I hear you're ready to play your first game of Level Up Nurse Squad. How about we cover how to set the game up and start playing?

Open the box and take out the instructions and throw them out.

Let's begin setting up your game space. Grab the question cards. The back of the question cards show you the core subject and subtopic of each question, as well as the point value of the questions on that card.

Each card has two questions, one on top and one on bottom.

Decide amongst all players whether you will ask the top row or bottom row questions during your game. There's no difference in difficulty or scoring between the rows.

Remove the rest of the cards from the package.

Separate the remaining question cards, shuffle well, and place them face down in the center of your play area.

You are left with white cards with people on them and yellow cards that say hazard.

Grab the cards with pictures of people on them. These are your avatar cards. You will play as one of these nurse recruits working to level up their nursing knowledge and join the elite Level Up Nurse Squad. The front side of these cards show your character as a recruit and the back as a member of the Nurse Squad. Read each avatar card and choose the recruit that best represents the kind of nurse that you want to be.

When working as a nurse, you will undoubtedly encounter obstacles in your shifts that slow you down. It's no different in our game. These are the hazard cards. Hazards allow you to challenge your opponent's nursing knowledge and potentially cost them points. You will learn more about hazard cards in a bit. Distribute the hazard cards evenly among all players. Since we have two players, each player will get four hazard cards. Each player should display their hazard cards face up in front of them.

Each player will take a turn selecting the avatar card representing the recruit that they wish to play as. Once a player has selected their avatar, they should place the card in front of them in the play area next to the hazard cards with the student side showing. You can then set the remaining avatar cards aside. You won't need them for the rest of this game.

The last step in setting up the game is to choose a scorekeeper. The scorecard should be visible to all players at all times, as knowing the score of the game could influence your decisions about when to play your hazard card.

Now it's time for the fun part, playing the game. Every game of Level Up Nurse Squad starts with the oldest player going first, with play moving in a clockwise direction. On a player's turn, they can choose to either attempt to answer a question card or elect to play a Hazard card against their opponent.

Since this game just started, it wouldn't make a lot of sense to play a hazard card yet. So Jeff chooses to attempt a question. The player to Jeff's right would draw a card and read the question out loud.

Jeff's clearly no slouch when it comes to nursing knowledge, earning him the number of points listed on the card. In this case, one point. The scorekeeper would add the points earned to Jeff's total score, and gameplay moves clockwise.

Meris also decides to attempt a one-point question card. Uh-oh, Meris got it wrong. Bummer. Luckily for Meris, if you answer incorrectly, you suffer no penalty. Her score simply remains at zero. The question card is placed question side up in the discard pile, and play continues clockwise.

But how do you use all these hazard cards exactly? Let's assume Jeff and Meris have answered some questions and have scored some points. On Jeff's next turn, he decides he wants to play a hazard card against Meris.

Meris must now attempt to answer the question on the next card. If she gets it correct, she neither gains nor loses points.

If she gets it wrong though, Meris would lose four points from her score. Let's see how she does.

Good job, Meris! She gets it right and does not lose any points. Jeff's turn is over, and gameplay moves clockwise back to Meris.

Meris decides to play a hazard card right back at Jeff.

Oh, no, against all odds, Jeff got it wrong. That means he gets four points deducted from his score, and gameplay continues back and forth until a player either reaches an agreed-upon score total to win, or all cards in the question pile have been used.

Whoa, looks like Meris not only took over the lead, but reached the agreed-upon score total to win. Meris is our winner, and she gets to flip her avatar card over to signify that she is leveled up and is ready to join the Level Up Nurse Squad.

Up to 8 players can play with the Hazard cards provided in a single game. Distribute the Hazard cards so that each player has the same number of Hazards, then follow Hazard instructions from the standard gameplay. 

Keep in mind adding more players means there are 1) fewer questions for each player and 2) fewer opportunities to utilize Hazard cards. For this reason, we recommend that larger groups purchase multiple subjects to improve the gameplay experience. If you own multiple subjects, you may use the additional Hazard cards to add to each player’s Hazard cards.

This option is all about teamwork. First, each player selects a Nurse Squad avatar card and places the card in front of them with the student side showing. As a group, you will be playing as a Nurse Squad and leveling up together!

Next, decide if you will play using the top or bottom row of questions. After that, thoroughly shuffle the Hazard and Question cards together. Place the shuffled pile so it’s accessible to all players. Each group member takes turns reading a question aloud for other group members to answer. The oldest player starts the game by asking the first question.

When it is your turn to ask a question, select a card from the top of the question pile and read the question to the group. All players (aside from the one asking the question) may call out answers. If the players answer the question correctly, add the points from the front of the card to the group’s score. If none of the players provides the correct answer, no points are added to the group’s score. Place the card in the discard pile. Gameplay continues until all cards in the question pile have been used.

Eventually someone will draw a Hazard card. What comes next depends on the type of Hazard drawn. For Hazard cards, the group must attempt to answer the next available question. If they get it right, they neither gain nor lose points. If they get it wrong, the group deducts four points from the group’s point total. Place the Hazard card in the discard pile. Gameplay continues until all cards in the question pile have been used.

Though Level Up Nurse Squad works best as a team mission, here’s how to win your spot on the Nurse Squad all on your own. 

To get started, select a Nurse Squad Avatar card–you’ll play as that recruit. Then choose an unused Avatar card to use as a cover card. This ensures you won’t see the answers on the Question cards. Once your Avatar cards are selected, shuffle all Hazard cards into the Question pile. Now you’re ready to begin.

Draw cards in order, including Hazard cards. Once you’ve drawn a card, place your cover card on it and move the cover card down to reveal only the question. After answering, slide the cover card down further to reveal the answer. For each question you get right, add 1 point to your score. For each question you miss, subtract 1 point from your score.

If you draw a Hazard, attempt to answer the first question on the next card. A correct answer means no points are added or subtracted. If you get it wrong, subtract four points from your score.

Duration Options for Solo Play
Choose what’s best for you:

- Play until you reach a specific score total (e.g., 50 points).

- Accumulate points over a specific number of Question cards (e.g., play through 20 Question cards, answering all questions on each card to earn points).

- Play a timed game by picking a specific period of time (e.g., 10 minutes). Challenge yourself to answer as many questions correctly as you can in that timeframe.

If you’re reviewing material in preparation for the NCLEX, shuffle together ALL subjects of Level Up Nurse Squad. Use any gameplay instructions—standard play, solo play, etc.—that suit your needs, and you’ll cover questions from all subject areas at random, just like the NCLEX.

To save yourself some time, we recommend setting a total point goal (e.g.,100 points) in order to win the game.