Galen NSG 4800 Transition to Professional Nursing Practice:
Midterm Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. Kramer's concept of 'reality shock' describes:
A. A physiological response to night shift
B. A type of compassion fatigue in experienced nurses
C. The stress of taking the NCLEX
D. The conflict new graduates feel when school-taught values clash with the realities of the
workplace
Correct Answer: D. The conflict new graduates feel when school-taught values clash with the
realities of the workplace
Rationale: Kramer described phases of honeymoon, shock, recovery and resolution as new nurses
reconcile ideals with practice. It is not a physical condition or test anxiety, and recognizing it helps new
graduates seek support rather than leave the profession.
2. The primary purpose of the state Nurse Practice Act is to:
A. Protect nurses from lawsuits
B. Protect the public by defining nursing scope of practice and licensure requirements
C. Set hospital staffing ratios nationally
D. Determine nursing salaries
Correct Answer: B. Protect the public by defining nursing scope of practice and licensure
requirements
Rationale: Each state's NPA, enforced by the board of nursing, exists to safeguard the public. It does not
shield nurses from liability or set pay; staffing ratios are mandated in only a few states.
3. Preceptors support new graduate nurses by:
A. Doing all the work for them
B. Criticizing publicly
C. Role modeling, teaching, providing feedback and gradually increasing responsibility
D. Ignoring questions
Correct Answer: C. Role modeling, teaching, providing feedback and gradually increasing
responsibility
Rationale: Effective precepting builds confidence and competence. Doing the work for orientees or
criticizing them publicly undermines learning; effective preceptors coach and gradually increase
responsibility.
,4. Joining a professional nursing organization such as the ANA benefits a new nurse by:
A. Guaranteeing a raise
B. Replacing licensure
C. Exempting them from CE
D. Providing advocacy, continuing education, networking and practice standards
Correct Answer: D. Providing advocacy, continuing education, networking and practice
standards
Rationale: Professional organizations shape policy and practice standards, such as the ANA Code of
Ethics. Membership does not substitute for licensure or CE requirements.
5. When experiencing incivility from a coworker, the new nurse should first:
A. Gossip with other staff
B. Quit immediately
C. Address the behavior directly and privately, using 'I' statements, if safe to do so
D. Retaliate in kind
Correct Answer: C. Address the behavior directly and privately, using 'I' statements, if safe to
do so
Rationale: Direct, respectful communication often resolves incivility, and the chain of command is used if
it continues. Gossip and retaliation perpetuate the problem.
6. In Benner's model, a new graduate nurse who relies heavily on rules and protocols is at which
stage?
A. Expert
B. Advanced beginner
C. Proficient
D. Competent
Correct Answer: B. Advanced beginner
Rationale: Benner places most new graduates at the advanced beginner stage: they recognize recurring
patterns but still need guidelines. Competence typically develops after 2-3 years, and experts act
intuitively from deep experience.
,7. Professional accountability means a nurse:
A. Blames others for errors
B. Accepts responsibility for their actions and outcomes of care
C. Avoids documentation
D. Follows orders without question
Correct Answer: B. Accepts responsibility for their actions and outcomes of care
Rationale: Accountability includes questioning unsafe orders and reporting errors. Accountable nurses do
not blame others or follow unsafe orders blindly; they own decisions and report errors.
8. Whistleblower protections allow nurses to:
A. Share patient data publicly
B. Report illegal or unsafe practices without retaliation, within legal protections
C. Avoid all consequences for any action
D. Refuse all assignments
Correct Answer: B. Report illegal or unsafe practices without retaliation, within legal
protections
Rationale: State and federal laws protect good-faith reporting through proper channels. Protections apply
to good-faith reports through proper channels; they do not permit sharing patient data publicly.
9. A nurse is mandated to work overtime and feels too fatigued to practice safely. The nurse
should:
A. Leave without notifying anyone
B. Communicate the safety concern to the supervisor and follow facility policy and state law
C. Work while impaired by fatigue without saying anything
D. Post the complaint online
Correct Answer: B. Communicate the safety concern to the supervisor and follow facility
policy and state law
Rationale: Fatigue impairs judgment similar to alcohol. Many states restrict mandatory overtime;
communication through proper channels balances patient safety and obligations.
, 10. Reflective practice helps new nurses by:
A. Analyzing experiences to improve future clinical judgment
B. Assigning blame
C. Avoiding feedback
D. Repeating mistakes
Correct Answer: A. Analyzing experiences to improve future clinical judgment
Rationale: Structured reflection (e.g., Gibbs cycle) turns experience into learning and builds clinical
judgment. Reflection is not about blame; it helps nurses learn from what went well and what did not.
11. Emotional intelligence in nursing leadership includes:
A. IQ score
B. Clinical skill only
C. Self-awareness, self-regulation, motivation, empathy and social skills
D. Authoritarian control
Correct Answer: C. Self-awareness, self-regulation, motivation, empathy and social skills
Rationale: Goleman's domains support teamwork and conflict resolution; they are distinct from technical
skill or IQ. Technical skill and IQ do not guarantee effective leadership; managing emotions and
relationships is what helps teams function under stress.
12. Professional liability insurance for nurses:
A. Can provide personal legal defense coverage beyond employer policies
B. Is illegal
C. Guarantees immunity
D. Replaces licensure
Correct Answer: A. Can provide personal legal defense coverage beyond employer policies
Rationale: Employer policies cover the employer's interests and may not cover off-duty actions.
Insurance does not grant immunity or replace licensure, but it can fund the nurse's own legal defense.
Midterm Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. Kramer's concept of 'reality shock' describes:
A. A physiological response to night shift
B. A type of compassion fatigue in experienced nurses
C. The stress of taking the NCLEX
D. The conflict new graduates feel when school-taught values clash with the realities of the
workplace
Correct Answer: D. The conflict new graduates feel when school-taught values clash with the
realities of the workplace
Rationale: Kramer described phases of honeymoon, shock, recovery and resolution as new nurses
reconcile ideals with practice. It is not a physical condition or test anxiety, and recognizing it helps new
graduates seek support rather than leave the profession.
2. The primary purpose of the state Nurse Practice Act is to:
A. Protect nurses from lawsuits
B. Protect the public by defining nursing scope of practice and licensure requirements
C. Set hospital staffing ratios nationally
D. Determine nursing salaries
Correct Answer: B. Protect the public by defining nursing scope of practice and licensure
requirements
Rationale: Each state's NPA, enforced by the board of nursing, exists to safeguard the public. It does not
shield nurses from liability or set pay; staffing ratios are mandated in only a few states.
3. Preceptors support new graduate nurses by:
A. Doing all the work for them
B. Criticizing publicly
C. Role modeling, teaching, providing feedback and gradually increasing responsibility
D. Ignoring questions
Correct Answer: C. Role modeling, teaching, providing feedback and gradually increasing
responsibility
Rationale: Effective precepting builds confidence and competence. Doing the work for orientees or
criticizing them publicly undermines learning; effective preceptors coach and gradually increase
responsibility.
,4. Joining a professional nursing organization such as the ANA benefits a new nurse by:
A. Guaranteeing a raise
B. Replacing licensure
C. Exempting them from CE
D. Providing advocacy, continuing education, networking and practice standards
Correct Answer: D. Providing advocacy, continuing education, networking and practice
standards
Rationale: Professional organizations shape policy and practice standards, such as the ANA Code of
Ethics. Membership does not substitute for licensure or CE requirements.
5. When experiencing incivility from a coworker, the new nurse should first:
A. Gossip with other staff
B. Quit immediately
C. Address the behavior directly and privately, using 'I' statements, if safe to do so
D. Retaliate in kind
Correct Answer: C. Address the behavior directly and privately, using 'I' statements, if safe to
do so
Rationale: Direct, respectful communication often resolves incivility, and the chain of command is used if
it continues. Gossip and retaliation perpetuate the problem.
6. In Benner's model, a new graduate nurse who relies heavily on rules and protocols is at which
stage?
A. Expert
B. Advanced beginner
C. Proficient
D. Competent
Correct Answer: B. Advanced beginner
Rationale: Benner places most new graduates at the advanced beginner stage: they recognize recurring
patterns but still need guidelines. Competence typically develops after 2-3 years, and experts act
intuitively from deep experience.
,7. Professional accountability means a nurse:
A. Blames others for errors
B. Accepts responsibility for their actions and outcomes of care
C. Avoids documentation
D. Follows orders without question
Correct Answer: B. Accepts responsibility for their actions and outcomes of care
Rationale: Accountability includes questioning unsafe orders and reporting errors. Accountable nurses do
not blame others or follow unsafe orders blindly; they own decisions and report errors.
8. Whistleblower protections allow nurses to:
A. Share patient data publicly
B. Report illegal or unsafe practices without retaliation, within legal protections
C. Avoid all consequences for any action
D. Refuse all assignments
Correct Answer: B. Report illegal or unsafe practices without retaliation, within legal
protections
Rationale: State and federal laws protect good-faith reporting through proper channels. Protections apply
to good-faith reports through proper channels; they do not permit sharing patient data publicly.
9. A nurse is mandated to work overtime and feels too fatigued to practice safely. The nurse
should:
A. Leave without notifying anyone
B. Communicate the safety concern to the supervisor and follow facility policy and state law
C. Work while impaired by fatigue without saying anything
D. Post the complaint online
Correct Answer: B. Communicate the safety concern to the supervisor and follow facility
policy and state law
Rationale: Fatigue impairs judgment similar to alcohol. Many states restrict mandatory overtime;
communication through proper channels balances patient safety and obligations.
, 10. Reflective practice helps new nurses by:
A. Analyzing experiences to improve future clinical judgment
B. Assigning blame
C. Avoiding feedback
D. Repeating mistakes
Correct Answer: A. Analyzing experiences to improve future clinical judgment
Rationale: Structured reflection (e.g., Gibbs cycle) turns experience into learning and builds clinical
judgment. Reflection is not about blame; it helps nurses learn from what went well and what did not.
11. Emotional intelligence in nursing leadership includes:
A. IQ score
B. Clinical skill only
C. Self-awareness, self-regulation, motivation, empathy and social skills
D. Authoritarian control
Correct Answer: C. Self-awareness, self-regulation, motivation, empathy and social skills
Rationale: Goleman's domains support teamwork and conflict resolution; they are distinct from technical
skill or IQ. Technical skill and IQ do not guarantee effective leadership; managing emotions and
relationships is what helps teams function under stress.
12. Professional liability insurance for nurses:
A. Can provide personal legal defense coverage beyond employer policies
B. Is illegal
C. Guarantees immunity
D. Replaces licensure
Correct Answer: A. Can provide personal legal defense coverage beyond employer policies
Rationale: Employer policies cover the employer's interests and may not cover off-duty actions.
Insurance does not grant immunity or replace licensure, but it can fund the nurse's own legal defense.
