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?

• “I should care for an increased number of patients to enhance work organization skills.”

• “I will observe staff nurses as they perform nursing procedures to refine technique.”

• “I should seek increasingly close guidance from the nursing instructor to reduce errors.”

• “I will evaluate my progress every 7 weeks or more to allow time for growth.”

Answer explanation

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.

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?

• Recovery

• Transitional

• Honeymoon

• Shock & Rejection

Answer explanation

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.

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 developmental transition

• A situational transition

• An organizational transition

• • A health-oriented transition

Answer explanation

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.

Which action by the graduate nurse shows that a successful transition to nursing has been made?

• The nurse meets regularly with other new graduates to compare and discuss problems.

• The nurse begins to work with the nursing team and functions as others expect.

• The nurse believes everything is great, patients are wonderful, and the new unit is so nice.

• The nurse begins to objectively evaluate work experiences and enjoy the humor of clinical situations.

Answer explanation

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.

A student in the last semester of a 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 48-year-old man with heart failure who has oral and IV medications due and needs a new IV started

• A 25-year-old man who is leaving the hospital against medical advice

• A 40-year-old man who needs education on diabetes management

• • A 38-year-old woman who cares for herself independently and is going home later today

Answer explanation

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 most complex 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 complex patient.

What actions should a graduate nurse take in the first work experience to avoid problems with burnout?

• • Cross-train to work in different areas of the hospital.

• Plan on several sessions with a counselor regarding managing stress.

• Develop a social group of nurses with whom to share work experiences.

• Maintain good nutrition and good sleep habits.

Answer explanation

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 the reduction of stress from work.

Which action by the nurse exemplifies a sense of spiritual health?

• Feeling loved and cared for

• Feeling purposeful and fulfilled

• Belonging to a church

• Changing religious affiliations

Answer explanation

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.

A student wants to begin planning for future educational goals. Which of the following actions would NOT help the student plan?

• • Crossing out goals as they are met.

• Making a master list of goals.

• Prioritizing goals.

• Reviewing a list of goals once a year.

Answer explanation

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.

When taking an online or web-enhanced course, what are effective time-management strategies? (Select all that apply.)

• • Print your syllabus and create a calendar with assignment due dates and discussion posting requirements.

• Develop an online group of colleagues that meet in the chat room or participate in instant messaging.

• Determine what the best time is for logging into the course website and create a schedule for weekly log-in times.

• Create a directory on your computer to place assignments and resources specific for the course.

• 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.

Answer explanation

Online or web-enhanced courses can take as much, if not more, time as traditional face-to-face 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.

• Identify how to contact your instructor, and schedule online office hours in your calendar.

• Schedule daily times for logging into the class website.

• Schedule a time for class work and select a specific site.

• Cultivate collegial support groups with individuals who provide support and are good listeners.

• Be active in the course by participating appropriately in discussion groups.

• Establish an evidence-based file to download important articles (.pdf format).

• Bookmark websites (but before bookmarking these, review the information; do not assume all sites are up-to-date and evidence based)

The graduate nurse demonstrates an understanding of the purpose of the NCLEX-RN® when making which following statement?

• “The exam prepares new graduates as efficient, effective staff nurses.”

• “The exam gives employers an opportunity to hire graduates who have scored highest among first-time licensure candidates.”

• “The exam provides feedback to the candidate regarding areas of weakness in nursing practice.”

• “The exam determines the candidate’s ability or inability to meet minimum standards for safe practice.”

Answer explanation

The purpose of the NCLEX-RN® is to determine whether a candidate is competent to perform safe, effective, and entry-level nursing care. It does not prepare nurses but rather measures their performance on a test. Candidates who are unsuccessful receive information about their weak areas on the test, but this is not the purpose of it. Employers want to know if the person has passed because there is no specific score given other than pass or fail.