Evolve 1 Flashcards
A nursing manager has just hired several new graduates on an inpatient unit. Having heard of the “honeymoon phase” of transitioning into nursing, which action by the manager would be most helpful?
a Educate the graduates on phases of reality shock.
b Help the graduates concentrate on principles of safe care.
c Offer social events for new and seasoned nursing staff.
d Remind the graduates that they should keep their positive attitudes.
a
A nurse with 15 years’ experience has been working in the intensive care unit (ICU) for two months. The nurse’s preceptor is expressing frustration to the unit manager because the new nurse follows all the rules “to the letter” and is inflexible. Which action by the manager is most helpful?
a Encourage the preceptor to be patient and give the new nurse easier assignments.
b Explain that as a nurse new to the ICU setting, this rule-bound practice is expected.
c Discuss the situation with the new nurse and emphasize the nurse’s years of experience.
d Mediate a conversation with the nurses where performance expectations are reviewed.
b
A nurse is preparing to give a performance review to a new graduate who has worked on the unit for one year. Which action by the nurse leads the manager to conclude that a successful professional transition is occurring for the new nurse?
a Staff members relay that the nurse is easy to work with and is cooperative
b Has not called in sick or been late during the entire time of employment
c Picks up extra shifts and frequently works overtime to care for “my patients”
d Able to adjust to workload without compromising safety or quality care
d
A nurse manager is teaching a seminar for managers on reality shock experienced by new graduates. What information does the nurse manager provide? (Select all that apply.)
a Honeymoon phase: seems energetic and fascinated with nursing
b Shock and rejection phase: blames everyone else for any mistakes
c Shock and rejection phase: nurses may complain of minor illnesses
d Shock and rejection phase: uses black humor to cope with work
e Recovery phase: no longer catches contagious illnesses to which he or she is exposed
a c
A nursing manager wants to plan a program to help decrease new graduates’ stress. Which activities should the nurse manager include in this program? (Select all that apply.)
a Creating a master plan for increasing responsibilities of new staff
b Ensuring that new staff understand the unit’s formal chain of command
c Including formal skills practice and competency testing in a skills or scenario lab
d Providing an orientation to facility benefits and time-off policies \
e Reviewing proper communication techniques for calling physicians
a c
A nurse is the chairperson of the research-based practice council on her unit. Most members work well together and complete their assignments on time, but one nurse seems disorganized, can’t meet deadlines, and often strays “off topic” during meetings. Which action by the chairperson would be most helpful?
a Ask the nurse to lead a brainstorming session for new council projects.
b Enlist the help of the unit manager to reinforce council responsibilities.
c Give this nurse small, easy to complete projects with strict deadlines.
d Speak privately with the nurse and ask if council participation is desired.
a
A student nurse is reading about Pareto’s 80/20 rule and is trying to explain it to a classmate. Which explanation is best?
a Concentrating even 20% of your efforts on high-priority items leads to greater success.
b Eighty percent of your time should be spent on 20% of your daily to-do list.
c Most of your success can be accomplished by a smaller amount of effort.
d You should spend 80% of your time on important tasks and 20% on the remainder.
a
A nurse is concerned about possible burnout. Which action should the nurse perform first?
a Begin reading self-help books on maintaining a balanced lifestyle.
b Determine if the cause of burnout is internal, external, or both.
c Look for another job in a facility that has a less stressful workload.
d Volunteer to join a committee that impacts patient care practices.
b
The first step in analyzing possible burnout is to determine if the cause of the burnout is internal, external, or both. Internal factors leading to burnout can be mediated with self-help strategies and by living a more balanced lifestyle. External factors such as conditions in a place of employment may not be amenable to change and the nurse may have to find other employment. But prior to taking any action such as reading self-help books, looking for another job, or volunteering to be on a committee, the nurse should first determine where the stress is coming from. In fact, if the nurse is already over-extended at work, joining a committee may add to his or her distress.
The charge nurse on a medical unit has noticed one of the seasoned and experienced nurses acting irritable and having critical angry outbursts at work. Which action by the charge nurse would be most helpful?
a Ask what other people are doing to make him or her so angry
b Explore the nurse’s use of self-care measures and leisure activities
c Help the nurse work on better communication techniques
d Send the nurse to Employee Assistance for anger management
b
This nurse is displaying some early signs of burnout. The most helpful response by the charge nurse is to explore how the nurse is caring for herself or himself and whether he or she engages in any leisure activities. These are two strategies that can decrease or mitigate burnout. Better communication techniques don’t seem to be the priority, because this behavior is something the charge nurse has just recently noticed. Anger management is also probably not warranted; again, this behavior is recent, and anger management alone will not help solve the nurse’s burnout. The nurse needs to take responsibility for his or her actions, so placing blame on others is not appropriate
A nurse works rotating shifts and always feels fatigued, irritable, and complains of insomnia. What suggestions for good sleep can a colleague make that would be helpful? (Select all that apply.)
Cut down on the amount of carbohydrates you eat each day Correct Exercise for 30 to 45 minutes before going to bed for the day. Incorrect Keep the bedroom temperature warmer than other rooms Incorrect Turn off the phone, computer, and other electronic devices Correct Wear an eye shield and keep your bedroom dark with shades Correct
Suggestions for good sleep, especially when circadian rhythms are disrupted, such as seen in shift work, can be found in Box 2-1. They include using the bedroom only for sleeping and avoiding watching TV or using the computer in bed, engaging in a routine of quiet, relaxing activities prior to bedtime, keeping the bedroom cool and dark (e.g., use a ceiling fan for air movement and for some noise; use window shades or eye shields to darken the room), using other white noise generators, maintaining a quiet environment by turning off the phone and electronic devices and sleeping with earplugs, if necessary, and altering your diet to include more protein and less carbohydrates. Exercising just before bedtime or keeping the bedroom warmer are not a recommended techniques.
A new graduate nurse is paired with a registered nurse during work shifts. The registered nurse understands the professional role to be focused on socialization, role transition, clinical decision-making, and prioritization. What relationship does this describe?
Coaching Mentoring Precepting Correct Role Modeling
This role is that of the preceptor. The preceptorship experience promotes role transition and socialization for the nursing student while fostering professional leadership skills in the preceptor. Although role modeling is part of all three of the other relationships, that is not a description of a formal role. Coaching consists of helping individuals attain their potential, partly by recognizing and helping develop unique qualities in the person that may not be fully appreciated. Mentoring is based on the mentor’s unique knowledge and skills. Mentoring is also associated with a trusted friend and advisor.
A registered nurse has been mentoring a new graduate for four weeks out of a five-week formal mentoring program. The graduate nurse is caring for a group of patients, including one with complex needs, and is having trouble organizing the required tasks. Which action by the mentor is most helpful?
Give the graduate a schedule of the activities that the graduate must complete Have the graduate work with the complex patient only as a good learning experience. Let the graduate work through the process unless patient care is compromised Correct Offer advice on different methods of organizing a shift with a complex patient
Mentors should follow the advice of Peddy and lead, follow, or get out of the way and should know when each action is appropriate. Near the end of a formal mentoring program, it is time for the mentor to stand back and let the graduate nurse figure things out, and be ready to step in if patient care is compromised. Pushing the mentee and allowing the mentee to learn from failure are desirable traits in a mentor. The graduate is too far along to need a written schedule, should be able to manage more than one patient, and should have already gotten advice on organization
A nurse manager wants to create a program to decrease burnout and increase retention in new graduates. The facility already has a preceptorship program. Which component, if added, would fundamentally change the preceptorship program?
Communication guidelines Evidence-based curriculum Correct Long-term relationships Personality matching
The best way to decrease burnout and increase retention of new graduates is to establish a nurse residency program. One major component of such programs is a curriculum that is evidence-based. Long -term relationships among the staff, personality matching, and communication guidelines might be helpful to include, but do not substantially change the nature of the existing program
A student nurse wishes to participate in a mentee-mentor relationship with a senior nursing student. According to the mentee checklist, the student has a score of 82. Which statement by the nursing faculty best describes the student’s mentoring ability?
"A score of 82 shows you will interact positively with a mentor." Correct "I can help find a senior student to work with you on skills." "This lack of flexibility will probably hinder a mentoring relationship." "You should work on your listening skills prior to becoming a mentee."
The mentee checklist (Table 3-1) shows the positive traits that a successful mentee should have. A score of 80 or higher indicates that the student probably has good interaction skills that will be needed in a mentoring relationship. Helping the student find a mentor is helpful, but does not give information about the score. The score does not indicate a lack of flexibility or poor listening skills.
The nursing manager is looking for nurses to assign as mentors to new graduates. Which of the following nurses would the manager choose? (Select all that apply.)
Charge nurse with over 10 years' experience Incorrect Nurse who is enthusiastic about nursing; able to laugh at self Correct Nurse who gives meticulous care using a standard approach Incorrect Nurse who is known for being an out of the box thinker Correct Nurse who is planning to remain at the facility another 6 months Incorrect
A good mentor has many qualities shown in Box 3-1, including enthusiasm for nursing, and being able to use humor and listen to and accept differing points of view. A mentor should not be in a position of authority over the mentee, so that eliminates the charge nurse. Giving meticulous care is desirable, but using a standard approach is not as mentors have to be flexible. Because mentoring is a long-term relationship, a nurse planning to leave the facility after 6 months would not be the best choice.
A nurse is interviewing for a new job after working on a medical-surgical unit for 1 year. The interviewer asks why he is leaving his current job. Which is the best answer by the nurse?
"After some great experience, it's time to move to my career goal position." Correct "I think I learned all I could working on medical-surgical unit for a year." "It was too busy for me; I had trouble managing a large patient workload." "The manager did not like me and there were no other men working there."
When giving a reason for leaving a position, the nurse should remain positive, professional, and not burn bridges. Stating that he thinks it’s time to move to a position more in line with his career goals is a good option for the nurse. Stating that he has learned all he can make him seem dismissive of the current job. The other two options (that the unit was too busy with a large patient workload and the manager didn’t like me and there were no other men working on the unit) sound too much like complaints.
A graduate nurse is selecting an NCLEX-RN review course. This student graduated at the top of the class, is organized, plans study time, and feels fairly confident in the ability to pass the NCLEX-RN exam. Which type of review course would be best for this graduate to select?
Face-to-face, 3-day course None; study can be independent Correct Online, asynchronous course Online, real-time course
his student would probably be a good candidate for independent study with a review book rather than taking a review course (able to make and stick to a study schedule, top 25% of the class, experience with general medical-surgical patients, and confident about passing the exam).
An asynchronous online course would be good for independent learners who needed more guidance than self-study. A real-time on line course and face-to-face course would be good for those who don’t plan independent time well.
A faculty member explains to a group of nursing students about the functions of the National Council of State Boards of Nursing (NCSBN). Which item does the faculty member include in this description? (Select all that apply.)
Determines application and registration process Correct Negotiates passing scores in different states Provides equipment and sites for testing Incorrect Schedules, administers, and scores the exam Incorrect Sets specific deadlines for testing in each state Correct
The NCSBN determines the application and registration processes, and sets deadlines related to testing in each state. The passing score is the same in all states. Pearson VUE is a vendor selected by the NCSBN to provide equipment and testing sites; and to schedule, administer, and score the exams.
A student has test anxiety. Which action(s) should the student take to alleviate this problem? (Select all that apply.)
Find positive study buddies. Correct Make a study plan for exams. Correct Read only after the class time. Incorrect Schedule study time as a priority. Correct Take a break every 2 hours. Incorrect .
est anxiety is often compounded by being rushed, so the student needs to make study time a priority to avoid cramming. This means that studying will need to be put ahead of other things, such as housework and watching TV. The student should not study with people who are negative; negative attitudes are contagious. Reading before class prepares the student for the topic of the day, which facilitates learning. The student should take a break every 50 minutes or so to avoid being overwhelmed.
Which trend(s) will continue to be important in nursing and nursing education in the future? (Select all that apply.)
Aging workforce Correct
Alternative educational programs Correct
Decreasing wages Incorrect
Role confusion Incorrect
Retiring faculty Correct
The “graying of America” will affect health care because more patients are older and have multiple health care needs. As faculty and staff become older and retire both these topics will affect the nursing shortage. Nursing programs will have to consider many more alternative methods of delivering education to attract students. Role confusion and decreasing wages are not important trends
Which information about Florence Nightingale is correct? (Select all that apply.)
Came from a wealthy Victorian family Correct Developed the Nightingale education method Correct Entered nursing after a career in teaching Incorrect Studied nursing secretly to avoid family conflict Correct Wrote the Nightingale Pledge while bedridden Incorrect
There are many myths and legends about Nightingale, but some facts about her include that she came from a wealthy Victorian family, at one point studied nursing in secret, and developed schools of nursing that many other schools in Europe and America emulated. Florence Nightingale did not have an early career as a teacher, nor did she write the Nightingale pledge; Lystra Gretter did.
The student of nursing history recognizes that which of the following is an influence on nursing from early European history?
Changing emphasis to caring for victims of disasters Likelihood of surviving military wounds greatly increased Nursing education beginning at early European universities War widows finding purpose and means of living by nursing Correct
Because of the frequent nature of military conflicts, widows were common in the early European times. In order to survive, many widows joined the nuns and became nurses. Caring for disaster victims emerged as a 21st century concern. Soldiers became more likely to survive their wounds starting in the Crimean war, but this was also noted as a trend during the Civil War. Baccalaureate education is a fairly recent trend; in 1919, there were only nine BSN programs.
A student nurse is participating in an interactive session on nursing history in which the students can interview any figure from nursing’s past. Which question is appropriate?
Lilian Wald: "How did you avoid becoming ill nursing soldiers in the Crimean war?" Lystra Gretter: "What encouraged you to form the first school of nursing in America?" Mildred Montag: "How do you feel about the BSN as the entry point to nursing now?" Correct Sophia Palmer: "What made you realize that correspondence courses for nurses would work?"
Mildred Montag developed the Associate Degree program of nursing education. This question would be an appropriate one, matching person with interest. Sophia Palmer rejected the idea of correspondence courses and home study programs for nurses. Lillian Wald did not work in the Crimea. Lystra Gretter composed the Nightingale pledge.
A student nurse complains about writing “endless” care plans. The faculty explains how this teaches one of the nursing roles in addition to preparing the student to care for patients, and that all hospitals must demonstrate the use of the nursing process. Which nursing role is the faculty referring to?
Advocate Colleague Manager Correct Teacher
Organizing nursing care so that other nurses can continue caring for the patient in one’s absence is the essence of the earliest version of the nurse manager role. In addition to helping the student prepare to care for a particular patient, writing down directions (or entering the information into a computer) for patient care ensures consistency among the staff. The teacher provides patients with information. The advocate protects patients and, on occasion, speaks for them. The colleague works within interdisciplinary relationships for better patient care; nursing care plans are not used by other disciplines.
