Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
, Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
, Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
, Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
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
, Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
, Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
, Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau Test Bank – All chapters 1 - 26
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
