A better understanding of the relationships between symptom recognition, nursing response, and preferred thinking style is needed to improve nursing education practices. Final semester nursing students (N = 29) completed a high fidelity patient simulation (HFPS) scenario; recognized symptoms (i.e., dyspnea) and responses (i.e., apply oxygen) were recorded, and compared with students’ preferred thinking style using the Rational-Experiential Inventory-40. Relationships between concepts were explored. Significant relationships were noted between preference for Rational thinking styles and symptom recognition (p < .05). Preferred thinking style was not related to numbers of therapeutic responses. Thirty percent of students delayed application of oxygen until directed to do so by members of the health care team. Students having a stronger preference for rational thinking demonstrate greater accuracy in cue recognition. More nursing research is needed to explore the cognitive processing during simulation.