d.This job is perfect. I can finally do things my own way.

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” Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau (Test Bank All Chapters, 100% Original Verified, A+ Grade) 1 / 4

• Changing jobs every 6 to 12 months

ANS: A

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

• Which of the following statements by the graduate nurse shows an understanding of reality

shock as it applies to nursing?

• “Reality shock is the period when a person moves from school into the

workforce.”

• “Reality shock is the realization that practice and education are not the same.”
• “Reality shock is the period from graduation to becoming an experienced nurse.”
• “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

• 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 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.”

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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

• 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
• Shock and rejection
• Honeymoon
• 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

• 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?

• Honeymoon
• Shock and rejection
• Recovery
• Role transformation

ANS: B 3 / 4

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

• 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
• An organizational transition
• A health-oriented transition
• 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 MSC: NCLEX®: Not applicable

• 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?

• Acquiring new knowledge and skills required in the new environment
• Completing classwork required to obtain an advanced degree
• Reflecting on personal history of previous developmental transitions
• 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

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