[Video: Complete NGN Case Study Walkthrough — 15 min]
What Is an NGN Case Study?
An NGN case study presents a patient scenario (history, assessment findings, vital signs, lab results) followed by 6 questions, each testing a different layer of the Clinical Judgment Measurement Model:
- Recognise Cues
- Analyse Cues
- Prioritise Hypotheses
- Generate Solutions
- Take Actions
- Evaluate Outcomes
The 6 questions build on each other. Answer question 1 well and questions 2–6 become more manageable.
The Case: Mrs. Kamau, 72-Year-Old Admitted with Chest Pain
[Patient Chart: Vital signs, History, Medications, Lab Values for Mrs. Kamau]
Clinical Scenario: Mrs. Kamau, 72, presents to the ED with substernal chest pain radiating to her left arm, diaphoresis, and nausea for 2 hours. PMH: hypertension, type 2 diabetes. Current meds: metformin, lisinopril. BP 158/96, HR 102, RR 20, SpO2 94%, temp 37.2°C. ECG shows ST elevation in leads II, III, and aVF.
Q1 — Recognise Cues: Which findings are most concerning? (Select 3)
Strategy: Look for findings that deviate from normal AND are clinically significant. SpO2 94%, ST elevation, and diaphoresis are the abnormal cues that signal acute MI.
Q2 — Analyse Cues: What do these findings indicate?
Strategy: Connect the cues to pathophysiology. ST elevation in inferior leads (II, III, aVF) + chest pain + diaphoresis = inferior STEMI until proven otherwise.
Q3 — Prioritise Hypotheses: What is the priority concern?
Strategy: Use Maslow and ABCs. Airway/Oxygenation (SpO2 94%) is the immediate physiological priority, followed by cardiac perfusion.
Q4 — Generate Solutions: Which interventions are appropriate? (Select all that apply)
Strategy: Think MONA for ACS management: Morphine (or nitrates), Oxygen, Nitroglycerin, Aspirin. Know what to HOLD (metformin pre-procedure).
Q5 — Take Actions: What is the FIRST action?
Strategy: The first action is always the most time-sensitive. Oxygen and calling the provider for STEMI protocol simultaneously.
Q6 — Evaluate Outcomes: Which finding shows the interventions are working?
Strategy: Look for improvement in the original abnormal findings: SpO2 improving, pain reducing, ST elevation resolving.
💡 The Golden Rule for Case Studies
Every question in an NGN case study flows from the same patient scenario. Read the scenario thoroughly once before attempting any questions. Context from earlier questions may appear in later ones.
Practice more case studies: Free NGN Practice Questions • Cardiovascular NCLEX Questions