From Student to Graduate Nurse : Chapter 101

Psychosocial

"________ integrity" is the term used to describe client needs such as coping and adaptation.

telephone

A TORB note in the client's chart indicates "__________ order, read back."

Answer: Resume, original nursing license, and immunization records RATIONALE: The nurse should include a copy of his personal resume, an original nursing license, and immunization records in his personal nursing file. Apart from its use in seeking employment, a personal nursing file will be useful when applying for the initial license or renewing the license. A copy of the driving license or of a bank statement need not be included in the personal nursing file.

A new graduate nurse is compiling a personal nursing file for the purpose of seeking a job. The nurse should include copies of which of the following in his personal nursing file ?

The guidelines to help organize the workload include the following: •Establish goals, plans, and priorities. •Set up a "to do" checklist of what to accomplish, in order of importance. •Stay focused and avoid procrastinating. •Ask when in doubt about a technique or procedure. •Review protocols in advance and refer to them when needed. •Know when and to whom to report significant findings. •Know where to find information about medications. •Know the institution's emergency, fire, and disaster regulations. •Follow agency protocol for waste management or reporting defective equipment. •Follow nursing procedures, as taught in the nursing program.

A new graduate nurse is learning organizational skills from her mentor. What are the guidelines to help organize the workload ?

Answer: Orientation to appropriate job placement RATIONALE: Orientation to appropriate job placement is one of the benefits of the probationary period. An employee in the probationary period can be terminated without cause. The probationary nurse is not eligible to use vacation time and should use sick leave minimally.

A new nurse is given probationary employment in as an intern in a healthcare facility. What is a benefit of the probationary period ?

Answer: Eat a snack or meal during the shift RATIONALE: The nurse should eat a snack or meal during the shift. A short nap during breaks can help greatly in staying awake all night and should not be avoided. Drinking plenty of fluids maintains hydration and is beneficial. Caffeine intake should be limited after about 3 am, not 6 am.

A new nurse is put on the night shift as part of the orientation to a healthcare facility. Which should the nurse consider when on night shift ?

Answer: Keep it pending until clarified by the person using it RATIONALE: The nurse should keep the order pending until the person issuing the order clarifies it. The nurse taking verbal orders must take responsibility for their accuracy, and hence should carry them out after clarifying them. The order should not be clarified by a colleague or simply carried out in the best way understood. Referring to the Internet or to a nursing book for clarification of an order issued is inappropriate.

A new nurse receives a verbal order of medications to be given to a client scheduled for hip surgery. What action should the nurse take in case the order is not clear ?

Answer: Less stressful, higher pay, and easier parking RATIONALE: In comparison with day shifts, night shifts are less stressful because of fewer interruptions, higher pay, and easier parking. The difference in the amount of work between day and night shifts cannot be quantified because it varies according to circumstances. Fewer staff members are available during night shifts.

A nurse chooses a permanent night shift so as to suit their daily schedule. What are the advantages of night shifts over day shifts ?

The eligibility criteria for taking the licensure examination include graduation from an approved nursing program, a completed application, a transcript of the student's records, payment of the required fee (sent from the school to the licensing authority), and certification of the applicant's expected graduation date from the school.

A nurse is planning to take the NCLEX-licensing examination. What are the eligibility criteria for taking the licensure examination ?

Answer: Check medications on arrival against the healthcare provider's orders RATIONALE: The nurse should check all medications on arrival against the healthcare provider's orders. "Stat" orders should be documented immediately after they are given and not toward the end of the day. Written orders need not be read back to the healthcare provider to be valid, but this should be done in case of verbal or telephone orders. Medications must be returned to the pharmacy, not discarded, if not used

A nurse is transcribing medication orders issued by a healthcare provider for a client admitted with acute gastroenteritis. Which guideline should the nurse follow when transcribing medication orders ?

Answer: Within 24 hours RATIONALE: All verbal orders must be signed by the primary healthcare provider within 24 hours after they are given. Certain orders, such as those for leather restraints, must be signed within 1 hour. Time frames of 36 hours, 48 hours, or 72 hours are too long and are not applicable.

A nurse needs to obtain the signature of the primary care provider for a verbal order that was given for a client admitted with fever. Which is the time frame for getting the verbal order signed by the primary care provider ?

Answer: Heart disorders, seizure disorders, and bipolar disorder RATIONALE: Heart disorders, seizure disorders, and bipolar disorders are considered to be risks if a nurse works night shifts. The lack of sleep and the stress involved with night shifts may aggravate these conditions. Neurofibromatosis and immature cataracts will not be aggravated by working night shifts.

A nurse working at a pediatric healthcare facility is exempted from working night shifts due to a health problem. What conditions exempt a nurse from night shifts ?

In most healthcare facilities, new graduates are required to practice for a period, often 6 months, as an "intern," "orientee," or "nurse resident."

How long is the orientation period ?

To prepare for the NCLEX examination, the nurse should: •Study during the entire time in the basic nursing program. •Refer to review books, CDs with practice questions, and computerized test banks for practice. •Relax and get plenty of sleep on the night before the test. •Eat a good breakfast and dress comfortably on the morning of the test. •Make sure to have agency-issued identification information and photo identification for admittance to the examination. •Know how to get to the examination venue and parking location. •Allow ample travel time to the examination venue.

How should the nurse prepare before appearing for the NCLEX examination ?

charge

In a nursing home setting, the licensed practical nurse often works as a __________________ nurse.

Evaluation

Measurement of the effectiveness of nursing care.

Some factors that will contribute to a nurse's feelings of professional satisfaction are avoiding complaining and blaming others, concentrating on helping, seeking solutions to challenges, clarifying personal values, and having a strategic plan.

Name some factors that will contribute to the nurse's feelings of professional satisfaction.

Implementation

Provision of actual nursing care to achieve goals.

Planning

Setting goals and designing strategies for meeting client needs.

Data collection

Setting up a database of client needs and clinical findings.

False

T/F : The best approach to prepare for the NCLEX is to "cram" immediately prior to taking the examination.

True

T/F: If a new nurse does not become licensed during the probationary period, the healthcare agency may terminate the person's employment.

True

T/F: Nursing students do not take telephone orders from a healthcare provider.

False

T/F: Taking photos of a client is allowed by most healthcare agencies.

False

T/F: When a nurse from Canada moves to the United States, he or she usually has to retake the NCLEX examination.

Answer: Chemical dependency and addiction RATIONALE: Chemical dependency is considered a just cause for revoking a license. Accidental needlestick injury to oneself is not a just cause for revoking a license. Recent detection of HIV infection is not a cause for revoking a license, because the nurse is still permitted to work with extra precautions. Disciplinary actions other than revoking a license may be taken for use of more sick leave time than permitted.

The Board of Nursing has revoked a nurse's license due to negligent behavior. What is a just cause for revoking a license ?

entry

The NCLEX examination measures _______________ - level competencies in nursing.

computer

The NCLEX test is a _________ adaptive test, rather than a paper-and-pencil test.

waivered

The ______________________ license is usually not transferable to another state.

Implementation

The four phases of the nursing process include Data Collection, Planning, __________, and Evaluation.

Answer: Clients experience fever more often in the evening RATIONALE: When working on evening shifts, the nurse should be aware that clients experience fever more often in the evening, because the body temperature usually tends to rise in the evenings. Fewer staff are on duty during non-day shifts. Fewer orders are written during evening shifts. Clients are usually discharged in the morning.

The new nurse is working on the evening shift. What should the nurse keep in mind when on evening shifts ?

The following actions can be taken in the case of license revocation, denial of license renewal, denial of first license, letter of reprimand, suspension of license, and placement on formal probation with specific conditions for full reinstatement.

What actions can be taken in case of license revocation ?

The challenges that the new graduate faces with regard to work shifts include: •Working on shifts other than the day shift •Working only in the evenings, nights, or rotating shifts •Working on weekends, often every other weekend •Working during "off hours" and on holidays •Having to stay late to cover others

What are the challenges that the new graduate faces with regard to work shifts ?

The aspects assessed in NCLEX examination are knowledge, comprehension, and application.

What aspects are assessed in the NCLEX examination ?

Political activism is the ability of a nurse to affect nursing and healthcare through political, economic, and societal activities by developing and reviewing policies and procedures.

What is meant by the term "political activism" ?

According to the NLN, the primary role of a licensed practical nurse involves providing basic therapeutic, rehabilitative, and preventive care for clients experiencing common, well-defined health problems.

What is the primary role of a licensed practical nurse ?

After receiving the license, the nurse should renew the license as per regulations; inform the licensing agency of changes in name, address, or employment status; and present the license to the employer.

What is the responsibility of a nurse after receiving the license ?

The mentor can assist the new graduate in accessing important information, such as nursing protocols, in the library or on the computer. In addition, the mentor can serve as a "sounding board" for the new graduate's questions and concerns.

What is the role of a mentor ?

The nurse should take the following precautions to maintain client confidentiality: "exit" or clear the screen after documenting or referring to client information, keep password confidential, and be aware of the actions of unlicensed personnel with whom the nurse works.

What precautions should the nurse take to maintain client confidentiality when using the computer charting system ?

Transcribing

________ orders means reading the healthcare provider's order sheet and carrying out necessary actions, so the client receives ordered treatment.

unlicensed

_________________________ assistive personnel are members of the nursing team in community settings.

mandatory

_________________________ overtime occurs when the nurses from the preceding shift must stay on or return to the facility and cover additional time.

internet

a global system of electronic, wireless, or optically interconnected computers and other technologic devices that access and transmit information

career mobility

ability of a person to advance or diversify within his or her profession; career ladder