovered at 36 weeks 1 day gestation. The technician or faculty member may role play the client’s mother or the fetus’s adoptive family at the bedside to add additional family dynamics to the scenario.
OB Complication: Fetal demise
Students will care for a multifunction OB virtual patient portraying a 19-year old female presenting to the hospital accompanied by an older male, who she identifies as her uncle. He reports to the intake nurse that she has been experiencing symptoms of burning with urination, fever, and flank pain. The client looks to her uncle to answer all of the questions. Students provide routine care throughout all three states of the scenario. A simulated EHR with tabbed chart content is available on the WOW cart to augment the reality of the scenario. The technician or faculty member may role play the client’s uncle at the bedside to add additional family dynamics to the scenario.
Gen 2 Multi-Function Patient: Heart Failure With New Onset Diabetes
Students will care for a multifunction virtual patient who was recently admitted to a long-term care facility due to recurring falls at home. At the time of admission, he had a history of chronic heart failure. Since then, he has been diagnosed with diabetes mellitus and has mostly been lying in bed. Students should perform a comprehensive assessment as well as provide therapeutic communication focusing on his concerns related to the new conditions.
Gen 2 Multi-Function Patient:
End of Life Care – End Stage Heart Failure
Hector Fernandez, a 62 year-old Hispanic male, was admitted to a long-term care facility several months ago with chronic heart failure and recurrent falls. He was subsequently diagnosed with new onset diabetes mellitus and developed an infected pressure ulcer. Months later, he contracted Influenza A during a nursing home outbreak, causing a further decline in his health. He was recently admitted into hospice care with end-stage heart failure. Students provide care to Hector who is actively dying and provide therapeutic communication to his family member who is at the bedside.
About Open RN
The Open RN project is led by Chippewa Valley Technical College as part of the Wisconsin Technical College System (WTCS) consortium. OER nursing textbooks and virtual simulations are collaboratively developed by faculty based on the WTCS State Nursing curriculum and the current NCLEX-RN Test Plan. Textbooks undergo national peer review by faculty, deans, industry members, and nursing students to ensure the content is accurate and relevant, written in clear language for pre-licensure nursing students, and based on current, evidence-based practices. All Open RN materials have CC-BY 4.0 Creative Commons licensing.
Open RN textbooks are published in Pressbooks where they are free and accessible in online or downloadable formats. The textbooks are also uploaded to LibreTexts where they can easily be “remixed” by faculty and aligned to their curriculum. Affordable print versions are published by XanEdu and available in college bookstores and on Amazon.
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