Novice Nurse to Expert Clinician

Which statements made by the novice and advanced beginner nurses indicate to the nurse manager that they are progressing in their level of nursing experience? Select all that apply. "It is easier to manage time when I plan at the beginning of the shift." "I am gaining a better sense of how to organize my day." "Case studies give me time to think about how I would handle them." "Families of the clients always distract me from what I'm doing." "I feel guilty asking others to help me do my work." "I called a rapid response today because the client was on a steady decline."

"It is easier to manage time when I plan at the beginning of the shift." "I am gaining a better sense of how to organize my day." "Case studies give me time to think about how I would handle them." "I called a rapid response today because the client was on a steady decline."

Within Benner's novice to expert theory (1982), which nurse is in the competence level of experience? A staff nurse with over five years of experience A staff nurse with almost two years of experience A staff nurse with three years of experience A staff nurse with less than a year of experience A staff nurse with fifteen years of experience

A staff nurse with three years of experience

During orientation to the oncology unit, the nurse manager presents material that helps new nurses identify their experience levels by providing examples. Match the nursing experience level and situation that the nurse manager will use for the presentation. -When experiencing something new, the nurse asks the charge nurse for help. -After making a medication error, the nurse assesses the client before proceeding to notify the healthcare provider. -The nurse jumps to action in an emergent situation, giving direction to other nurses. -The nurse struggles with prioritization between four clients' needs. -The nurse presents at a conference on best practices for pressure ulcer prevention.

Advanced beginner Competent Proficient Novice Expert

Practicing how to set priorities through scenarios helps the nurse develop neuropathways for real-life experiences. Utilizing priority frameworks and principles, place the clients the nurse should assess in order from highest priority to lowest priority. A client with new shortness of breath and crackles in their lungs A client with chronic emphysema and pulse oximetry of 89% A client with a chest tube in moderate pain A client with asthma that is requesting a breathing treatment

All of the answer choices were in the range of breathing issues, except the first. The order in which clients ​should be assessed from highest priority to lowest priority is: 1. A client with new shortness of breath and crackles in their lungs.​ New is the key word here to indicate that there is a change to acute issues. Crackles indicate fluid overload, so the nurse will need to prioritize this client first as they could decrease their oxygenation fast.​ 2. A client with asthma that is requesting a breathing treatment.​ Requesting a breathing treatment could indicate the client is experiencing a worsening of symptoms. Nothing is indicating they have obstruction, such as wheezing, which is why they are second.​ 3. A client with a chest tube in moderate pain.​ This client is having a pain problem, not a breathing problem. They will need to be seen after the two breathing issues because they need something to relieve their pain. 4. A client with chronic emphysema and pulse oximetry of 89%.​ This client is having expected symptoms of their disease and is not having a problem at the moment.

The nurse manager developed multiple scenarios to help novice nurses gain experience in their understanding of proper delegation to unlicensed assistive personnel (UAP) on the medical-surgical floor. Click to specify if the task is appropriate or contraindicated to delegate to a UAP on the medical-surgical floor. Applying hydrocortisone cream on a client's back after their bath Teaching the client about the importance of using their incentive spirometer Reinforcing fluid restrictions for a client with diabetes insipidus Unhooking a nasogastric tube to walk a client to the bathroom Monitoring trends in intake and output for a client that has continuous bladder irrigation Determining if the client needs assistance getting from the bed to the chair Checking the glucose level of a client before they eat breakfast Increasing the oxygen of a client that has a pulse oximetry of 81%

Contraindicated Contraindicated Contraindicated Appropriate Contraindicated Contraindicated Appropriate Contraindicated

The nurse manager is strategizing activities that will be best suited for the novice and advanced beginner nurses to ensure they gain experience within problem-based scenarios. Click to specify if the educational activity is indicated, nonessential, or contraindicated to help these nurses gain experience within their role as staff nurses. Assign the nurses to spend a shift with the charge nurse. Provide a list of policies they must review. Designate monthly case studies that encompass common disease processes admitted to that floor. Allocate time to be spent in the simulation lab. Offer opportunities for the nurses to present best practices at meetings. Require each nurse to report on their progress at the end of each shift.

Contraindicated Nonessential Indicated Indicated Indicated Contraindicated

The competent trauma emergency nurse is seeking opportunities to achieve proficiency in their specialty. Click to specify if the opportunity is indicated, nonessential, or contraindicated in helping this nurse achieve proficiency in trauma emergency nursing. Seek a degree in nursing education​. Help train unlicensed assistive personnel. Participate in conference presentations about trauma best practices. Volunteer to be the charge nurse at night. Seek certification as a trauma registered nurse. Join the Emergency Nurses Association. Apply for an intensive care unit manager position.

Contraindicated Nonessential Indicated Nonessential Indicated Indicated Contraindicated

The novice nurse has been in orientation for seven weeks and still lacks confidence about inserting an intravenous (IV) catheter. Which actions should the novice nurse take to gain experience in starting IVs? Select all that apply. Express interest in starting any IVs. Review the hospital policy and procedure​. Wait until orientation is over to try. Follow the IV therapy nurse for tips and tricks. Attempt insertion as many times as hospital policy allows. Practice on the mannequin arm. Allow other nurses to attempt difficult IVs. Seek opportunities to start difficult IVs.

Express interest in starting any IVs. Follow the IV therapy nurse for tips and tricks. Attempt insertion as many times as hospital policy allows. Practice on the mannequin arm. Seek opportunities to start difficult IVs.

The expert clinician is not bound to rules, principles, or guidelines as they use all knowledge, education, and experience to formulate endless outcomes. Which decision-making model is the expert clinician privy to that other nurses have not developed the skills to use yet? Nursing process model Traditional problem-solving model Intuitive thinking model ​Clinical judgment model ​

Intuitive thinking model

The nurse manager should first focus on the needs of ________ as evidenced by their struggle with _______.

Nurse A delegation

Identifying novice and advanced beginner nurses will take priority as they need the most continuing education amongst the staff. Which nurses will require immediate follow-up based on performance? Select all that apply. Nurse A: 6 months experience; struggling with delegation Nurse B: 6 years experience; struggling with schedules Nurse C: 1 year experience; struggling with documentation Nurse D: 2 years experience; struggling with time management Nurse E: 3 years experience; struggling with prioritization Nurse F: 10 years experience; struggling with career path

Nurse A: 6 months experience; struggling with delegation Nurse C: 1 year experience; struggling with documentation Nurse D: 2 years experience; struggling with time management Nurse E: 3 years experience; struggling with prioritization

The nurse educator is providing educational opportunities for novice nurses. Which educational activities should be chosen to increase experience? Select all that apply. Printouts about patient-controlled analgesia Unfolding case study of fluid overload PowerPoint presentation on medication errors Lecture videos of ethics in nursing Escape room of new-onset stroke symptoms High-fidelity simulation of a cardiac arrest

Unfolding case study of fluid overload Escape room of new-onset stroke symptoms High-fidelity simulation of a cardiac arrest

The staffing office is floating four nurses from different departments to other departments to cover short staffing. Drag and drop the floor that best fits each nurse's skill competencies and level of experience with the client population. -Postpartum nurse with four years of experience -Orthopedic nurse with six years of experience -Trauma emergency nurse with four years of experience -Pediatric intensive care unit nurse with eight years of experience

Women's surgical unit Medical-surgical unit Medical intensive care unit Newborn intensive care unit

Novice and advanced beginner nurses are at risk for _____ due to their lack of ______, so it is essential that these nurses be supported in the development of ______.

errors experience critical thinking

Highlight the prescription that is contraindicated at this time and would require immediate follow-up from the nurse manager if not selected during the simulation. The nurse manager provides a simulation experience for the novice and advanced beginner nurses of a client with cirrhosis who comes in for vomiting blood. The healthcare provider prescribes gastric lavage with a nasogastric tube, intravenous fluids at 150 ml/hr, neurological checks every four hours, and a pantoprazole infusion.

gastric lavage with a nasogastric tube

Highlight the parts of the scenario below that indicate to the nurse preceptor that the orienting nurse is still struggling in moving towards the advanced beginner level of experience. The nurse preceptor in a medical-surgical care unit presents specific instructions about how to start the day. The orienting nurse walks into the client room and begins preparing as the preceptor instructed, when the client begins pulling at their feeding tube. While the nurse continues to checkall the intravenous lines, the client grabs hold of the feeding tube and rips it out. The nurse preceptor rushes into the room, asking the orienting nurse what happened, and they respond by saying they were following the checklist and wanted to make sure tasks were completed before asking for help. The nurse preceptor asks if they noticed how the client was doing during these tasks. The orienting nurse said yes, but they did not think the client would rip the tube out and they did not want to disappoint the preceptor by not completing everything.

nurse continues to check all the intravenous lines client grabs hold of the feeding tube and rips it out they were following the checklist and wanted to make sure tasks were completed before asking for help they did not think the client would rip the tube out and they did not want to disappoint the preceptor by not completing everything