Deck 24: Making the Transition from Student to Professional Nurse

Question 1

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed:

A) honeymoon.
B) shock or rejection.
C) recovery.
D) resolution.

Answer 1

shock or rejection.

Question 2

A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member?

A) "You have the patients in rooms 1 to 7. These patients require little skill so you will be fine."
B) "Your assignments are posted in writing by the nurses' station. Be certain all your tasks are completed so the next shift is not behind."
C) "You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I have to adjust. If you see you need help let me know."
D) "Everyone is capable of providing the best care, so please sign up for the patients you would like to be assigned to."

Answer 2

"You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I have to adjust. If you see you need help let me know."

Question 3

According to Kramer, nurses in the shock phase should ask themselves:

A) "How can I fit in with other staff?"
B) "Why can't I perform as everyone expects?"
C) "What changes can I make to make me feel good about the choice to become a nurse?"
D) "How can I get the rest of the staff to change?"

Answer 3

"What changes can I make to make me feel good about the choice to become a nurse?"

Question 4

A novice nurse is unsure how to correctly administer an injection using the Z-track method. What is the best approach for learning this procedure?

A) Read the procedure manual and follow the steps exactly.
B) Make an appointment at the skills laboratory of the former nursing school to practice.
C) Ask to observe the skill as it is being performed; then perform it under direct supervision.
D) Try to remember how the task was previously performed during a simulation.

Question 5

An experienced nurse working in oncology is shocked to realize that he feels little empathy when a patient explains, "I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. Now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine." The nurse is experiencing:

A) burnout.
B) compassion fatigue.
C) reality shock.
D) horizontal hostility.

Question 6

A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is known as:

A) mentoring.
B) role modeling.
C) a preceptorship.
D) socialization.

Question 7

A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, "No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I." This nurse is experiencing which stage of reality shock?

A) loner.
B) "rutter."
C) change agent.
D) "native."

Question 8

A novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress?

A) When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level.
B) Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors.
C) Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed.
D) Make an effort to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.

Question 9

A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." The recruiter further explains that a residency program:

A) provides housing for the graduate nurse to decrease expenses until income is established.
B) partners a medical resident with a nurse resident to learn interprofessional care.
C) allows new graduates to work on a higher degree in nursing while being paid full-time.
D) offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.

Question 10

In distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes:

A) determining whether steps are logical.
B) formulating increments in correct order.
C) efficiently organizing stages of the procedure.
D) appraising outcomes according to policy.

Question 11

Which nurse is more prone to burnout? The nurse who:

A) graduated last in the class.
B) is industrious and conscientious.
C) refuses to work an extra shift even though he or she needs the money.
D) volunteers to serve on only one committee and keeps in touch with schoolmates.

Question 12

When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated?

A) Priority setting
B) Delegation
C) Organization
D) Clinical skills

Question 13

In orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, "What kind of violence is common in hospitals?" The educator describes workplace violence as: (select all that apply)

A) care of patients admitted who are victims of domestic violence.
B) experienced nurses withholding pertinent information from coworkers to portray them as incompetent.
C) coworkers participating in an employee assistance program (EAP) to learn more about anger management for adult children living at home.
D) care of persons being held for treatment prior to be incarcerated for committing homicide.
E) statements such as "The new nurse has book sense but can't perform an admission physical without the help of everyone on the unit."

Question 14

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed:

A) biculturalism.
B) socialization.
C) transition.
D) "going native."

Question 15

Several novice nurses share lunch breaks and have comments such as, "I have insomnia from worrying about what I forgot to do for my patient," and "I have no energy," and "I can't believe I can't do my job correctly." These novice nurses are each experiencing different symptoms of:

A) burnout.
B) low self-esteem.
C) lack of confidence.
D) resilience.

Question 16

A student nurse wants to meet other nursing students from different countries and to learn of employment possibilities. The student nurse should:

A) participate in the clinical facility's employee satisfaction task force.
B) join the Student Nurses Association.
C) take part in self-mentoring.
D) postpone taking the licensure examination so he or she can take a tour of foreign countries.

Question 17

A novice nurse notices the medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and "What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. The novice nurse speaks to the nurse manager about her observations and describes her concerns. The novice nurse has assumed the role of:

A) loner.
B) "rutter."
C) change agent.
D) "native."

Question 18

When comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations?

A) The experienced nurse is unaware that the novice nurse is observing him or her gathering supplies needed to start intravenous antibiotics.
B) The novice nurse mimics conversations with his or her own patients that were unobtrusively overheard between the experienced nurse and his or her patients.
C) The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself."
D) An experienced nurse is nominated for outstanding employee of the month by the novice nurse.

Question 19

The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of _____ skills.

A) organizational
B) communication
C) interpersonal
D) clinical

Question 20

During orientation, a novice nurse sits and "virtually spends" the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing?

A) Honeymoon
B) Shock or rejection
C) Recovery
D) Resolution

Question 21

Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, "Why join this organization? It is just a bunch of students like us. I'll wait and join the real nursing organization after graduation." This student is not aware of which benefits of SNA? (select all that apply)

A) Members are eligible to sit for the licensure examination at a reduced rate.
B) Leadership skills can be refined by working with other schools of nursing.
C) The National SNA provides discounted rates for study abroad opportunities.
D) A global view of nursing can be obtained through networking internationally.
E) Lobbying efforts are a major benefit of belonging to SNA.

Question 22

A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply)

A) Glaring at the nurse
B) Nervousness, twisting of hands
C) Murmuring when talking
D) Diagnosis of a terminal illness
E) Isolation, desire to be alone

Question 23

It is important for novice nurses to know that "self-esteem = self-confidence + self-______."