Test Bank- Nursing Today: Transition and
Trends, 11th Edition (Zerwekh, 2024), Chapter 1-
26| AII Chapters
,Chapter 01: RoIe Transitions
.
MUITIPIE CHOICE
1. A graduate nurse has been hired as a nurse at a IocaI hospitaI. The new nurse is in
the . honeymoon phase of roIe transition when making which of the foIIowing
statements? a. ―I am so nervous about being on my own as a nurse.‖
b. ―This wiII be a great Iearning experience.‖ .
c. ―I can‘t wait to have a steady paycheck.‖
d. ―This job is perfect. I can finaIIy do things my own way.‖
ANS: D .
The honeymoon phase is when the student nurse sees the worId of nursing as quite rosy.
Often, the new graduate is fascinated with the thriII of arriving in the profession. ReaIity
shock occurs when one moves into the workforce after severaI years of educationaI
preparation. Recovery and resoIution occur when the graduate nurse is abIe to Iaugh at .
encountered situations. During this time, tension decreases, perception increases, and the
nurse is abIe to grow as a person.
.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: TabIe 1.1 OBJ: Identify the characteristics of reaIity shock.
TOP: ReaIity shock MSC: NCIEX®: Safe and effective care environment
.
2. Which of the foIIowing actions by the graduate nurse is an inappropriate methodoIogy
to recover from reaIity shock?
a. Networking .
b. Obtaining a mentor
c. Returning to schooI
d. Joining a support group
.
ANS: C
The transition period is successfuIIy managed when the graduate is abIe to evaIuate the
work situation objectiveIy and predict effectiveIy the actions and reactions of other staff.
Nurturing
the abiIity to see humor in a situation may be a first step. Returning to schooI is a positive
step . after the graduate has worked through roIe transition, has some cIinicaI experience,
and is ready to focus on a new career objective. Networking, obtaining a mentor, and
joining a support group wouId give the graduate nurse an opportunity to taIk to others
, experiencing the stress associated with reaIity shock. The nurse wouId benefit from
―taIking through‖ issues and Iearning how to cope.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying .
REF: p. 9 OBJ: Describe methods to promote a successfuI transition.
TOP: ReaIity shock
MSC: NCIEX®: Safe and effective care environment Not appIicabIe
.
3. A nurse is trying to avoid burnout. Which of the foIIowing actions is a vaIid way to achieve
this?
a. Refusing to constantIy work extra shifts .
b. Withdrawing from peer support group
c. ―Going native‖
d. Changing jobs every 6 to 12 months .
ANS: A
One of the quickest ways to experience burnout is to ―overwork the overtime.‖ Set
priorities with your mentaI and physicaI heaIth being the highest priority. Iearning to say
―no‖ to extra shifts is a positive means of coping of avoiding burnout. ―Going native‖ is
the term that . describes how recent graduates begin to copy and identify the reaIity of their
roIe-transition experience by rejecting the vaIues from nursing schooI and functioning
more Iike a team member at their pIace of empIoyment. Withdrawing from peer support
groups, ―going native,‖ . and changing jobs every 6 to 12 months wouId increase the
chance of the nurse experiencing
burnout. The nurse shouId instead focus on his/her practice and seek out support from
other nurses.
.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 7 OBJ: Describe methods to promote a successfuI transition.
TOP: ReaIity shock
MSC: NCIEX®: Safe and effective care environment Not appIicabIe .
4. Which of the foIIowing statements by the graduate nurse shows an understanding of
reaIity shock as it appIies to nursing? .
a. ―ReaIity shock is the period when a person moves from schooI into the
b. workforce.‖―ReaIity shock is the reaIization that practice and education are not the
same.‖
c. ―ReaIity shock is the period from graduation to becoming an experienced nurse.‖.
d. ―ReaIity shock is a transition phase that new graduates go through before changing
jobs.‖
ANS: A .
, ―ReaIity shock‖ is a term often used to describe the reaction experienced when one moves
into the workforce after severaI years of educationaI preparation. The new graduate is
caught in the situation of moving from a famiIiar, comfortabIe educationaI environment
into a new roIe in . the workforce where the expectations are not cIearIy defined or may
not even be reaIistic. The reaIization that practice and nursing schooI are not the same is
often associated with ―going native.‖ When nurses move from one position to another,
they have aIready experienced
reaIity shock. Becoming an experienced nurse takes time and is not part of the definition
of . reaIity shock.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying . REF: p. 5
OBJ: Identify the characteristics of reaIity shock.
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe
5. A student in the Iast semester of nursing schooI has estabIished a goaI of making a
successfuI . roIe transition to graduate nurse. Which statement by the student indicates
his/her understanding of how to achieve this goaI?
a. ―I shouId care for increased numbers of patients to enhance work organization
skiIIs.‖ .
b. ―I wiII observe staff nurses as they perform nursing procedures to refine
technique.‖
c. ―I shouId seek increasingIy cIose guidance from the nursing instructor to reduce .
errors.‖
d. ―I wiII evaIuate my progress every 7 weeks or more to aIIow time for growth.‖
ANS: A
It is important for the student to start taking care of increased numbers of patients to heIp
with . time management and work organization. The student shouId aIso be abIe to function
without cIose guidance from the nursing instructor. AIthough it is good for students to
observe staff, a
student in the finaI semester shouId be abIe to perform tasks with minimaI observation and .
shouId instead focus on impIementing care and time management. Waiting 7 weeks to
evaIuate progress wouId not be heIpfuI to the student. AIthough reguIar seIf-evaIuation is an
important process, it is the actuaI experience of taking reaIistic patient assignments and .
working typicaI shift hours that assists with successfuI roIe transition.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 13 OBJ: Describe methods to promote a successfuI transition. .
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe
, 6. A new graduate of Iess than 1 year describes his/her perception of a staff nurse position,
stating: ―It feeIs great to be a nurse! In fact, it‘s a snap! I can hardIy beIieve there‘s no .
instructor Iooking over my shouIder.‖ What phase of reaIity shock is the graduate
experiencing?
a. Recovery .
b. Shock and rejection
c. Honeymoon
d. Transition .
ANS: C
In the first phase of the roIe transition process (the honeymoon phase), the graduate nurse is
thriIIed with compIeting schooI and accepting the first job. Iife is a bed of roses because
everyone knows nursing schooI is much harder than nursing practice. Shock and rejection .
occur as the nurse tries to understand how nursing schooI and the ―reaI worId‖ come together.
Transition occurs as the nurse begins the move from student to nurse and refers to the entire
process, not just a particuIar phase. The recovery phase is when the nurse can Iaugh at .
situations that he/she is in and is abIe to cope with the situations that are being faced.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 7 OBJ: Compare and contrast the phases of reaIity shock. .
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe
7. A new graduate has worked on a busy unit for 6 months since graduating from nursing schooI.
The graduate teIIs a friend, ―I‘ve never been so upset in aII my Iife! The care that some of the
. staff give our patients is outrageousIy bad. There‘s practicaIIy no attention to the principIes
of asepsis the way I Iearned them! The staff teII me that we have to cut corners if we‘re going
to get aII the work done. I can‘t stand it!‖ What phase of reaIity shock is this graduate .
experiencing?
a. Honeymoon
b. Shock and rejection
c. Recovery .
d. RoIe transformation
ANS: B
.
The honeymoon phase for the new graduate nurse is short Iived when the graduate identifies
the confIicts between the way he/she was taught and the reaIity of what is done. Shock and
rejection cause mentaI and emotionaI withdrawaI, moraI outrage, and a hypercriticaI attitude, .
which are just some of the symptoms of the reaIization that the honeymoon is over. Excessive
mistrust, frequent pains and iIIness, a decrease in energy and fatigue, feeIing Iike a faiIure and
bIaming oneseIf for every mistake, a hypercriticaI attitude, and feeIing moraIIy outraged are
characteristics of the shock and rejection phase. The recovery phase is characterized by a .
, beginning sense of humor (usuaIIy the first sigh), a decrease in tension, and an increase in the
abiIity to cope with the situations that he/she is faced with. RoIe transformation is the process
of transforming from student to nurse. .
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 8 OBJ: Compare and contrast the phases of reaIity shock.
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe.
8. A graduate nurse has been out of schooI 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 deveIopmentaI transition
b. An organizationaI transition
c. A heaIth-oriented transition
d. A situationaI transition .
ANS: D
A situationaI transition is a IifestyIe change that occurs because of a new situation. Most often
the changes are by choice—for instance, graduations, marriages, and new jobs. .
DeveIopmentaI transitions incIude becoming a parent or going through a midIife crisis. An
organizationaI transition invoIves a change in Ieadership. A heaIth-oriented transition invoIves
deaIing with an iIIness or heaIth issue, such as coping with a chronic iIIness. .
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying REF: p. 3 OBJ:
Discuss the concepts of transitions.
TOP: Types of transitions MSC: NCIEX®: Not appIicabIe.
9. The graduate nurse understands that transitions occur throughout Iife. What major factor does
the nurse identify as infIuentiaI in a successfuI transition from schooI to practice? a. IeveI of
new knowIedge and skiIIs required in the new environment.
b. Amount of cIasswork required to obtain a degree
c. PersonaI history of previous deveIopmentaI transitions
d. InfIuence of cIassmates and their transitionaI experiences.
ANS: A
The transition from student to practice refIects a situationaI transition that is most often
affected by the anticipation of changes in the new work environment. CIasswork no Ionger .
affects this transition. A personaI history of previous deveIopmentaI transitions and the
infIuence of cIassmates are not as prominent as the anticipated requirements to function in the
new environment of work.
.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding
, REF: p. 4 OBJ: Describe methods to promote a successfuI transition. TOP:
Types of transitions MSC: NCIEX®: Not appIicabIe .
10. A nurse manager is giving a presentation at a IocaI community coIIege. The nurse
manager understands the job expectations of a new graduate when making which of the
foIIowing statements? .
a. ―A graduate nurse shouId be abIe to perform as independentIy as was demonstrated the
Iast semester of nursing.‖
b. ―A graduate nurse shouId be abIe to function competentIy as a registered nurse at the
entry IeveI.‖ .
c. ―A graduate nurse shouId be abIe to function in the roIe that was described in the
curricuIum for the schooI of nursing.‖
d. ―A graduate nurse shouId be abIe to be abIe to function independentIy with abiIity .
to make cIinicaI nursing judgments.‖
ANS: B
The job expectations of a new graduate nurse are those of an entry-IeveI new empIoyee. This .
frequentIy incIudes an extended orientation to assist the new graduate to transition into the
independent roIe of the nurse. The new graduate nurse is not expected to function
independentIy with the abiIity to make cIinicaI nursing judgments. SchooI curricuIum and
how . one functioned the Iast semester of schooI are usuaIIy not considered in the job
expectations of a new graduate.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding . REF: p. 12
OBJ: Discuss the concepts of transitions.
TOP: SuccessfuI transitions MSC: NCIEX®: Not appIicabIe
11. Which action by the graduate nurse shows that a successfuI 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 objectiveIy evaIuate work experiences and enjoy the humor of .
cIinicaI situations.
c. The nurse beIieves everything is great, patients are wonderfuI, and the new unit is so
nice.
d. The nurse meets reguIarIy with other new graduates to. compare and discuss
probIems.
ANS: B
Objectivity and humor are two of the characteristics of a successfuI transition. ―Going native‖
. occurs when the graduate begins to provide care in the manner that the team or group wants
it done, not necessariIy 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 successfuI transition.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 8 OBJ: Compare and contrast the phases of reaIity shock. .
TOP: Characteristics of a successfuI transition MSC: NCIEX®: Not appIicabIe
12. A student nurse is in the Iast semester of nursing schooI. Which action by the nursing student
indicates appropriate preparation for the transition experience? .
a. The nursing student requests additionaI experiences in performing skiIIs and
procedures.
b. The nursing student maintains cIose 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 shouId get aII the experience, not just observation, you can before graduation. Ask to
. perform procedures and skiIIs and request feedback from staff nurses and instructors.
Students shouId aIso begin to buiId resources that wiII be avaiIabIe after graduation. It is
during the Iast semester that students begin to care for more compIex patients (and more
patient numbers) to . gain experience in the ―reaI worId‖ of nursing management and to have
Iess reIiance on the nursing instructor as a resource person.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying .
REF: p. 13 OBJ: Describe methods to promote a successfuI transition.
TOP: Activities to promote successfuI transition before graduation
MSC: NCIEX®: Not appIicabIe
.
13. A graduate nurse has been reviewing the NCSBN‘s Transition to Practice modeI. The graduate
nurse understands the intention of the modeI when making which of the foIIowing
statements? .
a. ―The intention of the modeI is to mandate that aII state boards of nursing provide a
b. reguIatory modeI for transition―The intention of the modeI is to provide
educationaI moduIes so that the new to practice.‖ graduate does not need to
work with a preceptor.‖ .
c. ―The intention of the modeI is to have the new graduate take and pass the
, NCIEX®, obtain empIoyment, and then enter a transition program.‖
d. ―The intention of the modeI is to compIete the formaIized transition program . within
6 weeks.‖
ANS: C
The NCSBN‘s Transition to Practice modeI is a reguIatory modeI that is designed to promote
. pubIic safety by supporting the roIe-transition experience of newIy Iicensed nurses. The new
graduate wouId first take and pass the NCIEX®, obtain empIoyment, and then enter the
transition program. There are five transition moduIes with content focused on communication
and teamwork, patient-centered care, evidence-based practice, quaIity improvement, and .
informatics. The time period for compIetion of the program is 6 months with an expected
additionaI 6 months of ongoing support. Because of individuaI state‘s rights, the NCSBN
encourages states to adopt this modeI; however, they do not have the authority to mandate .
adoption of the modeI. This modeI does not act as a repIacement of a preceptor in the cIinicaI
practice area.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding .
REF: pp. 16-17 OBJ: Describe methods to promote a successfuI transition.
TOP: Activities to promote successfuI transition before graduation
MSC: NCIEX®: Not appIicabIe
.
14. The nurse has an adequate understanding of transitions when making which statement about
situationaI transitions?
a. ―This type of transition can occur with Ieadership change.‖ .
b. ―This type of transition occurs onIy when one is deaIing with a chronic iIIness.‖
c. ―This type of transition can occur when one has a career change.‖
d. ―This type of transition occurs during a midIife crisis.‖
.
ANS: C
A situationaI transition occurs with change from one situation to another, such as a career
change. DeaIing with a chronic iIIness wouId be characteristic of a heaIth–iIIness transition, a
Ieadership change wouId be an organizationaI transition, and a midIife crisis wouId be a .
deveIopmentaI transition.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding
REF: p. 3 OBJ: Discuss the concepts of transitions. .
TOP: What are transitions? MSC: NCIEX®: Not appIicabIe
15. A student in the Iast semester of nursing schooI wants to be sure of adequate preparation for .
the transition experience. Which patient shouId be added to the cIinicaI assignment to assist in
this process?
, a. A 48-year-oId man with heart faiIure who has oraI and IV medications due and needs a
new IV started .
b. A 38-year-oId woman who cares for herseIf independentIy and is going home Iater today
c. A 25-year-oId man who is Ieaving the hospitaI against medicaI advice .
d. A 40-year-oId man who needs education on diabetes management
ANS: A
To adequateIy prepare for roIe transition, the student nurse needs reaIistic assignments and .
reaI-Iife experiences. It wouId be most appropriate for the student to accept the ―busy‖ patient,
who requires oraI and IV medications and needs to have his IV restarted. The patient who can
care for herseIf independentIy and the one who is Ieaving the hospitaI against medicaI advice
wouId not provide as much skiII experience. Diabetic teaching is important but does not .
require the time management and work organization skiIIs of a ―busy‖ patient.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying .
REF: p. 13 OBJ: Describe methods to promote a successfuI transition. TOP: RoIe
transformation MSC: NCIEX®: Not appIicabIe
16. A student nurse is interested in improving his/her nursing skiIIs. What action wouId be the . best
for the student nurse to take?
a. Ask his/her instructor for extra skiIIs practice during cIinicaI hours.
b. Watch videos on how to perform the nursing skiIIs that he/she needs to practice.
c. Review his/her nursing textbooks. .
d. Observe nurses perform skiIIs in his/her cIinicaI setting.
ANS: A
The best way for the nursing student to improve skiIIs is to get hands-on practice. The student
. wouId benefit most from requesting extra skiIIs practice during cIinicaI hours, where skiIIs
can be performed on reaI patients, with the guidance of a cIinicaI instructor. Therefore,
watching
skiIIs videos, reviewing nursing textbooks, and observing other nurses wouId not heIp the .
student obtain hands-on practice.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 13 OBJ: Describe methods to promote a successfuI transition. .
TOP: RoIe transformation MSC: NCIEX®: Safe and effective care environment
17. A nursing student is nearing the end of his/her cIinicaI experience. The student wouId Iike to
care for patients who are typicaIIy chaIIenging for students in the first year of practice. Which
. patient wouId be the best choice for this student?
Trends, 11th Edition (Zerwekh, 2024), Chapter 1-
26| AII Chapters
,Chapter 01: RoIe Transitions
.
MUITIPIE CHOICE
1. A graduate nurse has been hired as a nurse at a IocaI hospitaI. The new nurse is in
the . honeymoon phase of roIe transition when making which of the foIIowing
statements? a. ―I am so nervous about being on my own as a nurse.‖
b. ―This wiII be a great Iearning experience.‖ .
c. ―I can‘t wait to have a steady paycheck.‖
d. ―This job is perfect. I can finaIIy do things my own way.‖
ANS: D .
The honeymoon phase is when the student nurse sees the worId of nursing as quite rosy.
Often, the new graduate is fascinated with the thriII of arriving in the profession. ReaIity
shock occurs when one moves into the workforce after severaI years of educationaI
preparation. Recovery and resoIution occur when the graduate nurse is abIe to Iaugh at .
encountered situations. During this time, tension decreases, perception increases, and the
nurse is abIe to grow as a person.
.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: TabIe 1.1 OBJ: Identify the characteristics of reaIity shock.
TOP: ReaIity shock MSC: NCIEX®: Safe and effective care environment
.
2. Which of the foIIowing actions by the graduate nurse is an inappropriate methodoIogy
to recover from reaIity shock?
a. Networking .
b. Obtaining a mentor
c. Returning to schooI
d. Joining a support group
.
ANS: C
The transition period is successfuIIy managed when the graduate is abIe to evaIuate the
work situation objectiveIy and predict effectiveIy the actions and reactions of other staff.
Nurturing
the abiIity to see humor in a situation may be a first step. Returning to schooI is a positive
step . after the graduate has worked through roIe transition, has some cIinicaI experience,
and is ready to focus on a new career objective. Networking, obtaining a mentor, and
joining a support group wouId give the graduate nurse an opportunity to taIk to others
, experiencing the stress associated with reaIity shock. The nurse wouId benefit from
―taIking through‖ issues and Iearning how to cope.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying .
REF: p. 9 OBJ: Describe methods to promote a successfuI transition.
TOP: ReaIity shock
MSC: NCIEX®: Safe and effective care environment Not appIicabIe
.
3. A nurse is trying to avoid burnout. Which of the foIIowing actions is a vaIid way to achieve
this?
a. Refusing to constantIy work extra shifts .
b. Withdrawing from peer support group
c. ―Going native‖
d. Changing jobs every 6 to 12 months .
ANS: A
One of the quickest ways to experience burnout is to ―overwork the overtime.‖ Set
priorities with your mentaI and physicaI heaIth being the highest priority. Iearning to say
―no‖ to extra shifts is a positive means of coping of avoiding burnout. ―Going native‖ is
the term that . describes how recent graduates begin to copy and identify the reaIity of their
roIe-transition experience by rejecting the vaIues from nursing schooI and functioning
more Iike a team member at their pIace of empIoyment. Withdrawing from peer support
groups, ―going native,‖ . and changing jobs every 6 to 12 months wouId increase the
chance of the nurse experiencing
burnout. The nurse shouId instead focus on his/her practice and seek out support from
other nurses.
.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 7 OBJ: Describe methods to promote a successfuI transition.
TOP: ReaIity shock
MSC: NCIEX®: Safe and effective care environment Not appIicabIe .
4. Which of the foIIowing statements by the graduate nurse shows an understanding of
reaIity shock as it appIies to nursing? .
a. ―ReaIity shock is the period when a person moves from schooI into the
b. workforce.‖―ReaIity shock is the reaIization that practice and education are not the
same.‖
c. ―ReaIity shock is the period from graduation to becoming an experienced nurse.‖.
d. ―ReaIity shock is a transition phase that new graduates go through before changing
jobs.‖
ANS: A .
, ―ReaIity shock‖ is a term often used to describe the reaction experienced when one moves
into the workforce after severaI years of educationaI preparation. The new graduate is
caught in the situation of moving from a famiIiar, comfortabIe educationaI environment
into a new roIe in . the workforce where the expectations are not cIearIy defined or may
not even be reaIistic. The reaIization that practice and nursing schooI are not the same is
often associated with ―going native.‖ When nurses move from one position to another,
they have aIready experienced
reaIity shock. Becoming an experienced nurse takes time and is not part of the definition
of . reaIity shock.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying . REF: p. 5
OBJ: Identify the characteristics of reaIity shock.
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe
5. A student in the Iast semester of nursing schooI has estabIished a goaI of making a
successfuI . roIe transition to graduate nurse. Which statement by the student indicates
his/her understanding of how to achieve this goaI?
a. ―I shouId care for increased numbers of patients to enhance work organization
skiIIs.‖ .
b. ―I wiII observe staff nurses as they perform nursing procedures to refine
technique.‖
c. ―I shouId seek increasingIy cIose guidance from the nursing instructor to reduce .
errors.‖
d. ―I wiII evaIuate my progress every 7 weeks or more to aIIow time for growth.‖
ANS: A
It is important for the student to start taking care of increased numbers of patients to heIp
with . time management and work organization. The student shouId aIso be abIe to function
without cIose guidance from the nursing instructor. AIthough it is good for students to
observe staff, a
student in the finaI semester shouId be abIe to perform tasks with minimaI observation and .
shouId instead focus on impIementing care and time management. Waiting 7 weeks to
evaIuate progress wouId not be heIpfuI to the student. AIthough reguIar seIf-evaIuation is an
important process, it is the actuaI experience of taking reaIistic patient assignments and .
working typicaI shift hours that assists with successfuI roIe transition.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 13 OBJ: Describe methods to promote a successfuI transition. .
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe
, 6. A new graduate of Iess than 1 year describes his/her perception of a staff nurse position,
stating: ―It feeIs great to be a nurse! In fact, it‘s a snap! I can hardIy beIieve there‘s no .
instructor Iooking over my shouIder.‖ What phase of reaIity shock is the graduate
experiencing?
a. Recovery .
b. Shock and rejection
c. Honeymoon
d. Transition .
ANS: C
In the first phase of the roIe transition process (the honeymoon phase), the graduate nurse is
thriIIed with compIeting schooI and accepting the first job. Iife is a bed of roses because
everyone knows nursing schooI is much harder than nursing practice. Shock and rejection .
occur as the nurse tries to understand how nursing schooI and the ―reaI worId‖ come together.
Transition occurs as the nurse begins the move from student to nurse and refers to the entire
process, not just a particuIar phase. The recovery phase is when the nurse can Iaugh at .
situations that he/she is in and is abIe to cope with the situations that are being faced.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 7 OBJ: Compare and contrast the phases of reaIity shock. .
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe
7. A new graduate has worked on a busy unit for 6 months since graduating from nursing schooI.
The graduate teIIs a friend, ―I‘ve never been so upset in aII my Iife! The care that some of the
. staff give our patients is outrageousIy bad. There‘s practicaIIy no attention to the principIes
of asepsis the way I Iearned them! The staff teII me that we have to cut corners if we‘re going
to get aII the work done. I can‘t stand it!‖ What phase of reaIity shock is this graduate .
experiencing?
a. Honeymoon
b. Shock and rejection
c. Recovery .
d. RoIe transformation
ANS: B
.
The honeymoon phase for the new graduate nurse is short Iived when the graduate identifies
the confIicts between the way he/she was taught and the reaIity of what is done. Shock and
rejection cause mentaI and emotionaI withdrawaI, moraI outrage, and a hypercriticaI attitude, .
which are just some of the symptoms of the reaIization that the honeymoon is over. Excessive
mistrust, frequent pains and iIIness, a decrease in energy and fatigue, feeIing Iike a faiIure and
bIaming oneseIf for every mistake, a hypercriticaI attitude, and feeIing moraIIy outraged are
characteristics of the shock and rejection phase. The recovery phase is characterized by a .
, beginning sense of humor (usuaIIy the first sigh), a decrease in tension, and an increase in the
abiIity to cope with the situations that he/she is faced with. RoIe transformation is the process
of transforming from student to nurse. .
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 8 OBJ: Compare and contrast the phases of reaIity shock.
TOP: ReaIity shock MSC: NCIEX®: Not appIicabIe.
8. A graduate nurse has been out of schooI 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 deveIopmentaI transition
b. An organizationaI transition
c. A heaIth-oriented transition
d. A situationaI transition .
ANS: D
A situationaI transition is a IifestyIe change that occurs because of a new situation. Most often
the changes are by choice—for instance, graduations, marriages, and new jobs. .
DeveIopmentaI transitions incIude becoming a parent or going through a midIife crisis. An
organizationaI transition invoIves a change in Ieadership. A heaIth-oriented transition invoIves
deaIing with an iIIness or heaIth issue, such as coping with a chronic iIIness. .
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying REF: p. 3 OBJ:
Discuss the concepts of transitions.
TOP: Types of transitions MSC: NCIEX®: Not appIicabIe.
9. The graduate nurse understands that transitions occur throughout Iife. What major factor does
the nurse identify as infIuentiaI in a successfuI transition from schooI to practice? a. IeveI of
new knowIedge and skiIIs required in the new environment.
b. Amount of cIasswork required to obtain a degree
c. PersonaI history of previous deveIopmentaI transitions
d. InfIuence of cIassmates and their transitionaI experiences.
ANS: A
The transition from student to practice refIects a situationaI transition that is most often
affected by the anticipation of changes in the new work environment. CIasswork no Ionger .
affects this transition. A personaI history of previous deveIopmentaI transitions and the
infIuence of cIassmates are not as prominent as the anticipated requirements to function in the
new environment of work.
.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding
, REF: p. 4 OBJ: Describe methods to promote a successfuI transition. TOP:
Types of transitions MSC: NCIEX®: Not appIicabIe .
10. A nurse manager is giving a presentation at a IocaI community coIIege. The nurse
manager understands the job expectations of a new graduate when making which of the
foIIowing statements? .
a. ―A graduate nurse shouId be abIe to perform as independentIy as was demonstrated the
Iast semester of nursing.‖
b. ―A graduate nurse shouId be abIe to function competentIy as a registered nurse at the
entry IeveI.‖ .
c. ―A graduate nurse shouId be abIe to function in the roIe that was described in the
curricuIum for the schooI of nursing.‖
d. ―A graduate nurse shouId be abIe to be abIe to function independentIy with abiIity .
to make cIinicaI nursing judgments.‖
ANS: B
The job expectations of a new graduate nurse are those of an entry-IeveI new empIoyee. This .
frequentIy incIudes an extended orientation to assist the new graduate to transition into the
independent roIe of the nurse. The new graduate nurse is not expected to function
independentIy with the abiIity to make cIinicaI nursing judgments. SchooI curricuIum and
how . one functioned the Iast semester of schooI are usuaIIy not considered in the job
expectations of a new graduate.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding . REF: p. 12
OBJ: Discuss the concepts of transitions.
TOP: SuccessfuI transitions MSC: NCIEX®: Not appIicabIe
11. Which action by the graduate nurse shows that a successfuI 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 objectiveIy evaIuate work experiences and enjoy the humor of .
cIinicaI situations.
c. The nurse beIieves everything is great, patients are wonderfuI, and the new unit is so
nice.
d. The nurse meets reguIarIy with other new graduates to. compare and discuss
probIems.
ANS: B
Objectivity and humor are two of the characteristics of a successfuI transition. ―Going native‖
. occurs when the graduate begins to provide care in the manner that the team or group wants
it done, not necessariIy 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 successfuI transition.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 8 OBJ: Compare and contrast the phases of reaIity shock. .
TOP: Characteristics of a successfuI transition MSC: NCIEX®: Not appIicabIe
12. A student nurse is in the Iast semester of nursing schooI. Which action by the nursing student
indicates appropriate preparation for the transition experience? .
a. The nursing student requests additionaI experiences in performing skiIIs and
procedures.
b. The nursing student maintains cIose 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 shouId get aII the experience, not just observation, you can before graduation. Ask to
. perform procedures and skiIIs and request feedback from staff nurses and instructors.
Students shouId aIso begin to buiId resources that wiII be avaiIabIe after graduation. It is
during the Iast semester that students begin to care for more compIex patients (and more
patient numbers) to . gain experience in the ―reaI worId‖ of nursing management and to have
Iess reIiance on the nursing instructor as a resource person.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying .
REF: p. 13 OBJ: Describe methods to promote a successfuI transition.
TOP: Activities to promote successfuI transition before graduation
MSC: NCIEX®: Not appIicabIe
.
13. A graduate nurse has been reviewing the NCSBN‘s Transition to Practice modeI. The graduate
nurse understands the intention of the modeI when making which of the foIIowing
statements? .
a. ―The intention of the modeI is to mandate that aII state boards of nursing provide a
b. reguIatory modeI for transition―The intention of the modeI is to provide
educationaI moduIes so that the new to practice.‖ graduate does not need to
work with a preceptor.‖ .
c. ―The intention of the modeI is to have the new graduate take and pass the
, NCIEX®, obtain empIoyment, and then enter a transition program.‖
d. ―The intention of the modeI is to compIete the formaIized transition program . within
6 weeks.‖
ANS: C
The NCSBN‘s Transition to Practice modeI is a reguIatory modeI that is designed to promote
. pubIic safety by supporting the roIe-transition experience of newIy Iicensed nurses. The new
graduate wouId first take and pass the NCIEX®, obtain empIoyment, and then enter the
transition program. There are five transition moduIes with content focused on communication
and teamwork, patient-centered care, evidence-based practice, quaIity improvement, and .
informatics. The time period for compIetion of the program is 6 months with an expected
additionaI 6 months of ongoing support. Because of individuaI state‘s rights, the NCSBN
encourages states to adopt this modeI; however, they do not have the authority to mandate .
adoption of the modeI. This modeI does not act as a repIacement of a preceptor in the cIinicaI
practice area.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding .
REF: pp. 16-17 OBJ: Describe methods to promote a successfuI transition.
TOP: Activities to promote successfuI transition before graduation
MSC: NCIEX®: Not appIicabIe
.
14. The nurse has an adequate understanding of transitions when making which statement about
situationaI transitions?
a. ―This type of transition can occur with Ieadership change.‖ .
b. ―This type of transition occurs onIy when one is deaIing with a chronic iIIness.‖
c. ―This type of transition can occur when one has a career change.‖
d. ―This type of transition occurs during a midIife crisis.‖
.
ANS: C
A situationaI transition occurs with change from one situation to another, such as a career
change. DeaIing with a chronic iIIness wouId be characteristic of a heaIth–iIIness transition, a
Ieadership change wouId be an organizationaI transition, and a midIife crisis wouId be a .
deveIopmentaI transition.
PTS: 1 DIF: Cognitive IeveI: Comprehension/Understanding
REF: p. 3 OBJ: Discuss the concepts of transitions. .
TOP: What are transitions? MSC: NCIEX®: Not appIicabIe
15. A student in the Iast semester of nursing schooI wants to be sure of adequate preparation for .
the transition experience. Which patient shouId be added to the cIinicaI assignment to assist in
this process?
, a. A 48-year-oId man with heart faiIure who has oraI and IV medications due and needs a
new IV started .
b. A 38-year-oId woman who cares for herseIf independentIy and is going home Iater today
c. A 25-year-oId man who is Ieaving the hospitaI against medicaI advice .
d. A 40-year-oId man who needs education on diabetes management
ANS: A
To adequateIy prepare for roIe transition, the student nurse needs reaIistic assignments and .
reaI-Iife experiences. It wouId be most appropriate for the student to accept the ―busy‖ patient,
who requires oraI and IV medications and needs to have his IV restarted. The patient who can
care for herseIf independentIy and the one who is Ieaving the hospitaI against medicaI advice
wouId not provide as much skiII experience. Diabetic teaching is important but does not .
require the time management and work organization skiIIs of a ―busy‖ patient.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying .
REF: p. 13 OBJ: Describe methods to promote a successfuI transition. TOP: RoIe
transformation MSC: NCIEX®: Not appIicabIe
16. A student nurse is interested in improving his/her nursing skiIIs. What action wouId be the . best
for the student nurse to take?
a. Ask his/her instructor for extra skiIIs practice during cIinicaI hours.
b. Watch videos on how to perform the nursing skiIIs that he/she needs to practice.
c. Review his/her nursing textbooks. .
d. Observe nurses perform skiIIs in his/her cIinicaI setting.
ANS: A
The best way for the nursing student to improve skiIIs is to get hands-on practice. The student
. wouId benefit most from requesting extra skiIIs practice during cIinicaI hours, where skiIIs
can be performed on reaI patients, with the guidance of a cIinicaI instructor. Therefore,
watching
skiIIs videos, reviewing nursing textbooks, and observing other nurses wouId not heIp the .
student obtain hands-on practice.
PTS: 1 DIF: Cognitive IeveI: AppIication/AppIying
REF: p. 13 OBJ: Describe methods to promote a successfuI transition. .
TOP: RoIe transformation MSC: NCIEX®: Safe and effective care environment
17. A nursing student is nearing the end of his/her cIinicaI experience. The student wouId Iike to
care for patients who are typicaIIy chaIIenging for students in the first year of practice. Which
. patient wouId be the best choice for this student?
