Case 2: Introduction and Instructions

Care of an Older Adult with Infection and Impaired Cognition in an Acute Medical Setting

Scenario Introduction

The goal of this virtual case-based scenario is to promote participants’ clinical reasoning and decision-making when providing nursing care for an older adult with dementia and infection in an acute medical setting. Participants will use a virtual case-based scenario to assess a client, identify priority problems, formulate and implement a nursing plan, and evaluate the plan. The virtual scenario provides entry-level BSN students with an experience of working with a client in a community setting.


  • Chronic Disease Management
  • Clinical Judgement
  • Cognition
  • Communication
  • Gas Exchange
  • Infection
  • Pharmacology
  • Safety


Acute medical unit of a hospital.

Level of Participant

Entry-level (year 1 or 2)

Completion Time

Varied, up to 3.5 hours.

  • Pre-Learning: Varied depending on the knowledge students have prior to engaging in the scenario. Completing all activities in their entirety may take up to 2.5 hours.
  • Scenario: Allow for about 30 minutes to complete the activity.
  • Reflection: Allow for about 30 minutes to complete the activity.

Learning Objectives

By the end of this scenario, participants will be able to do the following in a virtual case-based scenario:

  1. Identify and differentiate between the signs and symptoms of delirium, dementia, and depression to provide prioritized nursing care.
  2. Implement a client-specific nursing plan of care in an acute care setting to safely manage altered cognition and infection-related diagnoses.
  3. Communicate effectively with an older adult with dementia in an acute care setting to enhance a therapeutic relationship and provide culturally sensitive care.


  • Complete each section in the order it is presented.
  • After completing the pre-brief and pre-learning, you will find a short scenario to work through with decision-making questions. You can go through the scenario as many times as you would like.
  • After you complete the scenario, work through the post-scenario activities.
  • Your role is to assume all aspects of a practicing nurse’s professional behavior as if caring for a client in the clinical setting. However, work within your scope of practice as a student nurse.
  • Several aspects of the scenario may be limited in realism and when a gap occurs between simulated reality and actual reality, act according to the goals of the learning session.
  • These scenarios follow what is known as the Basic Assumption™ of simulation, meaning that it is believed that you are intelligent, capable, and want to do your best to improve your skills.[1]

  1. © Copyright 2004-2022 Center for Medical Simulation, Boston, Massachusetts, USA. All Rights Reserved – Used with permission.


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Nursing Virtual Case Studies Copyright © 2023 by Adrianna D'Ilio and Amanda Egert is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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