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Nursing Today 10th Edition Zerwekh
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,Chapter 01: Role Transitions
Zerwekh: Nursing Today: Transition and Trends, 11th Edition
MULTIPLE CHOICE
1. A graduate nurse has been hired as a nurse at a local hospital. The new nurse is in the
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.”
ANS: 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. Reality
shock 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 the
nurse is able to grow as a person.
DIF: Cognitive Level: Application/Applying
OBJ: Identify the characteristics of transition shock. TOP: Reality shock
MSC: NCLEX®: Safe and effective care environment
2. Which of the following actions by the graduate nurse is an inappropriate methodology to
recover from transition shock?
a. Networking
b. Obtaining a mentor
c. Returning to school
d. Joining a support group
ANS: C
The transition period is successfully managed when the graduate is able to evaluate the work
situation objectively and effectively predict the actions and reactions of other staff. Nurturing
the ability to see the humor in a situation may be a first step. Returning to school is a positive
step 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” issues
and learning how to cope.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Transition shock
MSC: NCLEX®: Safe and effective care environment—not applicable
3. A new nurse who has been off orientation for 4 months now 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
ANS: A
At this phase of the nurse’s career, he or she is in the Doing Stage of Transition. One common
characteristic of this phase is the inability to set reasonable boundaries related to work.
Constantly working overtime will lead the new nurse to burnout. “Going native” is the term
that describes how recent graduates begin to copy and identify the reality of their role-
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
from other nurses.
DIF: Cognitive Level: Application/Applying
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 of reality
shock as it applies to nursing?
a. “Reality shock is the period when a person moves from school into the
workforce.”
b. “Reality shock is the realization that practice and education are not the same.”
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 changing
jobs.”
ANS: A
“Reality shock” is a term often used to describe the reaction experienced when one moves into
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 definition of
reality shock.
DIF: Cognitive Level: Application/Applying
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 indicates his/her
understanding of how to achieve this goal?
a. “I should care for increased number of patients to enhance work organization
skills.”
b. “I will observe staff nurses as they perform nursing procedures to refine
technique.”
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.”
, ANS: A
It is important for the student to start taking care of increased number of patients to help with
time management and work organization. The student should also be able to function without
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 an
important process, it is the actual experience of taking realistic patient assignments and
working typical shift hours that assists with successful role transition.
DIF: Cognitive Level: Application/Applying
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
ANS: 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.
A 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.
DIF: Cognitive Level: Application/Applying
OBJ: Compare and contrast the phases of reality shock. TOP: Reality shock
MSC: NCLEX®: Not applicable
7. A new graduate has worked in 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
ANS: 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. Excessive
mistrust, frequent pains and illness, a decrease in energy and fatigue, feeling like a failure and
blaming oneself for every mistake, a hypercritical attitude, and feeling morally outraged are
the 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 process
of transforming from a student to nurse.
DIF: Cognitive Level: Application/Applying
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 for
the 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
ANS: D
A situational transition is a lifestyle change that occurs because of a new situation. Most often
the 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.
DIF: Cognitive Level: Application/Applying
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 action does the
nurse identify as influential in a successful transition from school to practice?
a. Acquiring new knowledge and skills required in the new environment
b. Completing classwork required to obtain an advanced degree
c. Reflecting on personal history of previous developmental transitions
d. Discuss transitional experiences with other classmates
ANS: 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 the
new environment of work.
DIF: Cognitive Level: Application/Applying
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 manager
demonstrates an awareness of the job expectations of a new graduate when making which of
the following statements?
a. “A newly graduated nurse should be able to perform as independently as was
demonstrated the last semester of nursing.”
b. “A newly graduated nurse should be able to function competently as a registered
nurse at the entry level.”
c. “A newly graduated nurse should be able to function in the role that was described
in the curriculum for the school of nursing.”
d. “A newly graduated nurse should be able to be able to function independently with
the ability to make clinical nursing judgments.”
ANS: B
A newly graduated nurse is expected to be competent and capable. Hospitals frequently
provide 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.
DIF: Cognitive Level: Application/Applying
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
so nice.
d. The nurse meets regularly with other new graduates to compare and discuss
problems.
ANS: 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 a successful transition.
DIF: Cognitive Level: Application/Applying
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 student
indicates appropriate preparation for the transition experience?
a. The nursing student requests additional experiences in performing skills and
procedures.
b. The nursing student maintains close contact with a nursing instructor to observe
nursing procedures.
c. The nursing student practices nursing assessments and care on one or two patients
, to become more competent.
d. The nursing student increases communication with a nursing instructor to maintain
a resource person after graduation.
ANS: A
Students should get all the experience, not just observation, possible before graduation. They
should request opportunities 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 have less reliance on the nursing instructor as a resource person.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
13. A nurse manager reviewing the NCSBN’s Transition to Practice (TTP) model best
demonstrates an understanding of 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
regulatory model for transition to practice.”
b. “The intention of the model is to provide educational modules so that the new
graduate does not need to work with a preceptor.”
c. “The intention of the model is to promote public safety by supporting newly
licensed nurses in their critical entry and progression into practice.”
d. “The intention of the model is to complete the formalized transition program
within 6 weeks.”
ANS: 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 TTP
model recommends a 9- to 12-month internship, so the new graduate receives continued
support during the vulnerable period from 6 to 9 months. Because of the individual state’s
rights, the NCSBN encourages states to adopt this model; however, they do not have the
authority to mandate the adoption of the model. This model does not act as a replacement for a
preceptor in the clinical practice area.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
14. The nurse demonstrates an understanding of transitions when making which statement about
situational transitions?
a. “This type of transition can occur when a new nurse manager is hired.”
b. “This type of transition occurs only when with a person is diagnosed with a
chronic illness.”
c. “I experienced this type of transition when I became a pediatric nurse practician .”
d. “I’ve seen this type of transition occurs when nurses reach their 50’s.”
ANS: C
, A situational transition occurs with the change from one situation to another, such as a career
change. Dealing with a chronic illness would be characteristic of a health–illness transition, a
leadership change would be an organizational transition, and a midlife crisis would be a
developmental transition.
DIF: Cognitive Level: Application/Applying
OBJ: Discuss the concepts of transitions. TOP: What are transitions?
MSC: NCLEX®: Not applicable
15. A student in the last semester of a nursing school wants to be sure of adequate preparation for
the transition experience. Which patient should be added to the clinical assignment to assist in
this process?
a. A 48-year-old man with heart failure who has oral and IV medications due and
needs a new IV started
b. A 38-year-old woman who cares for herself independently and is going home later
today
c. A 25-year-old man who is leaving the hospital against medical advice
d. A 40-year-old man who needs education on diabetes management
ANS: A
To adequately prepare for role transition, the student nurse needs realistic assignments and
real-life experiences. It would be most appropriate for the student to accept the most complex
patient, who requires oral and IV medications and needs to have his IV restarted. The patient
who can care for herself independently and the one who is leaving the hospital against
medical advice would not provide as much skill experience. Diabetic teaching is important but
does not require the time management and work organization skills of a complex patient.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Not applicable
16. A student nurse is interested in improving nursing skills. What action would be the best for the
student nurse to take?
a. Ask the instructor for extra skills practice during clinical hours.
b. Watch videos on how to perform the nursing skills that need practice.
c. Review current nursing textbooks.
d. Observe nurses perform skills in the clinical setting.
ANS: A
The best way for the nursing student to improve skills is to get hands-on practice. The student
would benefit most from requesting extra skills practice during clinical hours, where skills can
be performed on real patients, with the guidance of a clinical instructor. Therefore, watching
skills videos, reviewing nursing textbooks, and observing other nurses would not help the
student obtain hands-on practice.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Safe and effective care environment
, 17. A nursing student is nearing the end of his/her clinical experience. The student would like to
care for patients who are typically challenging for students in the first year of practice. Which
patient would be the best choice for this student?
a. A 62-year-old man with diabetes who needs outpatient care set up
b. A 30-year-old woman with a kidney stone requiring IV pain medications
c. A 45-year-old man with chest tubes recovering from a car crash
d. A 25-year-old woman who received blood yesterday
ANS: C
The skills that nursing students have identified as the most challenging include code blues,
chest tubes, intravenous skills, central lines, blood administration, and patient-controlled
analgesia. The most appropriate patient for the student to increase his/her skill level would be
the 45-year-old man with chest tubes. The other patients are not considered to be “challenging
patients” for most nursing students.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Not applicable
18. Which statement by the nursing student indicates an understanding of the importance of
constructive feedback?
a. “I will wait until my clinical evaluation and then make any changes to my practice
that are needed.”
b. “I will request routine feedback from my instructor so I can make any changes
needed to improve my skills.”
c. “My instructor will let me know if I need to change anything.”
d. “I will ask my colleagues if I need to make any changes to my practice.”
ANS: B
Students are responsible for their skills and growth as health care providers. To ensure that
their nursing skills are adequate, students should request periodic feedback from their clinical
instructors. Waiting for feedback or asking colleagues would not be an effective way for
nursing students to obtain feedback in a timely manner.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Not applicable
19. A graduate nurse has clocked in for his/her second shift on a busy orthopedic unit. After
accepting the assignment, the graduate nurse notices a fellow nurse complaining loudly at the
nurse’s station to other staff members. This fellow nurse is typically upset with floor
assignments and thinks that the “new nurses get all the easy assignments.” Which action
would be best for the graduate nurse to take?
a. Join the conversation and tell the fellow nurse that he/she does not care for the
assignment either.
b. Begin a conversation with another staff member about the fellow nurse who is
complaining.
c. Steer clear of the nurse who is complaining and try to focus on the positive.
d. Begin complaining about his/her own assignment.
ANS: C
Nursing Today 10th Edition Zerwekh
Important Notes
The file includes the complete test bank, organized chapter by chapter.
A sample of selected pages has been provided for preview.
All available appendices and Excel files (if included in the original resources) are
provided.
We continuously update our files to ensure you receive the latest and most accurate
editions.
New editions are added regularly – stay connected for updates!
Purchase Guarantee
If you believe you have purchased the wrong file, don’t worry. Contact us anytime and we
will gladly replace it with the correct version.
Contact Email:
,Chapter 01: Role Transitions
Zerwekh: Nursing Today: Transition and Trends, 11th Edition
MULTIPLE CHOICE
1. A graduate nurse has been hired as a nurse at a local hospital. The new nurse is in the
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.”
ANS: 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. Reality
shock 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 the
nurse is able to grow as a person.
DIF: Cognitive Level: Application/Applying
OBJ: Identify the characteristics of transition shock. TOP: Reality shock
MSC: NCLEX®: Safe and effective care environment
2. Which of the following actions by the graduate nurse is an inappropriate methodology to
recover from transition shock?
a. Networking
b. Obtaining a mentor
c. Returning to school
d. Joining a support group
ANS: C
The transition period is successfully managed when the graduate is able to evaluate the work
situation objectively and effectively predict the actions and reactions of other staff. Nurturing
the ability to see the humor in a situation may be a first step. Returning to school is a positive
step 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” issues
and learning how to cope.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Transition shock
MSC: NCLEX®: Safe and effective care environment—not applicable
3. A new nurse who has been off orientation for 4 months now 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
ANS: A
At this phase of the nurse’s career, he or she is in the Doing Stage of Transition. One common
characteristic of this phase is the inability to set reasonable boundaries related to work.
Constantly working overtime will lead the new nurse to burnout. “Going native” is the term
that describes how recent graduates begin to copy and identify the reality of their role-
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
from other nurses.
DIF: Cognitive Level: Application/Applying
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 of reality
shock as it applies to nursing?
a. “Reality shock is the period when a person moves from school into the
workforce.”
b. “Reality shock is the realization that practice and education are not the same.”
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 changing
jobs.”
ANS: A
“Reality shock” is a term often used to describe the reaction experienced when one moves into
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 definition of
reality shock.
DIF: Cognitive Level: Application/Applying
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 indicates his/her
understanding of how to achieve this goal?
a. “I should care for increased number of patients to enhance work organization
skills.”
b. “I will observe staff nurses as they perform nursing procedures to refine
technique.”
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.”
, ANS: A
It is important for the student to start taking care of increased number of patients to help with
time management and work organization. The student should also be able to function without
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 an
important process, it is the actual experience of taking realistic patient assignments and
working typical shift hours that assists with successful role transition.
DIF: Cognitive Level: Application/Applying
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
ANS: 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.
A 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.
DIF: Cognitive Level: Application/Applying
OBJ: Compare and contrast the phases of reality shock. TOP: Reality shock
MSC: NCLEX®: Not applicable
7. A new graduate has worked in 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
ANS: 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. Excessive
mistrust, frequent pains and illness, a decrease in energy and fatigue, feeling like a failure and
blaming oneself for every mistake, a hypercritical attitude, and feeling morally outraged are
the 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 process
of transforming from a student to nurse.
DIF: Cognitive Level: Application/Applying
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 for
the 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
ANS: D
A situational transition is a lifestyle change that occurs because of a new situation. Most often
the 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.
DIF: Cognitive Level: Application/Applying
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 action does the
nurse identify as influential in a successful transition from school to practice?
a. Acquiring new knowledge and skills required in the new environment
b. Completing classwork required to obtain an advanced degree
c. Reflecting on personal history of previous developmental transitions
d. Discuss transitional experiences with other classmates
ANS: 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 the
new environment of work.
DIF: Cognitive Level: Application/Applying
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 manager
demonstrates an awareness of the job expectations of a new graduate when making which of
the following statements?
a. “A newly graduated nurse should be able to perform as independently as was
demonstrated the last semester of nursing.”
b. “A newly graduated nurse should be able to function competently as a registered
nurse at the entry level.”
c. “A newly graduated nurse should be able to function in the role that was described
in the curriculum for the school of nursing.”
d. “A newly graduated nurse should be able to be able to function independently with
the ability to make clinical nursing judgments.”
ANS: B
A newly graduated nurse is expected to be competent and capable. Hospitals frequently
provide 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.
DIF: Cognitive Level: Application/Applying
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
so nice.
d. The nurse meets regularly with other new graduates to compare and discuss
problems.
ANS: 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 a successful transition.
DIF: Cognitive Level: Application/Applying
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 student
indicates appropriate preparation for the transition experience?
a. The nursing student requests additional experiences in performing skills and
procedures.
b. The nursing student maintains close contact with a nursing instructor to observe
nursing procedures.
c. The nursing student practices nursing assessments and care on one or two patients
, to become more competent.
d. The nursing student increases communication with a nursing instructor to maintain
a resource person after graduation.
ANS: A
Students should get all the experience, not just observation, possible before graduation. They
should request opportunities 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 have less reliance on the nursing instructor as a resource person.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
13. A nurse manager reviewing the NCSBN’s Transition to Practice (TTP) model best
demonstrates an understanding of 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
regulatory model for transition to practice.”
b. “The intention of the model is to provide educational modules so that the new
graduate does not need to work with a preceptor.”
c. “The intention of the model is to promote public safety by supporting newly
licensed nurses in their critical entry and progression into practice.”
d. “The intention of the model is to complete the formalized transition program
within 6 weeks.”
ANS: 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 TTP
model recommends a 9- to 12-month internship, so the new graduate receives continued
support during the vulnerable period from 6 to 9 months. Because of the individual state’s
rights, the NCSBN encourages states to adopt this model; however, they do not have the
authority to mandate the adoption of the model. This model does not act as a replacement for a
preceptor in the clinical practice area.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
14. The nurse demonstrates an understanding of transitions when making which statement about
situational transitions?
a. “This type of transition can occur when a new nurse manager is hired.”
b. “This type of transition occurs only when with a person is diagnosed with a
chronic illness.”
c. “I experienced this type of transition when I became a pediatric nurse practician .”
d. “I’ve seen this type of transition occurs when nurses reach their 50’s.”
ANS: C
, A situational transition occurs with the change from one situation to another, such as a career
change. Dealing with a chronic illness would be characteristic of a health–illness transition, a
leadership change would be an organizational transition, and a midlife crisis would be a
developmental transition.
DIF: Cognitive Level: Application/Applying
OBJ: Discuss the concepts of transitions. TOP: What are transitions?
MSC: NCLEX®: Not applicable
15. A student in the last semester of a nursing school wants to be sure of adequate preparation for
the transition experience. Which patient should be added to the clinical assignment to assist in
this process?
a. A 48-year-old man with heart failure who has oral and IV medications due and
needs a new IV started
b. A 38-year-old woman who cares for herself independently and is going home later
today
c. A 25-year-old man who is leaving the hospital against medical advice
d. A 40-year-old man who needs education on diabetes management
ANS: A
To adequately prepare for role transition, the student nurse needs realistic assignments and
real-life experiences. It would be most appropriate for the student to accept the most complex
patient, who requires oral and IV medications and needs to have his IV restarted. The patient
who can care for herself independently and the one who is leaving the hospital against
medical advice would not provide as much skill experience. Diabetic teaching is important but
does not require the time management and work organization skills of a complex patient.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Not applicable
16. A student nurse is interested in improving nursing skills. What action would be the best for the
student nurse to take?
a. Ask the instructor for extra skills practice during clinical hours.
b. Watch videos on how to perform the nursing skills that need practice.
c. Review current nursing textbooks.
d. Observe nurses perform skills in the clinical setting.
ANS: A
The best way for the nursing student to improve skills is to get hands-on practice. The student
would benefit most from requesting extra skills practice during clinical hours, where skills can
be performed on real patients, with the guidance of a clinical instructor. Therefore, watching
skills videos, reviewing nursing textbooks, and observing other nurses would not help the
student obtain hands-on practice.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Safe and effective care environment
, 17. A nursing student is nearing the end of his/her clinical experience. The student would like to
care for patients who are typically challenging for students in the first year of practice. Which
patient would be the best choice for this student?
a. A 62-year-old man with diabetes who needs outpatient care set up
b. A 30-year-old woman with a kidney stone requiring IV pain medications
c. A 45-year-old man with chest tubes recovering from a car crash
d. A 25-year-old woman who received blood yesterday
ANS: C
The skills that nursing students have identified as the most challenging include code blues,
chest tubes, intravenous skills, central lines, blood administration, and patient-controlled
analgesia. The most appropriate patient for the student to increase his/her skill level would be
the 45-year-old man with chest tubes. The other patients are not considered to be “challenging
patients” for most nursing students.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Not applicable
18. Which statement by the nursing student indicates an understanding of the importance of
constructive feedback?
a. “I will wait until my clinical evaluation and then make any changes to my practice
that are needed.”
b. “I will request routine feedback from my instructor so I can make any changes
needed to improve my skills.”
c. “My instructor will let me know if I need to change anything.”
d. “I will ask my colleagues if I need to make any changes to my practice.”
ANS: B
Students are responsible for their skills and growth as health care providers. To ensure that
their nursing skills are adequate, students should request periodic feedback from their clinical
instructors. Waiting for feedback or asking colleagues would not be an effective way for
nursing students to obtain feedback in a timely manner.
DIF: Cognitive Level: Application/Applying
OBJ: Describe methods to promote a successful transition. TOP: Role transformation
MSC: NCLEX®: Not applicable
19. A graduate nurse has clocked in for his/her second shift on a busy orthopedic unit. After
accepting the assignment, the graduate nurse notices a fellow nurse complaining loudly at the
nurse’s station to other staff members. This fellow nurse is typically upset with floor
assignments and thinks that the “new nurses get all the easy assignments.” Which action
would be best for the graduate nurse to take?
a. Join the conversation and tell the fellow nurse that he/she does not care for the
assignment either.
b. Begin a conversation with another staff member about the fellow nurse who is
complaining.
c. Steer clear of the nurse who is complaining and try to focus on the positive.
d. Begin complaining about his/her own assignment.
ANS: C
