This is an introductory scenario designed for Internationally educated nurses who have already completed their training in their country of origin and are completing additional training in Ontario Canada. Participants for this scenario have minimal if any, experience with high-fidelity simulation, and this scenario will serve to give each participant a similar introductory experience through the progression of the client’s condition. This scenario involves an older adult female patient admitted to a medical ward with newly diagnosed congestive heart failure (CHF). This scenario takes place on the first nightshift of her admission as she slowly begins to experience more severe symptoms of CHF. Participants will be expected to complete a physical assessment to determine what signs/symptoms the patient is experiencing, initiate and titrate oxygen, contact the healthcare provider with concerns and recommendations, and implement any prescribed interventions.