The purpose of the study was to determine if associate degree and baccalaureate student nurse utilization of Evolve Apply case studies had an impact on scores on the Evolve Reach Exit Examination (E2) scores, a proprietary examination taken by nursing students to predict success on the NCLEX-RN. The study further investigated how the Evolve Apply case studies were utilized by nursing schools around the United States, including a determination of whether or not schools placed consequences on the use of computerized and standardized case studies within the nursing curriculum, and if use of case studies was validated. The study employed a non-experimental descriptive study design using purposive sampling, a form of non-probability sampling. Three research questions guided the study: (1) Does the utilization of Evolve Apply case studies significantly increase baccalaureate and associate degree registered nurse student scores on the Evolve Reach E2 ascompared to students who do not use Evolve Apply case studies? (2) What consequences do nursing programs attach to the use of the Evolve Apply case studies in the curriculum? (3) Do the variables, consequences, and validation affect scores on the Evolve Reach E2 for those students using the Evolve Apply case studies? Findings revealed that the use of Evolve Apply case studies increased students' scores on the Evolve Exit exam. Common consequences programs attached to case study use included passing/failing course, grade impact, and remediation. Validation of case study use inversely influence E2 outcomes. Students in programs not validating case study use had higher E2 scores. Attaching consequences to case study use did not significantly influence E2 scores.