NSG 223 JUNETTA COOPER VSIM
COMPLETE BUNDLE | DOCUMENTATION
ASSIGNMENT, CLINICAL JUDGMENT
WORKSHEET & SBAR DEBRIEFING |
2026/2027 PRACTICE BANK | DETAILED
RATIONALES
INTRODUCTION
The NSG 223 Junetta Cooper vSim Complete Bundle is designed to help nursing
students integrate cardiovascular assessment, clinical judgment, medication safety,
documentation, patient education, and structured communication within a simulated
clinical encounter. The Junetta Cooper vSim focuses on the management of
nitroglycerin administration for angina pectoris, making recognition of ischemic
chest-pain cues, safe medication administration, reassessment, and escalation of care
central learning objectives.
This practice bank is intended for students completing NSG 223 medical-surgical
nursing coursework and preparing for related simulation, documentation, clinical-
judgment, and SBAR activities. It emphasizes application rather than memorization.
Questions require the learner to recognize significant cues, prioritize findings,
determine appropriate interventions, evaluate responses, document objectively,
educate the patient, and communicate clinically relevant information.
The questions are original practice items based on the published scenario
characteristics and nursing principles. They are not reproductions of an official
Herzing University examination or proprietary vSim assessment. Used alongside
the actual vSim, course materials, instructor guidance, and medication resources, this
bank can strengthen clinical reasoning and help identify areas requiring further review.
CORE DOMAINS TESTED
1.
Cardiovascular Assessment — Recognition and interpretation of anginal
symptoms, vital-sign changes, pain characteristics, and cardiac status.
2.
3.
1
,Angina Pectoris and Coronary Artery Disease — Differentiating stable
angina from potentially worsening ischemia and identifying concerning
changes.
4.
5.
Nitroglycerin Therapy — Safe administration, contraindications, adverse
effects, monitoring, and evaluation of therapeutic response.
6.
7.
Clinical Judgment — Recognizing cues, analyzing cues, prioritizing
hypotheses, generating solutions, taking action, and evaluating outcomes.
8.
9.
Medication Safety — Medication rights, allergy assessment, blood-pressure
monitoring, administration technique, and reassessment.
10.
11.
Documentation — Objective charting of assessment findings, interventions,
patient response, education, and communication.
12.
13.
Patient and Family Education — Medication instructions, safety precautions,
symptom reporting, and preparation for cardiac procedures.
14.
15.
SBAR Communication — Accurate Situation, Background, Assessment, and
Recommendation reporting.
16.
17.
Prioritization and Escalation — Determining when recurring or unresolved
chest pain requires immediate provider notification or emergency escalation.
18.
19.
2
, Simulation Debriefing — Connecting clinical decisions to outcomes,
identifying strengths, and developing improvement strategies.
20.
21.
Patient Safety — Prevention of medication-related hypotension, falls, delayed
treatment, and communication failures.
22.
23.
Interprofessional Communication — Concise transfer of clinically
significant information to providers and other members of the healthcare team.
24.
QUESTIONS 1-100
Q1: A 75-year-old patient with a history of chronic stable angina suddenly
reports central chest tightness described as heavy and burning and rates it 7/10.
What should the nurse do FIRST?
A) Ask the patient to ambulate to determine whether activity worsens the pain
B) Stop and perform an immediate focused cardiovascular assessment, including
vital signs and symptom characterization
C) Document the pain and reassess in 30 minutes
D) Explain that anxiety commonly causes chest discomfort
Rationale: B is correct because new or severe chest pain requires immediate
assessment before further intervention. The nurse should establish the patient's
current hemodynamic status, pain characteristics, and associated symptoms. A is
incorrect because ambulation may increase myocardial oxygen demand. C is unsafe
because delaying reassessment could delay treatment of ischemia. D is inappropriate
because anxiety must not be assumed to be the cause of chest pain.
Q2: Which pain description most strongly supports myocardial ischemia in the
Junetta Cooper scenario?
A) Sharp pain localized to one fingertip and worsened by palpation
B) Burning epigastric pain occurring after spicy food
C) Central chest pressure or tightness described as heavy or burning
D) Brief stabbing pain that increases only with inspiration
Rationale: C is correct because pressure, heaviness, tightness, or burning in the
central chest is characteristic of anginal discomfort. A suggests musculoskeletal pain,
particularly if reproducible. B may suggest gastrointestinal pathology, although
cardiac ischemia can sometimes present atypically. D is more suggestive of pleuritic
3
COMPLETE BUNDLE | DOCUMENTATION
ASSIGNMENT, CLINICAL JUDGMENT
WORKSHEET & SBAR DEBRIEFING |
2026/2027 PRACTICE BANK | DETAILED
RATIONALES
INTRODUCTION
The NSG 223 Junetta Cooper vSim Complete Bundle is designed to help nursing
students integrate cardiovascular assessment, clinical judgment, medication safety,
documentation, patient education, and structured communication within a simulated
clinical encounter. The Junetta Cooper vSim focuses on the management of
nitroglycerin administration for angina pectoris, making recognition of ischemic
chest-pain cues, safe medication administration, reassessment, and escalation of care
central learning objectives.
This practice bank is intended for students completing NSG 223 medical-surgical
nursing coursework and preparing for related simulation, documentation, clinical-
judgment, and SBAR activities. It emphasizes application rather than memorization.
Questions require the learner to recognize significant cues, prioritize findings,
determine appropriate interventions, evaluate responses, document objectively,
educate the patient, and communicate clinically relevant information.
The questions are original practice items based on the published scenario
characteristics and nursing principles. They are not reproductions of an official
Herzing University examination or proprietary vSim assessment. Used alongside
the actual vSim, course materials, instructor guidance, and medication resources, this
bank can strengthen clinical reasoning and help identify areas requiring further review.
CORE DOMAINS TESTED
1.
Cardiovascular Assessment — Recognition and interpretation of anginal
symptoms, vital-sign changes, pain characteristics, and cardiac status.
2.
3.
1
,Angina Pectoris and Coronary Artery Disease — Differentiating stable
angina from potentially worsening ischemia and identifying concerning
changes.
4.
5.
Nitroglycerin Therapy — Safe administration, contraindications, adverse
effects, monitoring, and evaluation of therapeutic response.
6.
7.
Clinical Judgment — Recognizing cues, analyzing cues, prioritizing
hypotheses, generating solutions, taking action, and evaluating outcomes.
8.
9.
Medication Safety — Medication rights, allergy assessment, blood-pressure
monitoring, administration technique, and reassessment.
10.
11.
Documentation — Objective charting of assessment findings, interventions,
patient response, education, and communication.
12.
13.
Patient and Family Education — Medication instructions, safety precautions,
symptom reporting, and preparation for cardiac procedures.
14.
15.
SBAR Communication — Accurate Situation, Background, Assessment, and
Recommendation reporting.
16.
17.
Prioritization and Escalation — Determining when recurring or unresolved
chest pain requires immediate provider notification or emergency escalation.
18.
19.
2
, Simulation Debriefing — Connecting clinical decisions to outcomes,
identifying strengths, and developing improvement strategies.
20.
21.
Patient Safety — Prevention of medication-related hypotension, falls, delayed
treatment, and communication failures.
22.
23.
Interprofessional Communication — Concise transfer of clinically
significant information to providers and other members of the healthcare team.
24.
QUESTIONS 1-100
Q1: A 75-year-old patient with a history of chronic stable angina suddenly
reports central chest tightness described as heavy and burning and rates it 7/10.
What should the nurse do FIRST?
A) Ask the patient to ambulate to determine whether activity worsens the pain
B) Stop and perform an immediate focused cardiovascular assessment, including
vital signs and symptom characterization
C) Document the pain and reassess in 30 minutes
D) Explain that anxiety commonly causes chest discomfort
Rationale: B is correct because new or severe chest pain requires immediate
assessment before further intervention. The nurse should establish the patient's
current hemodynamic status, pain characteristics, and associated symptoms. A is
incorrect because ambulation may increase myocardial oxygen demand. C is unsafe
because delaying reassessment could delay treatment of ischemia. D is inappropriate
because anxiety must not be assumed to be the cause of chest pain.
Q2: Which pain description most strongly supports myocardial ischemia in the
Junetta Cooper scenario?
A) Sharp pain localized to one fingertip and worsened by palpation
B) Burning epigastric pain occurring after spicy food
C) Central chest pressure or tightness described as heavy or burning
D) Brief stabbing pain that increases only with inspiration
Rationale: C is correct because pressure, heaviness, tightness, or burning in the
central chest is characteristic of anginal discomfort. A suggests musculoskeletal pain,
particularly if reproducible. B may suggest gastrointestinal pathology, although
cardiac ischemia can sometimes present atypically. D is more suggestive of pleuritic
3
