Head-to-Toe

What it is

Head-to-Toe puts a live patient on a stretcher in front of you. Pick from the Classic 6 or the case library of 170 trauma, ICU, and ER cases (ICU patients may be on multiple drips, and library cases include dosage calculations).

Work in order: vitals, neuro, head and neck, lungs, heart, abdomen, GU, and skin and extremities. Use IPPA (inspect, palpate, percuss, auscultate), and remember the abdomen goes inspect, auscultate, percuss, then palpate. Drag each tool to the right spot. The stethoscope plays real-style sounds like crackles, rhonchi, wheezes, stridor, heart sounds, and bowel sounds, and you can watch the chest rise and count the breaths.

Answer an NCLEX-style question on each finding before time runs out, at Easy, Medium, or Hard. Then decide what is going on, treat the patient, and catch the change that comes next, sometimes by titrating a drip on the IV pump or checking which drips need a central line. Sort your findings into normal and abnormal and get a system-by-system report.

What you'll learn

• A systematic head-to-toe assessment
• IPPA technique, including the abdomen order
• Normal versus abnormal lung, heart, and bowel sounds
• Visual cues like nasal flaring, accessory muscle use, and skin changes
• Which drips are central line only and which are peripheral OK
• How to respond when a patient changes after treatment
• Pick the priority NANDA-I nursing diagnosis for each case, with the why, and open its care plan

How it helps you

NCLEX tests clinical judgment, using NCSBN's Clinical Judgment Measurement Model. Every NURSYN game is built on the nursing process. Head-to-Toe works these ADPIE steps: Assessment, Diagnosis.

• Lives in Assessment and Diagnosis: collect the data, then decide what it means
• Every finding is a recognize-and-analyze-cues moment straight from the NCJMM
• Simulated patients let you practice the full sequence safely and repeatedly
• The normal versus abnormal sort trains what to report and what to watch

How to play

1. Pick a patient, case type, question level, and timer
2. Work head to toe using the right tool on the right spot
3. Answer a question on each finding before the clock runs out
4. Decide what is going on, treat, and catch the next change
5. Sort the findings and review your report

Clinical topics covered

Sources

The clinical content and the teaching approach behind this game line up with these references.

1. The Nursing ProcessAmerican Nurses Association. Assessment, diagnosis, outcomes and planning, implementation, and evaluation.
2. NCSBN Clinical Judgment Measurement ModelNCSBN. The framework NCSBN uses to measure clinical judgment and decision making on the NCLEX.
3. The NCSBN National Simulation Study (Hayden, Smiley, Alexander, Kardong-Edgren, and Jeffries, 2014). Journal of Nursing Regulation, 5(2). doi:10.1016/S2155-8256(15)30062-4Journal of Nursing Regulation. Found no significant differences in clinical competency, nursing knowledge, or NCLEX pass rates when up to half of traditional clinical hours were replaced with high-quality simulation.
4. Game-thinking: utilizing serious games and gamification in nursing education, a systematic review and meta-analysis (Nylén-Eriksen et al., 2025). BMC Medical EducationBMC Medical Education. Pooled studies show serious games and gamification work in nursing education, with the strongest benefit for knowledge and a more modest effect on skills.