The clinical nurse specialist (CNS) is an advanced practice role that has been evolving and ever evolving with the changes in the healthcare delivery system over the last 60 years. The CNS is a unique role with three spheres of influence: the patient/family, the professionals caring for those patients, and the healthcare system. There are seven core competencies that encompass the wide range of the CNS role: direct care, consultation, systems leadership, collaboration, coaching, research, and ethical decision-making. This chapter provides a comprehensive guide to clinical simulation scenarios for CNS. It provides clinical simulation scenarios for alarm fatigue, elder abuse, asthma and cystic fibrosis. The chapter also provides advanced practice registered nurse simulation run guide outlining the logistics for standardized patient/simulation technical team and leading a sentinel event team.