This paper explores the deliberate design of ‘problem’ situations within a 3-year problem-based nursing degree conducted at Griffith University, Nathan, Queensland, Australia. It examines problem situations within the first and third years of the course to illustrate the issues involved in designing material that enables students to achieve the curriculum aims. Although the problem situations are designed from the same health care setting, the discussion highlights how concepts and issues can be addressed in different ways depending on the desired student outcomes. The paper outlines and examines the nature of student learning and the clinical reasoning process used by students in making decisions that closely mirror those made as registered nurses in order to facilitate the achievement of clients' health goals.