TEST BANK - Nursing Today: Transition and Trends, 11th
Edition (Zerwekh)
Chapters 1 - 26 | All Chapters
,Test Bank - Nursing Today: Transition and Trends, 11th Edition
TABLE OF CONTENTS
,Chapter 01: Role Transitions
.
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MULTIPLE CHOICE
1. A graduate nurse has been hired as a nurse at a local hospital. The new nurse is
inthe . honeymoon phase of role transition when making which of the following
statements? a. “I am so nervous about being on my own as a nurse.”
b. “This will be a great learning experience.” .
c. “I can’t wait to have a steady paycheck.”
d. “This job is perfect. I can finally do things my own way.”
ANSWER: D .
The honeymoon phase is when the student nurse sees the world of nursing as quite
rosy. Often, the new graduate is fascinated with the thrill of arriving in the profession.
Realityshock occurs when one moves into the workforce after several years of
educational preparation. Recovery and resolution occur when the graduate nurse is
able to laugh at . encountered situations. During this time, tension decreases,
perception increases, and thenurse is able to grow as a person.
.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: Table 1.1 OBJ: Identify the characteristics of reality shock.
TOP: Reality shock MSC: NCLEX®: Safe and effective care environment
.
2. Which of the following actions by the graduate nurse is an inappropriate
methodologyto recover from reality shock?
a. Networking .
b. Obtaining a mentor
c. Returning to school
d. Joining a support group
.
ANSWER: C
The transition period is successfully managed when the graduate is able to evaluate the
work situation objectively and predict effectively the actions and reactions of other
staff.
Nurturing
the ability to see humor in a situation may be a first step. Returning to school is a
positivestep . after the graduate has worked through role transition, has some clinical
experience,and is ready to focus on a new career objective. Networking, obtaining a
mentor, and joining a support group would give the graduate nurse an opportunity to
talk to others experiencing the .
, stress associated with reality shock. The nurse would benefit from “talking through”
issuesand learning how to cope.
PTS: 1 DIF: Cognitive Level: Application/Applying .
REF: p. 9 OBJ: Describe methods to promote a successful
transition.TOP: Reality shock
MSC: NCLEX®: Safe and effective care environment Not applicable
.
3. A nurse is trying to avoid burnout. Which of the following actions is a valid way to achieve
this?
a. Refusing to constantly work extra shifts .
b. Withdrawing from peer support group
c. “Going native”
d. Changing jobs every 6 to 12 months .
ANSWER: A
One of the quickest ways to experience burnout is to “overwork the overtime.” Set
priorities with your mental and physical health being the highest priority. Learning to say
“no” to extra shifts is a positive means of coping of avoiding burnout. “Going native” is
the term that . describes how recent graduates begin to copy and identify the reality of
theirrole-transition experience by rejecting the values from nursing school and
functioning more like a team member at their place of employment. Withdrawing from
peer support groups, “going native,” . and changing jobs every 6 to 12 months would
increase the chance of the nurse experiencing
burnout. The nurse should instead focus on his/her practice and seek out support
fromother nurses.
.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 7 OBJ: Describe methods to promote a successful
transition.TOP: Reality shock
MSC: NCLEX®: Safe and effective care environment Not applicable .
4. Which of the following statements by the graduate nurse shows an understanding
ofreality shock as it applies to nursing? .
a. “Reality shock is the period when a person moves from school into the
b. workforce.”“Reality shock is the realization that practice and education are not
thesame.”
c. “Reality shock is the period from graduation to becoming an experienced nurse.”.
d. “Reality shock is a transition phase that new graduates go through before
changingjobs.”
ANSWER: A .
, “Reality shock” is a term often used to describe the reaction experienced when one
movesinto the workforce after several years of educational preparation. The new
graduate is caught in the situation of moving from a familiar, comfortable educational
environment into a new role in . the workforce where the expectations are not clearly
defined or may not even be realistic. The realization that practice and nursing school are
not the same is often associated with “going native.” When nurses move from one
position to another, they have already experienced
reality shock. Becoming an experienced nurse takes time and is not part of the
definitionof . reality shock.
PTS: 1 DIF: Cognitive Level: Application/Applying . REF: p. 5
OBJ: Identify the characteristics of reality shock.
TOP: Reality shock MSC: NCLEX®: Not applicable
5. A student in the last semester of nursing school has established a goal of making a
successful . role transition to graduate nurse. Which statement by the student
indicateshis/her understanding of how to achieve this goal?
a. “I should care for increased numbers of patients to enhance work
organizationskills.” .
b. “I will observe staff nurses as they perform nursing procedures to
refinetechnique.”
c. “I should seek increasingly close guidance from the nursing instructor to reduce .
errors.”
d. “I will evaluate my progress every 7 weeks or more to allow time for growth.”
ANSWER: A
It is important for the student to start taking care of increased numbers of patients to help
with . time management and work organization. The student should also be able to
functionwithout close guidance from the nursing instructor. Although it is good for
students to observe staff, a
student in the final semester should be able to perform tasks with minimal observation
and . should instead focus on implementing care and time management. Waiting 7 weeks
to evaluate progress would not be helpful to the student. Although regular self-evaluation
is animportant process, it is the actual experience of taking realistic patient assignments
and . working typical shift hours that assists with successful role transition.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 13 OBJ: Describe methods to promote a successful transition. .
TOP: Reality shock MSC: NCLEX®: Not applicable
, 6. A new graduate of less than 1 year describes his/her perception of a staff nurse
position,stating: “It feels great to be a nurse! In fact, it’s a snap! I can hardly believe
there’s no . instructor looking over my shoulder.” What phase of reality shock is the
graduate experiencing?
a. Recovery .
b. Shock and rejection
c. Honeymoon
d. Transition .
ANSWER: C
In the first phase of the role transition process (the honeymoon phase), the graduate nurse
is thrilled with completing school and accepting the first job. Life is a bed of roses because
everyone knows nursing school is much harder than nursing practice. Shock and rejection .
occur as the nurse tries to understand how nursing school and the “real world” come
together.Transition occurs as the nurse begins the move from student to nurse and refers to
the entire process, not just a particular phase. The recovery phase is when the nurse can
laugh at . situations that he/she is in and is able to cope with the situations that are being
faced.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 7 OBJ: Compare and contrast the phases of reality shock. .
TOP: Reality shock MSC: NCLEX®: Not applicable
7. A new graduate has worked on a busy unit for 6 months since graduating from nursing
school.The graduate tells a friend, “I’ve never been so upset in all my life! The care that
some of the .staff give our patients is outrageously bad. There’s practically no attention to
the principles of asepsis the way I learned them! The staff tell me that we have to cut
corners if we’re going to get all the work done. I can’t stand it!” What phase of reality shock
is this graduate . experiencing?
a. Honeymoon
b. Shock and rejection
c. Recovery .
d. Role transformation
ANSWER: B
.
The honeymoon phase for the new graduate nurse is short lived when the graduate
identifies the conflicts between the way he/she was taught and the reality of what is done.
Shock and rejection cause mental and emotional withdrawal, moral outrage, and a
hypercritical attitude, .which are just some of the symptoms of the realization that the
honeymoon is over. Excessivemistrust, frequent pains and illness, a decrease in energy and
fatigue, feeling like a failure andblaming oneself for every mistake, a hypercritical attitude,
and feeling morally outraged are characteristics of the shock and rejection phase. The
recovery phase is characterized by a .
, beginning sense of humor (usually the first sigh), a decrease in tension, and an increase in
the ability to cope with the situations that he/she is faced with. Role transformation is the
processof transforming from student to nurse. .
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 8 OBJ: Compare and contrast the phases of reality
shock.TOP: Reality shock MSC: NCLEX®: Not
.
applicable
8. A graduate nurse has been out of school for 3 months and working in a staff nurse position
forthe past 2 months. What type of transition is the nurse experiencing? .
a. A developmental transition
b. An organizational transition
c. A health-oriented transition
d. A situational transition .
ANSWER: D
A situational transition is a lifestyle change that occurs because of a new situation. Most
oftenthe changes are by choice—for instance, graduations, marriages, and new jobs. .
Developmental transitions include becoming a parent or going through a midlife crisis. An
organizational transition involves a change in leadership. A health-oriented transition involves
dealing with an illness or health issue, such as coping with a chronic illness. .
PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 3 OBJ:
Discuss the concepts of transitions.
TOP: Types of transitions MSC: NCLEX®: Not applicable.
9. The graduate nurse understands that transitions occur throughout life. What major factor
doesthe nurse identify as influential in a successful transition from school to practice? a.
Level of new knowledge and skills required in the new environment.
b. Amount of classwork required to obtain a degree
c. Personal history of previous developmental transitions
d. Influence of classmates and their transitional experiences.
ANSWER: A
The transition from student to practice reflects a situational transition that is most often
affected by the anticipation of changes in the new work environment. Classwork no longer .
affects this transition. A personal history of previous developmental transitions and the
influence of classmates are not as prominent as the anticipated requirements to function in
thenew environment of work.
.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
, REF: p. 4 OBJ: Describe methods to promote a successful transition. TOP:
Types of transitions MSC: NCLEX®: Not applicable .
10. A nurse manager is giving a presentation at a local community college. The nurse
managerunderstands the job expectations of a new graduate when making which of the
following statements? .
a. “A graduate nurse should be able to perform as independently as was demonstrated
thelast semester of nursing.”
b. “A graduate nurse should be able to function competently as a registered nurse at
theentry level.” .
c. “A graduate nurse should be able to function in the role that was described in
thecurriculum for the school of nursing.”
d. “A graduate nurse should be able to be able to function independently with ability .
to make clinical nursing judgments.”
ANSWER: B
The job expectations of a new graduate nurse are those of an entry-level new employee.
This .frequently includes an extended orientation to assist the new graduate to transition
into the independent role of the nurse. The new graduate nurse is not expected to function
independently with the ability to make clinical nursing judgments. School curriculum and
how . one functioned the last semester of school are usually not considered in the job
expectations of a new graduate.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding . REF: p. 12
OBJ: Discuss the concepts of transitions.
TOP: Successful transitions MSC: NCLEX®: Not applicable
11. Which action by the graduate nurse shows that a successful transition to nursing has been .
made?
a. The nurse begins to work with the nursing team and functions as others expect.
b. The nurse begins to objectively evaluate work experiences and enjoy the humor of .
clinical situations.
c. The nurse believes everything is great, patients are wonderful, and the new unit is
sonice.
d. The nurse meets regularly with other new graduates to. compare and
discussproblems.
ANSWER: B
Objectivity and humor are two of the characteristics of a successful transition. “Going native”
. occurs when the graduate begins to provide care in the manner that the team or group
wants it done, not necessarily the correct way. The “honeymoon phase” is when everything
is going
, great. Meeting with other new graduates can be productive, but it is a part of the transition
and
. not an indication of successful transition.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 8 OBJ: Compare and contrast the phases of reality shock. .
TOP: Characteristics of a successful transition MSC: NCLEX®: Not applicable
12. A student nurse is in the last semester of nursing school. Which action by the nursing
studentindicates appropriate preparation for the transition experience? .
a. The nursing student requests additional experiences in performing skills
andprocedures.
b. The nursing student maintains close contact with a nursing instructor. to
observenursing procedures.
c. The nursing student practices nursing assessments and care on one or two patients
tobecome more competent.
d. The nursing student increases communication with a nursing instructor to maintain .
a resource person after graduation.
ANSWER: A
Students should get all the experience, not just observation, you can before graduation. Ask to
. perform procedures and skills and request feedback from staff nurses and instructors.
Students should also begin to build resources that will be available after graduation. It is
during the last semester that students begin to care for more complex patients (and more
patient numbers) to . gain experience in the “real world” of nursing management and to
haveless reliance on the nursing instructor as a resource person.
PTS: 1 DIF: Cognitive Level: Application/Applying .
REF: p. 13 OBJ: Describe methods to promote a successful
transition.TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
.
13. A graduate nurse has been reviewing the NCSBN’s Transition to Practice model. The graduate
nurse understands the intention of the model when making which of the following
statements? .
a. “The intention of the model is to mandate that all state boards of nursing provide a
b. regulatory model for transition“The intention of the model is to provide
educationalmodules so that the new to practice.” graduate does not need
to work with a preceptor.” .
c. “The intention of the model is to have the new graduate take and pass the
, NCLEX®, obtain employment, and then enter a transition program.”
d. “The intention of the model is to complete the formalized transition program .
within6 weeks.”
ANSWER: C
The NCSBN’s Transition to Practice model is a regulatory model that is designed to promote
. public safety by supporting the role-transition experience of newly licensed nurses. The
newgraduate would first take and pass the NCLEX®, obtain employment, and then enter the
transition program. There are five transition modules with content focused on
communicationand teamwork, patient-centered care, evidence-based practice, quality
improvement, and . informatics. The time period for completion of the program is 6 months
with an expected additional 6 months of ongoing support. Because of individual state’s
rights, the NCSBN encourages states to adopt this model; however, they do not have the
authority to mandate . adoption of the model. This model does not act as a replacement of a
preceptor in the clinical practice area.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding .
REF: pp. 16-17 OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before
graduationMSC: NCLEX®: Not applicable
.
14. The nurse has an adequate understanding of transitions when making which statement
aboutsituational transitions?
a. “This type of transition can occur with leadership change.” .
b. “This type of transition occurs only when one is dealing with a chronic illness.”
c. “This type of transition can occur when one has a career change.”
d. “This type of transition occurs during a midlife crisis.”
.
ANSWER: C
A situational transition occurs with change from one situation to another, such as a career
change. Dealing with a chronic illness would be characteristic of a health–illness transition,
aleadership change would be an organizational transition, and a midlife crisis would be a .
developmental transition.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 3 OBJ: Discuss the concepts of transitions. .
TOP: What are transitions? MSC: NCLEX®: Not applicable
15. A student in the last semester of nursing school wants to be sure of adequate preparation
for . the transition experience. Which patient should be added to the clinical assignment to
assist inthis process?
