Nurse educators are challenged with finding innovative ways to improve student engagement. Gamification is a teaching tool used to increase student engagement. To help students understand type 1 diabetes mellitus, a new game called Mystery Patient in a Box was developed. This activity is a constructivist approach to help students use clinical judgment in the classroom or virtually. The students have 4 boxes to choose from on a PowerPoint slide. The students select whatever box they want, and the next slide takes them to the inside of the box that contains a clue about the patient. In this case, the 4 clues are: a new diagnosis of type 1 diabetes mellitus, 7 empty water cups at the bedside, the urinary output is 2500 mL/d, and a respiratory rate of 25 breaths per minute. Students then work in small groups on a worksheet that asks them to develop a patient scenario based on the clues. The students write down their assessment, expected laboratory values, and medication. Students then create priority nursing interventions, identify safety concerns, and educate their patients. At the end of the class, students come together to share their scenario and interventions. The discussion can change depending on the previous experience of the students. This activity allows students to construct their patients and create an appropriate plan of care.