NUR 210/NUR210 Exam 2 V2 | Transition
to Practice - Capstone Q&A with Rationale
| Fortis College
1. A nurse manager is discussing the transition from a student nurse to a registered nurse
with a group of new graduates. Which phase of the reality shock process is characterized by
the new nurse feeling that the school was too idealistic and that the workplace is too fast-
paced and stressful?
A. Honeymoon phase
B. Resolution phase
C. Recovery phase
D. Shock or Rejection phase
Correct Answer: D
Expert Explanation: The shock or rejection phase occurs when the new nurse realizes the
discrepancy between the ideal world of nursing school and the reality of the clinical setting.
During this time, the nurse may experience frustration, anger, or fatigue. It is a critical
period where the nurse needs support to transition successfully into the next stage.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN) on a medical-surgical unit.
Which of the following patients is most appropriate for the LPN to care for?
A. A patient newly admitted with chest pain and shortness of breath.
,B. A patient who is 4 hours post-op after a total hip replacement and is stable.
C. A patient with a new diagnosis of diabetes needing initial insulin teaching.
D. A patient who has just returned from a bronchoscopy and is lethargic.
Correct Answer: B
Expert Explanation: The LPN should be assigned to patients who are stable and have
predictable outcomes. The RN must handle initial assessments, teaching, and patients who
are unstable or require frequent monitoring of airway and circulation. A stable post-
operative patient falls within the scope of practice for the LPN to provide routine
monitoring and medications.
3. A nurse is preparing to administer a medication to a client. The client states, ‘I don’t think
I’ve ever taken that pill before.’ Which of the following actions should the nurse take first?
A. Administer the medication anyway since it is ordered.
B. Withhold the medication and double-check the order and pharmacy.
C. Inform the client that the doctor changed the orders.
D. Document that the patient refused the medication.
Correct Answer: B
Expert Explanation: When a patient questions a medication, the nurse must immediately
stop and verify the order to prevent a medication error. This action addresses the patient’s
concern and ensures safety before proceeding. The nurse should check the Medication
,Administration Record (MAR) against the original order and consult the pharmacy if
necessary.
4. A nurse manager is utilizing Lewin’s Change Theory to implement a new electronic
documentation system. Which stage involves moving the employees to the new behavior by
providing training and support?
A. Unfreezing
B. Moving
C. Refreezing
D. Developing
Correct Answer: B
Expert Explanation: In Lewin’s Change Theory, the ‘Moving’ stage is the actual
implementation of the change where strategies are executed. During this phase, it is vital to
provide staff with the necessary tools and education to adopt the new practice. This follows
‘Unfreezing,’ which prepares the staff for the necessity of change.
5. A nurse on a pediatric unit is caring for several clients. Which of the following clients
should the nurse assess first?
A. An 8-year-old with asthma who has a peak flow in the green zone.
B. A 5-year-old with a fractured arm who is crying for their parent.
C. A 10-year-old with diabetes who has a blood glucose of 140 mg/dL.
, D. A 2-year-old with a barking cough and mild inspiratory stridor.
Correct Answer: D
Expert Explanation: Using the ABC (Airway, Breathing, Circulation) priority framework,
the child with stridor represents a potential airway obstruction and must be assessed
immediately. Stridor indicates narrowed upper airways which can lead to respiratory
distress quickly. The other patients are either stable or have psychosocial needs that are
lower priority than airway management.
6. A nurse is caring for a client who is terminally ill. The client’s family wants to continue
aggressive treatment, but the client has expressed a desire for palliative care only. Which
ethical principle is the nurse upholding by supporting the client’s decision?
A. Beneficence
B. Justice
C. Autonomy
D. Non-maleficence
Correct Answer: C
Expert Explanation: Autonomy refers to the right of the individual to make their own
decisions regarding their healthcare. By advocating for the client’s wishes over the family’s
desires, the nurse is respecting the client’s self-determination. This principle is
fundamental in nursing ethics and the transition to professional practice.
to Practice - Capstone Q&A with Rationale
| Fortis College
1. A nurse manager is discussing the transition from a student nurse to a registered nurse
with a group of new graduates. Which phase of the reality shock process is characterized by
the new nurse feeling that the school was too idealistic and that the workplace is too fast-
paced and stressful?
A. Honeymoon phase
B. Resolution phase
C. Recovery phase
D. Shock or Rejection phase
Correct Answer: D
Expert Explanation: The shock or rejection phase occurs when the new nurse realizes the
discrepancy between the ideal world of nursing school and the reality of the clinical setting.
During this time, the nurse may experience frustration, anger, or fatigue. It is a critical
period where the nurse needs support to transition successfully into the next stage.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN) on a medical-surgical unit.
Which of the following patients is most appropriate for the LPN to care for?
A. A patient newly admitted with chest pain and shortness of breath.
,B. A patient who is 4 hours post-op after a total hip replacement and is stable.
C. A patient with a new diagnosis of diabetes needing initial insulin teaching.
D. A patient who has just returned from a bronchoscopy and is lethargic.
Correct Answer: B
Expert Explanation: The LPN should be assigned to patients who are stable and have
predictable outcomes. The RN must handle initial assessments, teaching, and patients who
are unstable or require frequent monitoring of airway and circulation. A stable post-
operative patient falls within the scope of practice for the LPN to provide routine
monitoring and medications.
3. A nurse is preparing to administer a medication to a client. The client states, ‘I don’t think
I’ve ever taken that pill before.’ Which of the following actions should the nurse take first?
A. Administer the medication anyway since it is ordered.
B. Withhold the medication and double-check the order and pharmacy.
C. Inform the client that the doctor changed the orders.
D. Document that the patient refused the medication.
Correct Answer: B
Expert Explanation: When a patient questions a medication, the nurse must immediately
stop and verify the order to prevent a medication error. This action addresses the patient’s
concern and ensures safety before proceeding. The nurse should check the Medication
,Administration Record (MAR) against the original order and consult the pharmacy if
necessary.
4. A nurse manager is utilizing Lewin’s Change Theory to implement a new electronic
documentation system. Which stage involves moving the employees to the new behavior by
providing training and support?
A. Unfreezing
B. Moving
C. Refreezing
D. Developing
Correct Answer: B
Expert Explanation: In Lewin’s Change Theory, the ‘Moving’ stage is the actual
implementation of the change where strategies are executed. During this phase, it is vital to
provide staff with the necessary tools and education to adopt the new practice. This follows
‘Unfreezing,’ which prepares the staff for the necessity of change.
5. A nurse on a pediatric unit is caring for several clients. Which of the following clients
should the nurse assess first?
A. An 8-year-old with asthma who has a peak flow in the green zone.
B. A 5-year-old with a fractured arm who is crying for their parent.
C. A 10-year-old with diabetes who has a blood glucose of 140 mg/dL.
, D. A 2-year-old with a barking cough and mild inspiratory stridor.
Correct Answer: D
Expert Explanation: Using the ABC (Airway, Breathing, Circulation) priority framework,
the child with stridor represents a potential airway obstruction and must be assessed
immediately. Stridor indicates narrowed upper airways which can lead to respiratory
distress quickly. The other patients are either stable or have psychosocial needs that are
lower priority than airway management.
6. A nurse is caring for a client who is terminally ill. The client’s family wants to continue
aggressive treatment, but the client has expressed a desire for palliative care only. Which
ethical principle is the nurse upholding by supporting the client’s decision?
A. Beneficence
B. Justice
C. Autonomy
D. Non-maleficence
Correct Answer: C
Expert Explanation: Autonomy refers to the right of the individual to make their own
decisions regarding their healthcare. By advocating for the client’s wishes over the family’s
desires, the nurse is respecting the client’s self-determination. This principle is
fundamental in nursing ethics and the transition to professional practice.
