TEST BANK FOR NURSING TODAY TRANSITION AND TRENDS 10TH EDITION BY ZERWEKH All chapters

TEST BANK FOR NURSING TODAY TRANSITION AND TRENDS 10TH EDITION BY ZERWEKH All chapters Chapter 01: Role Transitions ................................................................................................................... 2 Chapter 02: Personal Management: Time and Self-Care Strategies . .................................................... 13 Chapter 03: Mentorship, Preceptorship, and Nurse Residency Programs . ............................................ 23 Chapter 04: Employment Considerations: Opportunities, Resumes, and Interviewing . ......................... 32 Chapter 05: NCLEX-RN® and the New Graduate .................................................................................. 42 Chapter 06: Historical Perspectives: Influences on the Present ............................................................. 54 Chapter 07: Nursing Education .............................................................................................................. 63 Chapter 08: Nursing Theory ................................................................................................................... 73 Chapter 09: Professional Image of Nursing ............................................................................................ 81 Chapter 10: Challenges of Nursing Management and Leadership .......................................................... 88 Chapter 11: Building Nursing Management Skills . .............................................................................. 100 Chapter 12: Effective Communication, Team Building, and Interprofessional Practice ......................... 111 Chapter 13: Conflict Management ....................................................................................................... 121 Chapter 14: Delegation in the Clinical Setting ...................................................................................... 131 Chapter 15: The Health Care Organization and Patterns of Nursing Care Delivery .............................. 144 Chapter 16: Economics in the Health Care Delivery System ................................................................ 154 Chapter 17: Political Action in Nursing ................................................................................................. 165 Chapter 18: Collective Bargaining: Traditional (Union) and Nontraditional Approaches ....................... 176 Chapter 19: Ethical Issues ................................................................................................................... 186 Chapter 20: Legal Issues ..................................................................................................................... 197 Chapter 21: Cultural and Spiritual Awareness ...................................................................................... 211 Chapter 22: Quality Patient Care ......................................................................................................... 220 Chapter 23: Nursing Informatics .......................................................................................................... 232 Chapter 24: Using Evidence-Based Practice and Nursing Research ................................................... 242 Chapter 25: Workplace Issues. ............................................................................................................ 251 Chapter 26: Emergency Preparedness ................................................................................................ 262 1 | P a g eChapter 01: Role Transitions 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. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: Table 1.1 OBJ: Identify the characteristics of reality 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 reality 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 predict effectively the actions and reactions of other staff. Nurturing the ability to see 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. PTS: 1 REF: p. 9 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 . 3. A nurse is trying to avoid burnout. Which of the following actions is a valid way to achieve this? a. Refusing to constantly work extra shifts 2 | P a g e .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 mental and physical health being the highest priority. Learning 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 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. . PTS: 1 REF: p. 7 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 b. workforce.”“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. PTS: 1 DIF: Cognitive Level: Application/Applying . REF: p. 5 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 numbers of patients to enhance work organization skills.” . b. “I will observe staff nurses as they perform nursing procedures to 3 | P a g erefine 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 numbers 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. PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 13 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 . 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. 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. PTS: 1 REF: p. 7 TOP: Reality shock DIF: Cognitive Level: Application/Applying OBJ: Compare and contrast the phases of reality shock. . MSC: NCLEX®: Not applicable 7. A new graduate has worked on 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? 4 | P a g ea. 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 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 student to nurse. . PTS: 1 REF: p. 8 DIF: Cognitive Level: Application/Applying OBJ: Compare and contrast the phases of reality shock. TOP: Reality shock applicable. MSC: NCLEX®: Not 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. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 3 OBJ: Discuss the concepts of transitions. TOP: Types of transitions MSC: NCLEX®: Not applicable. 9. The graduate nurse understands that transitions occur throughout life. What major factor does the nurse identify as influential in a 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 5 | P a g eaffected 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. . PTS: 1 REF: p. 4 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 the job expectations of a new graduate when making which of the following statements? . a. “A graduate nurse should be able to perform as independently as was demonstrated the last semester of nursing.” b. “A graduate nurse should be able to function competently as a registered nurse at the entry level.” . c. “A graduate nurse should be able to function in the role that was described in the curriculum for the school of nursing.” d. “A graduate nurse should be able to be able to function independently with ability . to make clinical nursing judgments.” ANS: B The job expectations of a new graduate nurse are those of an entry-level new employee. This . frequently includes 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. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding . REF: p. 12 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 6 | P a g e. not an indication of successful transition. PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 8 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 appropriate preparation for the transition experience? . a. The nursing student requests additional experiences in performing skills and procedures. b. The nursing student maintains close contact with a nursing instructor. observe nursing procedures. to 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 should get all the experience, not just observation, you can before graduation. Ask to . perform procedures and skills and request feedback from staff nurses and instructors. Students should also begin to build resources that will be available after graduation. It is during the last semester that students begin to care for more complex patients (and more patient numbers) to . gain experience in the “real world” of nursing management and to have less reliance on the nursing instructor as a resource person. PTS: 1 DIF: Cognitive Level: Application/Applying . REF: p. 13 OBJ: Describe methods to promote a successful transition. TOP: Activities to promote successful transition before graduation MSC: NCLEX®: Not applicable . 13. A graduate nurse has been reviewing the NCSBN’s Transition to Practice model. The graduate nurse understands the intention of 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 b. regulatory model for transition“The intention of the model is to provide educational modules so that the new to practice.” 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 safety by supporting the role-transition experience of newly licensed nurses. The new graduate would first take and pass the NCLEX®, obtain employment, and then enter the transition program. There are five transition modules with content focused on communication 7 | P a g eand teamwork, patient-centered care, evidence-based practice, quality improvement, and . informatics. The time period for completion of the program is 6 months with an expected additional 6 months of ongoing support. Because of individual state’s rights, the NCSBN encourages states to adopt this model; however, they do not have the authority to mandate . adoption of the model. This model does not act as a replacement of a preceptor in the clinical practice area. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding . REF: pp. 16-17 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 situational transitions? 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 change from one situation to another, such as a career change. Dealing with a chronic illness would be characteristic of a health–illness transition, a leadership change would be an organizational transition, and a midlife crisis would be a . developmental transition. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 3 the concepts of transitions. . TOP: What are transitions? OBJ: Discuss MSC: NCLEX®: Not applicable 15. A student in the last semester of nursing school wants to be sure of adequate preparation for . the transition experience. Which 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 experiences. It would be most appropriate for the student to accept the “busy” patient, who requires oral and IV medications and needs to have his IV restarted. The patient who can care for herself independently and the one who is leaving the hospital against medical advice would not provide as much skill experience. Diabetic teaching is important but does not . require the time management and work organization skills of a “busy” patient. PTS: 1 DIF: Cognitive Level: Application/Applying . REF: p. 13 OBJ: Describe methods to promote a successful transition. TOP: Role transformation MSC: NCLEX®: Not applicable 8 | P a g e16. A student nurse is interested in improving his/her nursing skills. What action would be the . best for the student nurse to take? a. Ask his/her instructor for extra skills practice during clinical hours. b. Watch videos on how to perform the nursing skills that he/she needs to practice. c. Review his/her nursing textbooks. . d. Observe nurses perform skills in his/her clinical setting. ANS: A The best way for the nursing student to improve skills is to get hands-on practice. The student . would benefit most from requesting extra skills practice during clinical hours, where skills can be performed on real patients, with the guidance of a clinical instructor. Therefore, watching skills videos, reviewing nursing textbooks, and observing other nurses would not help the . student obtain hands-on practice. PTS: 1 REF: p. 13 DIF: Cognitive Level: Application/Applying OBJ: Describe methods to promote a successful transition. . TOP: Role transformation MSC: NCLEX®: Safe and effective care environment 17. A nursing student is nearing the end of his/her clinical experience. The student would like to care for patients who are typically challenging for students in the first year of practice. Which . patient would be the best choice for this student? a. A 62-year-old man with diabetes who needs outpatient care set up b. A 30-year-old woman with a kidney stone requiring IV pain medications c. A 45-year-old man with chest tubes recovering from a car accident. d. A 25-year-old woman who received blood yesterday ANS: C The skills that nursing students have identified as the most challenging include code blues, . chest tubes, intravenous skills, central lines, blood administration, and patient-controlled analgesia. The most appropriate patient for the student to increase his/her skill level would be the 45-year-old man with chest tubes. The other patients are not considered to be “challenging . patients” for most nursing students. PTS: 1 REF: p. 13 DIF: Cognitive Level: Application/Applying OBJ: Describe methods to promote a successful transition. . TOP: Role transformation MSC: NCLEX®: Not applicable 18. Which statement by the nursing student indicates an understanding of the importance of . constructive feedback? a. “I will wait until my clinical evaluation and then make any changes to my practice that are needed.” b. “I will request routine feedback from my instructor so I can make any changes . needed to improve my skills.” c. “My instructor will let me know if I need to change anything.” d. “I will ask my colleagues if I need to make any changes to my practice.” . ANS: B Students are responsible for their skills and growth as health care providers. To ensure that 9 | P a g etheir nursing skills are adequate, students should request periodic feedback from their clinical . instructors. Waiting for feedback or asking colleagues would not be an effective way for nursing students to obtain feedback in a timely manner. PTS: 1 REF: p. 14 DIF: Cognitive Level: Application/Applying . OBJ: Describe methods to promote a successful transition. TOP: Role transformation MSC: NCLEX®: Not applicable 19. A graduate nurse has clocked in for his/her second shift on a busy orthopedic unit. After . accepting the assignment, the graduate nurse notices a fellow nurse complaining loudly at the nurse’s station to other staff members. This fellow nurse is typically upset with floor assignments and thinks that the “new nurses get all the easy assignments.” Which action . would be best for the graduate nurse to take? a. Join the conversation and tell the fellow nurse that he/she does not care for the assignment either. b. Begin a conversation with another staff member about the fellow nurse who is . complaining. c. Steer clear of the nurse who is complaining and try to focus on the positive. d. Begin complaining about his/her own assignment. . ANS: C The graduate nurse would have the most success by steering clear of the complaining nurse and focus on the positive. Joining the conversation and focusing on the negative will not help . the graduate nurse adjust to his/her new job. PTS: 1 REF: p. 14 DIF: Cognitive Level: Application/Applying OBJ: Describe methods to promote a successful transition. . TOP: Role transformation MSC: NCLEX®: Not applicable 20. A new nurse is caring for five patients on a busy surgical floor. While hanging blood for a . patient, the nurse receives notice that another assigned patient is being taken for surgery. The nurse has not obtained informed consent from the patient. What action should the new nurse take? a. Immediately leave the room he/she is in and obtain informed consent from the . patient. b. Allow the patient to go to surgery without obtaining informed consent. c. Delegate obtaining informed consent to another nurse while staying with t . patient who is receiving blood. d. Ask the transporter to obtain informed consent from the patient. ANS: C . Although the nurse must stay with the patient while hanging blood, it is important that informed consent be obtained from the other patient before going to surgery. The best action for the nurse to take would be to compromise and delegate obtaining informed consent to another nurse. The other actions would be inappropriate and possibly dangerous to the . patients involved. PTS: 1 REF: p. 15 10 | P a g e DIF: Cognitive Level: Application/Applying OBJ: Describe methods to promote a successful transition. . heTOP: Role transformation MSC: NCLEX®: Safe and effective care environment 21. The new graduate has an understanding of the nursing journey ahead when stating . a. “It is not acceptable for me to make any mistakes at all.” b. “I am not worried about issues with transition. I am tough. I will do just fine!” c. “I know that I will make some mistakes, but I will learn and grow from them.” d. “I am going to keep studying so that I am always right.”. ANS: C It is important for graduate nurses to know that they will make mistakes in their nursing careers and that they learn and grow from them. It is not realistic for graduate nurses to . believe that they will not make any mistakes or will not struggle with transition. PTS: 1 DIF: Cognitive Level: Application/Applying . REF: p. 20 OBJ: Describe methods to promote a successful transition. TOP: Role transformation MSC: NCLEX®: Not applicable 22. A nurse has worked the past 5 days in a row to make some extra money. Today is a scheduled . day off. Which of the following actions would be the best for this nurse to take? a. Call the unit to see if they need the nurse to work. b. Read nursing articles and take practice quizzes to stay up -to-date. c. Take his/her small children to the zoo. . d. Work on a continuing education requirement. ANS: C It is important that the nurse take time to relax and have fun. Taking his/her small children to . the zoo is a non–work-related activity that would ease stress and be enjoyable. PTS: 1 DIF: Cognitive Level: Application/Applying . REF: p. 15 OBJ: Describe methods to promote a successful transition. TOP: Role transformation MSC: NCLEX®: Not applicable . MULTIPLE RESPONSE 1. A nurse manager is preparing a group of newly hired nurses to work on the unit. After educating them on reality shock, a student asks what physical and psychological symptoms . the nurse may experience? The nurse manager replies: (Select all that apply. ) a. “It is not possible to experience any physical or psychological sympto ms from reality shock.” . b. “You may experience headaches.” c. “It is possible that you will experience gastrointestinal upset.” d. “You could experience insomnia.” e. “Women may experience menorrhagia.” . ANS: B, C, D 11 | P a g eReality shock can cause physical and psychological symptoms that are important for the nurse to be aware of. These can include headache, insomnia, feeling stressed out, gastrointestinal . upset, and post-student blues. Menorrhagia (excessive menstrual bleeding) is not a typical physical symptom of reality shock but is caused by uterine fibroids, endometriosis, or uterine polyps. Amenorrhea (absent menstrual flow) may be experienced because of stress associated . with reality shock. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 9 OBJ: Identify the characteristics of reality shock. . TOP: What are the phases of reality shock? MSC: NCLEX®: Psychosocial integrity 2. A new nurse wants to make personal lifestyle changes to become a healthier individual. . Which actions would help with reaching this goal? (Select all that apply. ) a. Begin an exercise routine. b. Eat protein snacks late at night. . c. Incorporate relaxation into his/her schedule. d. Begin eating nutritious meals and snacks. e. Be sure to get adequate sleep. . ANS: A, C, D, E To maintain health and wellness, the new nurse should begin an exercise routine, incorporate relaxation into his/her schedule, begin eating adequate nutritious meals and snacks. The nurse should consider cutting out snacks late at night. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 15 TOP: Role transformation OBJ: Describe methods to promote a successful transition. MSC: NCLEX®: Health promotion and maintenance . 3. Which action would greatly help the graduate nurse when seeking out employment? (Select all that apply.) . a. Plan out interviews. b. Ask to speak to nurses who work on the unit. c. Wait until the interview to gather all of the information. d. Find out what type of nursing care is delivered. . e. Determine the length of orientation. ANS: A, B, D, E It is important for the graduate nurse to be prepared when seeking out employment. Planning . out interviews, speaking to nurses who work on the units, finding out what type of nursing care is provided, and determining the length of orientation are all actions the graduate nurse can take to prepare for employment. Waiting to gather information at the interview can leave . the graduate nurse feeling frazzled and disorganized. PTS: 1 REF: p. 16 DIF: Cognitive Level: Application/Applying OBJ: Describe methods to promote a successful transition. . TOP: Role transformation MSC: NCLEX®: Not applicable . 12 | P a g e. Chapter 02: Personal Management: Time and Self-Care Strategies . . MULTIPLE CHOICE 1. Which statement indicates the nurse’s understanding of effective time management? . a. “The purpose of effective time management is to save hours, minutes, and seconds.” b. “The purpose of effective time management is to do as much as possible in as short . a time as possible.” c. “The purpose of effective time management is to do as little as possible.” d. “The purpose of effective time management is to achieve personal and professional goals.” . ANS: D Making time to meet your individual, family, professional, and career needs and goals is vital to overall success and is the primary purpose of time management. Stating that the purpose of . effective time management as saving time or doing as much or as little as possible in a short time would not indicate the nurse’s understanding. Procrastinating and doing as little as possible are not characteristic of effective time management.. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 24 OBJ: Identify strategies for self-care. TOP: Time management MSC: NCLEX®: Not applicable . 2. A student nurse resists schedules and prefers to study when it “feels right” and in groups. Which of the following characteristics fits this student? . a. Left-brain dominant b. Right-brain dominant c. Equally right- and left-brain dominant d. Neither right or left brain dominant . ANS: B Right-brain–dominant people resist schedules and choose to do things their own way. Left- brain–dominant people process information in a linear, sequential manner, so they would . probably prefer a schedule of activities. Some people are equally right- and left- brain dominant and have a mix of behaviors. There are other people who have no clear pattern. . PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 26 OBJ: Identify your individual time style and personal time-management strategies. TOP: Time management MSC: NCLEX®: Not applicable. 3. In 4 weeks, a student nurse will have two tests and one paper due in the same week. What is the most effective time-management strategy for this student nurse? a. Control time wasters to have more time for studying and writing.. 13 | P a g eb. Delegate everything possible to create more time for studying. c. Schedule specific times on a calendar to study for the tests and to work on the paper. . d. Wait until the last minute because the student nurse “works best under pressure.” ANS: C The most effective approach to this problem would be to schedule specific time periods to prepare for the tests and write the paper. Waiting until the last minute to study and write the . paper creates unnecessary stress and sets the student nurse up for failure. Creating more time for studying does not solve the problem; how that time is organized and how it is used is the key. Procrastinating by putting off assignments until the last minute can lead to extreme . anxiety and stressful behavior. Although delegating some tasks is realistic and can create time for studying, it is unrealistic to delegate “everything possible” and impossible to control all time wasters. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 29 OBJ: Identify your individual time style and personal time-management strategies. . TOP: Time management MSC: NCLEX®: Not applicable 4. How can the student nurse increase studying efficiency? a. Maintaining a supply of simple carbohydrates for a quick energy spurt. b. Alternating mental and physical activities to increase productivity c. Working nonstop without breaks to focus concentration d. Delegating tasks of household chores to family members . ANS: B Alternating tasks that are mental with tasks that are physical can increase alertness and create a natural energy spurt to keep going. Carbohydrate-induced energy spurts are short lived and . ineffective for studying efficiency. Working nonstop without breaks leads to fatigue and burnout. Although delegating tasks would be helpful to the student nurse, it does not directly increase studying efficiency. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 42 OBJ: Identify your individual time style and personal time-management strategies. TOP: Time management MSC: NCLEX®: Not applicable. 5. The nurse has concluded that he/she is a right-brain–dominant person. Based on the nurse’s time style, which unit governance task will the nurse implement? . a. Devise a plan to restructure the nursing career ladder. b.c. Write a procedure for central line care using new equipment.Do the unit time schedule for the next pay period. d. Collate data obtained from a chart audit to report at the next unit staff meeting.. ANS: A Right-brain–dominant people like to brainstorm to create new, holistic ideas and approaches to old problems, so devising a restructured nursing career ladder would be an appropriate task . for this person. Writing procedures, completing time schedules, and collating data are indicative of a left-brain–dominant person. 14 | P a g e. PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 26 OBJ: Identify your individual time style and personal time-management strategies. TOP: Time management MSC: NCLEX®: Not applicable. 6. What actions should a graduate nurse take in the first work experience to avoid problems with burnout? a. Cross-train to work in different areas of the hospital. . b. Develop a social group of nurses with whom to share work experiences. c. Plan on several sessions with a counselor regarding managing stress. d. Maintain good nutrition and good sleep habits. . ANS: D Taking care of oneself is a primary component to preventing burnout—for example, avoiding alcohol, maintaining good nutrition, getting adequate amounts of sleep, and avoiding cigarette . smoking. Developing social contacts outside the work environment also facilitates reduction of stress from work. Cross-training in different areas of the hospital, developing a social group with nurses to share work experiences, and meeting with a counselor would not be helpful to the graduate nurse in avoiding problems with burnout in the first work experience because . they are all related to that experience. PTS: 1 REF: p. 37 TOP: Burnout DIF: Cognitive Level: Application/Applying OBJ: Discuss the importance of caring for yourself. . MSC: NCLEX®: Not applicable 7. Which action by the nurse exemplifies a sense of spiritual health? . a. Belonging to a church b. Feeling purposeful and fulfilled c. Feeling loved and cared for d. Changing religious affiliations . ANS: B A sense of spiritual health simply means that we have a daily awareness that there is something more to living than mere human existence. People who have a sense of spiritual . being find their lives to be positive experiences and feel good about the future. Belonging to a church, feeling loved and cared for, and changing religious affiliations are not identified as ways that one exemplifies a sense of spiritual health. . PTS: 1 REF: p. 39 DIF: Cognitive Level: Application/Applying OBJ: Discuss the importance of caring for yourself. TOP: Spiritual awareness MSC: NCLEX®: Not applicable. 8. Which of the following is an example of a self-defeating belief? a. I must always feel loved by everyone. b. I am a caring person. . c. I will get through nursing school. d. I am getting better. 15 | P a g eANS: A . Feeling as though you need to be loved by everyone is a self-defeating belief because there will always be some individuals who do not care for you. It would be unrealistic and hence self-defeating to have or express the need to be loved by everyone. There are many ways to . exercise our mental potential. One of the first ways is to concentrate on removing negative thoughts or self-defeating beliefs from our minds. Affirmations or positive statements, such as being a caring person, will get through nursing school, getting better with skills or recovering from an illness, and so on are ways to avoid self-defeating comments and behaviors.. PTS: 1 REF: p. 43 DIF: Cognitive Level: Knowledge/Remembering OBJ: Identify strategies for self-care. . TOP: Self-care MSC: NCLEX®: Not applicable 9. Which is an example of an effective self-care strategy for a nurse? a. Plan time for physical recuperation after working extra hours.. b. Push feelings of sadness, joy, anger, and fear out of awareness. c. Use alcohol to reduce tension. d. Respond to people and opportunities reactively. . ANS: A Taking care of ourselves physically entails getting proper nutrition and adequate sleep, exercising on a regular basis, and planning for additional time to recuperate when working . extra hours. Using alcohol or drugs only medicates feelings and is not considered an effective self-care strategy. Not dealing with feelings is a way to consciously suppress emotions, which can lead to a variety of anxiety disorders. Responding to people and opportunities with a reactive, or “knee-jerk,” response is not a good self-care strategy because the behavior can . lead to poor decisions without adequate thought. REF: pp. 41-42 PTS: 1 DIF: OBJ: Cognitive Level: Knowledge/Remembering Identify strategies for self-care. . TOP: Self-care MSC: NCLEX®: Not applicable 10. Nurse 1: “The manager told me that you and I have to change work schedules to . accommodate Jim. That means we will both have to work days and nights in the same week. There’s nothing we can do about it.” Nurse 2: “Let’s take a minute and look at the possible alternatives.” What is the best assessment of this situation? a. Nurse 1 is exhibiting reactive behavior, and nurse 2 is being proactive.. b. Nurse 1 is exhibiting a sense of empowerment, and nurse 2 is behaving c. codependently.Jim and the nurse manager have formed a coalition with the goal of dominating . other staff. d. The nurse manager is evidencing good self-esteem by daring to take an unpopular action that will expose criticism. . ANS: A Whereas nurse 1 is reacting to the situation, nurse 2 is taking time to assess the situation more thoroughly and see what choices they might have, which is a proactive response. Many of us go through life never realizing that we have many choices. You can choose to respond to . people and situations rather than react. It is important to assess the situation and see 16 | P a g ewhat options are available and what the consequence of the options might be. Exercising our choice potential also entails that we act responsibly toward others. Codependent behavior is a type of . control or enabling behavior. Empowerment is the power to do something and acting self-confidently to do so. The question is asking about the assessment of nurse 1 and nurse 2 responses, not the nurse manager. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: Box 2.10 OBJ: Identify strategies for self-care. TOP: Self-care—proactive response MSC: NCLEX®: Psychosocial integrity . 11. A nurse has been out of school about 6 months. Which of the following would indicate that the nurse is having problems with burnout? a. Has chronic fatigue, increased irritability, and feelings of helplessness. b. Feels angry about the type of care being delivered and scheduling of staff c. Signs up for extra courses for an advanced degree and works double shifts d. Is disorganized in patient care and has to stay late to finish shift work . ANS: A Fatigue, irritability, and feelings of helplessness are all early signs of burnout. Anger about care may be very appropriate; how the anger is directed is important. Overscheduling oneself . is something that may promote early burnout, as are disorganization and poor time management. PTS: 1 REF: Box 2.6 DIF: Cognitive Level: Application/Applying . OBJ: Describe early signs of compassion fatigue and burnout. TOP: Burnout MSC: NCLEX®: Not applicable 12. The nurse would identify which of the following strategies as a means of increasing feelings . of empowerment? a. Requesting an assignment to a different hospital unit b. Assisting friends to cover their shifts when they need time off . c. Telling a coworker that a joke heard in private was inconsiderate and thoughtless d. Declining to work an extra shift and going to the movies with friends ANS: D . Taking care of oneself is critical to preventing burnout and increasing feelings of empowerment, such as declining to work an extra shift so you can participate in activities with friends and family. Take care of yourself first; then assist others as you are able. Moving to a different hospital unit may be a type of avoidance with an issue that is unresolved. Humor and . laughter are important; however, if the joke was unethical, correcting the nurse would not increase empowerment. . PTS: 1 REF: p. 37 DIF: Cognitive Level: Application/Applying OBJ: Identify strategies for self-care. TOP: Empowerment MSC: NCLEX®: Not applicable . 13. What activity would most likely promote a positive feeling of well-being in a graduate nurse 17 | P a g eabout 6 months after employment? a. Have a group of staff nurses over for a party. b. Participate in hospital-sponsored programs for community health.. c. Spend some time with an old friend who is in the middle of a divorce. d. Get involved in a new hobby, and attend social gatherings to meet new people. ANS: D . Planning pleasurable activities, such as a hobby or attending a social gathering, that are not associated with nursing or other people’s problems can help you to reenergize and feel better about yourself. Having nurses over for a party or participating in hospital-sponsored programs . would not give the graduate nurse the time needed away from nursing. Spending time with a friend going through a divorce would not promote a positive feeling of well-being in the graduate nurse. . PTS: 1 REF: p. 39 DIF: Cognitive Level: Application/Applying OBJ: Identify strategies for self-care. TOP: Empowerment MSC: NCLEX®: Not applicable . 14. A nurse is considering pursuing additional education in nursing and hopes to be promoted to a management position. What action should the nurse take to best achieve this? a. Wait until “the time is right” and inquire about program and promotion opportunities. . b. Be the best nurse possible and hope a scholarship or promotion will be awarded. c. Set long-range, mid-range, and short-range goals with specific related activities and time frames to meet these goals. . d. Read three books on time management. ANS: C Setting goals so that you can prioritize your approach and identifying specific activities and . time frames to work toward a management promotion are keys to success. Assess the situation to see what activities will provide the highest payoff. Waiting for the right time to achieve promotion, hoping for a scholarship or promotion, and reading books on time management are not effective; instead, the nurse must take action to achieve a goal.. PTS: 1 REF: p. 33 DIF: Cognitive Level: Application/Applying OBJ: Identify strategies for self-care. . TOP: Time management MSC: NCLEX®: Not applicable 15. A student nurse is feeling stressed about the combination of nursing courses and clinical experience in the semester. What actions can the student nurse take to reduce stress level . based on biological rhythms? a. Schedule difficult activities at high-energy times. b. Shorten sleep time to accommodate increased study times. c. Study before bedtime to increase memorization. . d. Only study when not feeling stressed. ANS: A Student nurses should create schedules that work with their biological rhythms, such as . scheduling difficult activities at their high-energy times. Shortening sleep, studying right before bed, and only studying when they are not feeling stressed are not advised. . PTS: 1 DIF: Cognitive Application/Applying REF: p. 24 18 | P a g e Level:OBJ: Identify your individual time style and personal time-management strategies. TOP: Managing your time MSC: NCLEX®: Not applicable. 16. A nurse manager is assigning additional duties to the day shift nurses to keep the unit orderly and running smoothly. Which assignment would be the best for a right-brain–dominant nurse? . a. Clean up the break room by noon. b. Assist with completing a unit project, based on specific rules and guidelines. c. Create a poster board in honor of Nurse’s Week. d. Take part in a meeting regarding unit policies. . ANS: C . Right-brain–dominant people resist rules and schedules and prefer to complete activities on their own time. Creating a poster board in honor of Nurse’s Week gives the right-brain–dominant nurse a chance to create in a personal way without rules and restrictions. . Cleaning up the break room by noon, assisting with a unit project guided by rules and specific guidelines, and taking part in a unit policy meeting would be better suited for a left- brain–dominant nurse (structure, organization, rules, time limits, and priorities are important). . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 26 . OBJ: Identify your individual time style and personal time-management strategies. TOP: Managing your time MSC: NCLEX®: Safe and effective care environment 17. What action by student nurses indicates readiness for successful study habits? . a. Combining their study area with the space that they use to pay bills b. Color coding their materials from each class c. Keeping all materials and papers in one bin . d. Cleaning their study area at the end of each semester ANS: B To ensure success, students should first separate the area where they study from the area . where they pay bills. Second, students should color code their materials from each class to ensure that they can find what they need during study sessions. Students should separate out materials and discard what is no longer needed. Frequently cleaning their study area will help them maintain order. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 31 OBJ: Identify your individual time style and personal time-management strategies. . TOP: Managing your time MSC: NCLEX®: Not applicable 18. What actions can a student take to manage the phone calls received throughout the day? . a. Set a specific time during the day for business- or school -related phone calls. b. Allow phone calls at any time as long as they are short. c. If the student needs to leave a message, state that he/she can be contacted any time. 19 | P a g ed. Keep the phone turned off until all studying is completed for the day.. ANS: A Students should set up a time during the day for all phone calls related to business or school. If students need to leave a message, they should state when they can be contacted. Keeping . the phone turned off is not a realistic option. PTS: 1 REF: p. 28 OBJ: Identify your individual time style and personal time-management strategies. TOP: Managing your time MSC: NCLEX®: Not applicable . 19. A student wants to begin planning for future educational goals. Which of the following actions would NOT help the student plan? a. Review a list of goals once a year. b. Make a master list of goals. . c. Prioritize goals. d. Cross out goals as they are met. ANS: A In planning goal-related activities, making a master list of goals and prioritizing the list are . helpful strategies for completing activities and accomplishing goals. It is also helpful to cross off each goal as it is completed. Doing so provides a sense of accomplishment and immediate gratification for completing a goal. It is important to continually review the list of goals . established to determine if activities or tasks need to be moved based on how quickly they need to be attended to. Reviewing a list of goals yearly would not be sufficient in helping the student plan for completing his/her educational goals. . PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 35 OBJ: Identify your individual time style and personal time-management strategies. . TOP: Managing your goals MSC: NCLEX®: Not applicable 20. Which of the following actions by the nurse helps prevent burnout? a. Picking up extra shifts each week . b. Staying late to help out at the end of each shift c. Scheduling a massage on a day off d. Teaching at the local community college one day a week . ANS: C A fun, relaxing activity that is not work-related can help prevent burnout, such as scheduling a massage on a day off. Picking up extra shifts, staying late to help out at the end of the shift, . and teaching part-time one day a week may lead to burnout if the nurse is not careful. PTS: 1 REF: p. 36 DIF: Cognitive Level: Knowledge/Remembering OBJ: Identify strategies for self-care. . TOP: Self-care strategies MSC: NCLEX®: Health promotion and maintenance 21. Which of the following statements by the nursing student is an affirmation? a. “I must maintain As in my school grades.” . 20 | P a g e DIF: Cognitive Level: Application/Applying .b. “I am human and capable of making mistakes.” c. “If I fail at something, the results will be catastrophic.” d. “If I am not liked by everyone, I am a failure.” . ANS: B Stating, “I am human and capable of making mistakes” is an affirmation or a positive statement concerning the ways we would like to think, feel, or behave. The other statements . are self-defeating thoughts. PTS: 1 REF: Box 2.9 DIF: Cognitive Level: Knowledge/Remembering OBJ: Identify strategies for self-care. . TOP: Self-care activities MSC: NCLEX®: Not applicable MULTIPLE RESPONSE . 1. When taking an online or web-enhanced course, what are effective timemanagement strategies? (Select all that apply.) a. Enroll in an online or web-enhanced course that has fewer than 15 students to . reduce the amount of time it takes to respond to everyone in the class. b. Print your syllabus and create a calendar with assignment due dates and discussion posting requirements. . c. Create a directory on your computer to place assignments and resources specific for the course. d. Determine what the best time is for logging into the course website and create a schedule for weekly log-in times. . e. Develop an online group of colleagues that meet in the chat room or participate in instant messaging. . ANS: B, C, D, E Online or web-enhanced courses can take as much, if not more, time as traditional face-toface classes. The following are helpful strategies to improve time management involving the course: . • Print the syllabus and place deadlines on your calendar before the first course meeting.