James Okoye — Post-Stroke Day 2, NIHSS Was 14, Now Right Arm Weaker, BP 192/108

About This Case

This clinical reasoning case presents a patient with james okoye / post-stroke day 2 / nihss was 14 / now right arm weaker / bp 192/108 in a neurology context. Learners work through a structured 10-phase simulation covering initial differential, history-taking, physical examination, labs and imaging, and management planning.

"You complete your hourly neuro check. James's right grip is now trace versus 2/5 yesterday, and he is not following commands he followed this morning. BP is 192/108. His NIHSS was 14 at admission. You need to escalate. What does your NIHSS re-assessment tell you — and what is your SBAR to the neurology team right now?"

How the Simulation Works

1. Read the patient presentation and form your initial differential diagnosis
2. Interview the AI patient to gather history and explore your hypotheses
3. Perform a focused physical examination based on your differential
4. Order appropriate labs and imaging, then interpret the results
5. Revise your diagnosis and develop a management plan
6. Receive personalized teaching feedback from your AI attending, Dr. Patel

What You'll Learn

This case builds skills in systematic clinical reasoning, hypothesis-driven history-taking, appropriate test ordering, and evidence-based management. It is designed for Nursing students and practicing clinicians seeking to sharpen diagnostic thinking in neurology.

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About ReasonDx

ReasonDx is an AI-powered clinical reasoning education platform developed by Dr. Lauren Fine, MD, FAAAAI, Associate Professor and Assistant Dean of Clinical Skills Education at NSU Dr. Kiran C. Patel College of Allopathic Medicine. The platform features 394 simulation cases across 10 health professions, designed to train the cognitive processes underlying accurate diagnosis.