Question 1

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 co-workers' 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 co-workers who find fault with the novice nurse's work performance.

Accepted Answer

Correct:To reduce stress and cope with the rejection phase of transition,the novice nurse should think before answering-take a few minutes before answering and deciding what is best course of action.
Incorrect:b.The novice nurse should avoid minor stresses that drain energy.Bringing lunch and eating in a quiet space would be more helpful than spending most of the break waiting in line and eating lunch quickly or,even worse,eating on the unit.
c.The nurse should rather support co-workers by being a good listener.
d.The nurse should avoid people who are irritating or pessimistic.

Question 2

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?"

Accepted Answer

Correct:During the shock or rejection phase,novice nurses must ask themselves what they must do to become the type of nurse envisioned and to make a contribution.
Incorrect:a."Fitting in" comes with gaining confidence,which is the issue faced by the graduate.
b.Although becoming more organized and improving communication is part of resolving the shock phase,the novice should focus on positive accomplishments and should remember that a nurse cannot learn everything in school-many skills are learned after graduation.Expectations of new graduates are often unrealistic.
d.Although being a change agent is beneficial,blaming others is not the best choice.

Question 3

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."

Accepted Answer

Correct:The novice nurse is working to improve the safety and patient environment and is a patient advocate.
Incorrect:a.The novice nurse is interacting with the manager rather than preferring to work alone or in isolation.
b.The novice nurse is taking an interest in her professional and work environment rather than viewing it as just a job.
d.The novice nurse is not mimicking the actions of the experienced nurse but instead is taking action to improve patient care.

Question 4

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

Accepted Answer

Correct:The novice nurse is considering the legal and safety ramifications if the task is not completed.
Incorrect:b.The novice nurse did not ask,"Who else can perform this task?"
c.Prioritization is one part of organization but does not fully operationalize this concept.
d.The novice nurse may be able to perform any required tasks but may be limited by time.

Question 5

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

Accepted Answer

Correct:The novice nurse lacks proficiency,which may be exaggerated by feelings of being overwhelmed by the new environment,causing him or her to not get the facts before asking for help.
Incorrect:b.The novice nurse was able to communicate her need for help but lacked justification.
c.The novice nurse was able to interact with the supervisor and was not required to interact with other members of the health care team.
d.Feeling incompetent or lacking skills may lead to the feeling of being overwhelmed; however,the novice nurse was disorganized and had not accurately assessed the needs of the unit.

Question 6

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.

Accepted Answer

Correct:The novice nurse can become familiar with the technique,then can perform the skill under the supervision of an experienced nurse,ensuring competency.
Incorrect:a.Although it does allow the novice to follow set steps,there is often more than one correct way to perform a skill,and this approach does not allow competency to be assessed.
b.Once the student has graduated,the staff educator most likely will seek to refine the skills of the novice by demonstrating skills before asking the novice to perform them.
d.Patient safety may be compromised should a critical step be forgotten.

Question 7

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.

Accepted Answer

Correct:Students who participate in preprofessional organizations such as the Student Nurses Association have an opportunity to meet students across the nation and around the world and can network with leaders to gain knowledge about employment possibilities.
Incorrect:a.The clinical facility's employee satisfaction task force is interested only in the population at the place of employment.
c.Self-mentoring can help a novice become more self-sufficient but does not facilitate networking or interacting with individuals from other states or nations.
d.Completing the curriculum and studying for the licensure exam is a priority-investigation study abroad as part of the curriculum is an alternative.

Question 8

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 experiencing:
A) burnout.
B) self-worth.
C) confidence.
D) resilience.

Accepted Answer

Correct:Symptoms of burnout include extreme fatigue,headaches,difficulty sleeping,mood swings,anxiety,poor work quality,depression,and anger.
Incorrect:b.These novice nurses are demonstrating low self-esteem.
c.These novice nurses are uncertain about their abilities as nurses.
d.These novice nurses feel defeated and lack flexibility to overcome feelings of inadequacy.

Question 9

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.

Accepted Answer

Correct:The nurse is experiencing a gradual decline in compassion over time as a result of being exposed to events that have distressed his or her patients,such as working at a young age to support a family while inadvertently being exposed to carcinogens.
Incorrect:a.Burnout refers to feelings of being overwhelmed and distressed,resulting in poor work quality and symptoms such as insomnia and lack of professional pride.
c.Reality shock occurs when a novice nurse enters the workforce after graduating from school and is not prepared to deal with differences between school and workplace values.
d.Horizontal hostility is to control,diminish,or devalue another peer or person,in this situation the nurse is not displaying nor is not the target of bullying or person insults rather is demonstrating compassion fatigue that is the result of working with complex or patient trauma over time resulting in a decline in empathy.

Question 10

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.

Accepted Answer

Correct:Residency programs offer a longer precepted orientation period (often 12 months) to bridge the gap between the classroom and practice.
Incorrect:a.Housing is not the focus of residency programs,but moving expenses may be negotiated as part of the employment process.
b.Interprofessional education may be part of the residency program's content,but partnerships are not included.
c.Residency programs focus on content/activities that help the novice move to a higher level of confidence rather than focusing on higher education.

Question 11

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."

Accepted Answer

Correct:Socialization involves the acceptance and integration of the novice nurse into the profession of nursing,as well as the identification of the novice nurse with the profession of nursing.
Incorrect:a.Biculturalism is the blending of school values with those of the workplace.
c.Transition involves competency when moving from the school to the work environment,and this situation does not require competency on the part of the novice nurse.
d."Going native" describes an inappropriate attempt to move from the shock phase to the recovery phase in which the novice nurse mimics the unsafe practices of experienced nurses.

Question 12

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

Accepted Answer

Correct:During the honeymoon phase,the novice nurse has a positive image of nursing that coincides with the reason for becoming a nurse; this feeling is experienced immediately after the nurse begins work and often while still in orientation.
Incorrect:b.During the shock or rejection phase,the novice nurse is overwhelmed by fear and a sense of incompetence.
c.During the recovery phase,the novice nurse regains some confidence and begins to heal.
d.At the resolution phase,the novice nurse has adjusted to the work environment and can work through change.

Question 13

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.

Accepted Answer

Correct:The experienced nurse knowingly enters into a relationship to advocate for and to enhance the self-esteem of the novice nurse.
Incorrect:a.Mentoring requires an interactive process.
b.The novice nurse mimicked the experienced nurse,and the experienced nurse is most likely unaware of this role.
d.The novice nurse is promoting the professional satisfaction of the experienced nurse; however,the experienced nurse is not building the confidence and self-esteem of the novice nurse in an effort to enhance his or her professional confidence.

Question 14

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.

Accepted Answer

Correct:The experienced and novice nurses have entered into a mutually agreed upon interactive relationship to ease the transition of the novice nurse into the profession.
Incorrect:b.An interactive relationship is present.
c.A preceptorship is usually a short-term relationship.
d.Socialization is the desired outcome of mentoring but not of actual interactions.

Question 15

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."

Accepted Answer

Correct:The nurse is clearly stating the assignments,allowing for a need to adjust both to needs of the unit and the delegate's needs.
Incorrect:a.This could be demeaning because it could be interpreted that the delegate has few skills.
b.Posting assignments in writing is a good idea; however,this may seem as a threat.
d.This is not an example of smooth delegation,which should consider the credentials of the delegate and health status of the patient.

Question 16

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 co-workers to portray them as incompetent.
C) co-workers 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."

Accepted Answer

Correct:b.Withholding information from novices or co-workers to purposely cause them to appear inadequate or unskilled is considered workplace violence because of the anxiety and stress it produces.This should not be tolerated and should be reported.
e.Such statements,which belittle employees,lead to job dissatisfaction,lack of teamwork,and burnout and are considered lateral or workplace violence.This should not be tolerated and should be reported.
Incorrect:a.Employees are not involved in the violence,but compassion fatigue may result.
c.The employee is seeking help for issues outside work.
d.The inmate's violent behavior occurred prior to admission to the health care agency.

Question 17

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."

Accepted Answer

Correct:The novice nurse is mimicking the actions of the experienced nurse taking shortcuts that were not taught in school and not following policy and procedure.
Incorrect:a.The "loner" stage occurs when the nurse prefers to be alone and often works night shift.
b.The "rutter" stage occurs when the nurse just views her work as a job rather than a profession-"Just let me make it through 8 hours and I'll go home."
c.The "change agent" would be working with administration to improve processes to streamline tasks to ensure time for reflection and other tasks

Question 18

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.

Accepted Answer

Correct:Outcomes are based on meeting existing criteria rather than on knowing how the outcome was achieved.
Incorrect:a.The step "determining whether steps are logical" represents the school environment,in which steps are performed on the basis of sound rationales.
b.The step "formulating increments in correct order" represents the school environment evaluation,which stems from the "correct step" aspect.
c.The step "appraising outcomes according to policy" represents the school environment,in which each step is evaluated,rather than indicating the overall outcome.

Question 19

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.

Accepted Answer

Correct:Burnout is more common among nurses with type A personalities and those who are overachievers.
Incorrect:a.Burnout most often occurs among students who are at the top of the class and have high grades.
c.Long hours and repeated overtime can lead to burnout; thus refusing to work overtime or back-to-back long shifts may help avoid burnout.
d.Prioritizing obligations and retaining friendships outside the work environment can reduce stress,thus reducing the likelihood of burnout.

Question 20

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.

Accepted Answer

Correct:During the shock or rejection phase,there is inconsistency with what was learned in school and the work environment,and the novice nurse lacks many of the skills needed to be independent in this new role.
Incorrect:a.During the honeymoon phase,the novice nurse has not yet been faced with complicated tasks that he or she feels uncomfortable or incompetent to perform.
c.The novice nurse lacks confidence in himself or herself,and no healing is evident.The novice nurse has not reached the recovery phase,which precedes the resolution phase.
d.The novice nurse lacks confidence in himself or herself,and no healing is evident.The novice nurse has not reached the recovery phase,which precedes the resolution phase.

Quiz 24: Making the Transition from Student to Professional Nurse

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?

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

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

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

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 experiencing:

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:

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:

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?

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

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?

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.)

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

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