Nursing Today 10th Edition Zerwekh Te
Chapter 01: Role Transitions
Zerwekh: Nursing Today: Transition and Trends, 10th Edition
MULTIPLE CHOICE
1. A graduate nurse has been hired as a nurse at a local hospital. The new nurse is in the honeymoon phas
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
the thrill of arriving in the profession. Reality shock occurs when one moves into the workforce after s
preparation. Recovery and resolution occur when the graduate nurse is able to laugh at encountered sit
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
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
predict the actions and reactions of other staff. Nurturing the ability to see the humor in a situation may
school is a positive step after the graduate has worked through role transition, has some clinical experie
a new career objective. Networking, obtaining a mentor, and joining a support group would give the gr
to talk to others experiencing the stress associated with reality shock. The nurse would benefit from “ta
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 fo
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 characte
inability to set reasonable boundaries related to work. Constantly working overtime will lead the new n
native” is the term that describes how recent graduates begin to copy and identify the reality of their ro
rejecting the values from nursing school and functioning more like a team member at their place of em
peer support groups, “going native,” and changing jobs every 6 to 12 months would increase the chanc
burnout. The nurse should instead focus on his/her practice and seek out support from other nurses.
,5. A student in the last semester of nursing school has established a goal of making a successful role trans
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 man
organization. The student should also be able to function without close guidance from the nursing instr
for students to observe staff, a student in the final semester should be able to perform tasks with minim
instead focus on implementing care and time management. Waiting 7 weeks to evaluate progress woul
student. Although regular self-evaluation is an important process, it is the actual experience of taking r
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 fee
fact, it’s a snap! I can hardly believe there’s no instructor looking over my shoulder.” What phase of re
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 wi
accepting the first job. Life is a bed of roses because everyone knows nursing school is much harder th
and rejection occur as the nurse tries to understand how nursing school and the “real world” come toge
the nurse begins the move from student to nurse and refers to the entire process, not just a particular ph
when the nurse can laugh at situations that he/she is in and is able to cope with the situations that are be
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 grad
never been so upset in all my life! The care that some of the staff give our patients is outrageously bad.
attention to the principles of asepsis the way I learned them! The staff tell me that we have to cut corne
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 confli
was taught and the reality of what is done. Shock and rejection cause mental and emotional withdrawa
hypercritical attitude, which are just some of the symptoms of the realization that the honeymoon is ov
frequent pains and illness, a decrease in energy and fatigue, feeling like a failure and blaming oneself f
hypercritical attitude, and feeling morally outraged are the characteristics of the shock and rejection ph
characterized by a beginning sense of humor (usually the first sigh), a decrease in tension, and an incre
with the situations that he/she is faced with. Role transformation is the process of transforming from a
DIF: Cognitive Level: Application/Applying
, 9. The graduate nurse understands that transitions occur throughout life. What major factor does the nurse
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
ANS: A
The transition from student to practice reflects a situational transition that is most often affected by the
the new work environment. Classwork no longer affects this transition. A personal history of previous
and the influence of classmates are not as prominent as the anticipated requirements to function in the n
DIF: Cognitive Level: Comprehension/Understanding
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 understands
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 ext
the new graduate to transition into the independent role of the nurse. The new graduate nurse is not exp
independently with the ability to make clinical nursing judgments. School curriculum and how one fun
school are usually not considered in the job expectations of a new graduate.
DIF: Cognitive Level: Comprehension/Understanding
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 w
provide care in the manner that the team or group wants it done, not necessarily the correct way. The “
everything is going great. Meeting with other new graduates can be productive, but it is a part of the tra
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
the transition experience?
a. The nursing student requests additional experiences in performing skills and
procedures.
, 13. A graduate nurse has been reviewing the NCSBN’s Transition to Practice model. The graduate nurse u
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 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
within 6 weeks.”
ANS: C
The NCSBN’s Transition to Practice model is a regulatory model that is designed to promote public sa
role-transition experience of newly licensed nurses. The new graduate would first take and pass the NC
and then enter the transition program. There are five transition modules with content focused on comm
patient-centered care, evidence-based practice, quality improvement, and informatics. The time period
program is 6 months with an expected additional 6 months of ongoing support. Because of the individu
encourages states to adopt this model; however, they do not have the authority to mandate the adoption
does not act as a replacement for a preceptor in the clinical practice area.
DIF: Cognitive Level: Comprehension/Understanding
OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
14. The nurse has an adequate understanding of transitions when making which statement about situationa
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.”
ANS: C
A situational transition occurs with the change from one situation to another, such as a career change. D
illness would be characteristic of a health–illness transition, a leadership change would be an organiza
midlife crisis would be a developmental transition.
DIF: Cognitive Level: Comprehension/Understanding
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 trans
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 exp
appropriate for the student to accept the most complex patient, who requires oral and IV medications a
restarted. The patient who can care for herself independently and the one who is leaving the hospital ag
not provide as much skill experience. Diabetic teaching is important but does not require the time mana
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
Chapter 01: Role Transitions
Zerwekh: Nursing Today: Transition and Trends, 10th Edition
MULTIPLE CHOICE
1. A graduate nurse has been hired as a nurse at a local hospital. The new nurse is in the honeymoon phas
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
the thrill of arriving in the profession. Reality shock occurs when one moves into the workforce after s
preparation. Recovery and resolution occur when the graduate nurse is able to laugh at encountered sit
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
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
predict the actions and reactions of other staff. Nurturing the ability to see the humor in a situation may
school is a positive step after the graduate has worked through role transition, has some clinical experie
a new career objective. Networking, obtaining a mentor, and joining a support group would give the gr
to talk to others experiencing the stress associated with reality shock. The nurse would benefit from “ta
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 fo
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 characte
inability to set reasonable boundaries related to work. Constantly working overtime will lead the new n
native” is the term that describes how recent graduates begin to copy and identify the reality of their ro
rejecting the values from nursing school and functioning more like a team member at their place of em
peer support groups, “going native,” and changing jobs every 6 to 12 months would increase the chanc
burnout. The nurse should instead focus on his/her practice and seek out support from other nurses.
,5. A student in the last semester of nursing school has established a goal of making a successful role trans
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 man
organization. The student should also be able to function without close guidance from the nursing instr
for students to observe staff, a student in the final semester should be able to perform tasks with minim
instead focus on implementing care and time management. Waiting 7 weeks to evaluate progress woul
student. Although regular self-evaluation is an important process, it is the actual experience of taking r
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 fee
fact, it’s a snap! I can hardly believe there’s no instructor looking over my shoulder.” What phase of re
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 wi
accepting the first job. Life is a bed of roses because everyone knows nursing school is much harder th
and rejection occur as the nurse tries to understand how nursing school and the “real world” come toge
the nurse begins the move from student to nurse and refers to the entire process, not just a particular ph
when the nurse can laugh at situations that he/she is in and is able to cope with the situations that are be
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 grad
never been so upset in all my life! The care that some of the staff give our patients is outrageously bad.
attention to the principles of asepsis the way I learned them! The staff tell me that we have to cut corne
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 confli
was taught and the reality of what is done. Shock and rejection cause mental and emotional withdrawa
hypercritical attitude, which are just some of the symptoms of the realization that the honeymoon is ov
frequent pains and illness, a decrease in energy and fatigue, feeling like a failure and blaming oneself f
hypercritical attitude, and feeling morally outraged are the characteristics of the shock and rejection ph
characterized by a beginning sense of humor (usually the first sigh), a decrease in tension, and an incre
with the situations that he/she is faced with. Role transformation is the process of transforming from a
DIF: Cognitive Level: Application/Applying
, 9. The graduate nurse understands that transitions occur throughout life. What major factor does the nurse
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
ANS: A
The transition from student to practice reflects a situational transition that is most often affected by the
the new work environment. Classwork no longer affects this transition. A personal history of previous
and the influence of classmates are not as prominent as the anticipated requirements to function in the n
DIF: Cognitive Level: Comprehension/Understanding
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 understands
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 ext
the new graduate to transition into the independent role of the nurse. The new graduate nurse is not exp
independently with the ability to make clinical nursing judgments. School curriculum and how one fun
school are usually not considered in the job expectations of a new graduate.
DIF: Cognitive Level: Comprehension/Understanding
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 w
provide care in the manner that the team or group wants it done, not necessarily the correct way. The “
everything is going great. Meeting with other new graduates can be productive, but it is a part of the tra
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
the transition experience?
a. The nursing student requests additional experiences in performing skills and
procedures.
, 13. A graduate nurse has been reviewing the NCSBN’s Transition to Practice model. The graduate nurse u
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 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
within 6 weeks.”
ANS: C
The NCSBN’s Transition to Practice model is a regulatory model that is designed to promote public sa
role-transition experience of newly licensed nurses. The new graduate would first take and pass the NC
and then enter the transition program. There are five transition modules with content focused on comm
patient-centered care, evidence-based practice, quality improvement, and informatics. The time period
program is 6 months with an expected additional 6 months of ongoing support. Because of the individu
encourages states to adopt this model; however, they do not have the authority to mandate the adoption
does not act as a replacement for a preceptor in the clinical practice area.
DIF: Cognitive Level: Comprehension/Understanding
OBJ: Describe methods to promote a successful transition.
TOP: Activities to promote successful transition before graduation
MSC: NCLEX®: Not applicable
14. The nurse has an adequate understanding of transitions when making which statement about situationa
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.”
ANS: C
A situational transition occurs with the change from one situation to another, such as a career change. D
illness would be characteristic of a health–illness transition, a leadership change would be an organiza
midlife crisis would be a developmental transition.
DIF: Cognitive Level: Comprehension/Understanding
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 trans
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 exp
appropriate for the student to accept the most complex patient, who requires oral and IV medications a
restarted. The patient who can care for herself independently and the one who is leaving the hospital ag
not provide as much skill experience. Diabetic teaching is important but does not require the time mana
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
