Question 1

Based on the Dreyfus model of skill acquisition, at what stage do nurses understand the basic elements of practice, can organize and prioritize clinical tasks, but are only able to partially grasp the unique complexity of each patient's situation?

Accepted Answer

In the advanced beginner stage, nurses understand the basic elements of practice and can organize and prioritize clinical tasks. Although clinical analysis of health care situations occurs at a higher level than strict association with the textbook picture, the advanced beginner is only able to partially grasp the unique complexity of each patient's situation. By paying close attention to their patients, and to what seems to work best, advanced beginner nurses learn the art of nursing. This time has been referred to as a "neutral zone," the phase in which communication with others, including physicians or patients, is still problematic, while feeling more comfortable with organization and knowledge. After the first year and before 18 months, the new nurse enters a "new beginning" phase of feeling comfortable with nursing activities.

Question 2

Based on the Dreyfus model of skill acquisition, at what stage do nurses see the clinical situation as a whole, have well-developed psychosocial skills, and know from experience what needs to be modified in response to a given situation?

Accepted Answer

In the proficiency stage, 3 to 5 years into practice, nurses are self-confident about their clinical skills and perform them with competence, speed, and flexibility. The proficient nurse sees the clinical situation as a whole, has well-developed psychosocial skills, and knows from experience what needs to be modified in response to a given situation.

Question 3

The nurse is caring for a patient who has just refused to undergo an invasive procedure that could possibly extend his life by a few months. The nurse supports the patient's decision based on which essential value?

Accepted Answer

Advocacy should support patient autonomy. Patients need to be in control of their own destiny, even when the decision reached is not what you as the nurse would recommend for the patient's health and well-being.

Question 4

The scope of practice for professional nurses has continued to expand in all of the areas below, with the exception of what generally traditional area?

Accepted Answer

By its very nature, clinical practice has always combined knowledge, skills, and attitudes and brought it to bear on patient care in the nursing field. The other areas more contemporary aspects within the scope of practice for professional nurses that are still on the increase.

Question 5

What development in the nursing industry permits swift transactions, universal access, and levels of portability unanticipated 20 years ago?

Accepted Answer

Technology permits swift transactions, universal access, and levels of portability unanticipated 20 years ago. Defining aspects of caring and patient communication are supported, not led, by technology. Advanced practice roles is a relatively recent development spurred by health care reform, but its development does not sync with the details in the question. Contemporary health care education depends on experiential learning for developing both technical care skills and communication proficiency. However, it does not match the question either. Interdisciplinary courses are not actually a new concept, though some of the course topics may be.

Question 6

What general heading best identifies the group of relatively new roles that include: advanced practice nurses, clinical nurse leader, Doctor of Nursing practice, and PhD-prepared nurse researcher?

Accepted Answer

The IOM (2010) mandate to increase the number of professional nurses in advanced practice roles makes a strong statement in health care reform. An empowering aspect of the nurse role is the opportunity to evolve roles, change specialties of care, move into advanced roles, or take on new administrative roles. Nurses must put forth the value of nurses as skilled health care providers. Evolved scope of practice and professional standards serve as the foundation for practice accountability and decision authority in contemporary nursing practice.

Question 7

Where are the following professional role competencies for nurses found?
- Practice to the full extent of their education and training
- Achieve higher levels of education and training through an improved education that promotes seamless academic progression
- Remain full partners, with physicians and other health professionals, in redesigning health care in the United States
- Effective workforce planning and policymaking require better data collection and an improved information infrastructure in the

Accepted Answer

The widely accepted IOM report, from 2003 and 2010, identifies the core professional role competencies required of contemporary nurses.

Question 8

What is defined as the capacity to accurately recognize emotional reactions as they happen and to understand your responses to different people and situations?

Accepted Answer

Self-awareness helps nurses work from their strengths and cope more effectively to minimize personal weaknesses in interactions with others. Developing self-awareness allows nurses to make higher quality decisions because decisions are more likely to be based on facts than personal feelings. Self-awareness directly affects self-management and how nurses professionally respond to others. Transformational leadership, nurses' rights, and structural empowerment are all key concepts, but are not as personal and self-focused.

Question 9

Which aspect of role standards is influenced by institutional norms and may vary depending on the work environment?

Accepted Answer

Role is a multidimensional psychosocial concept defined as a traditional pattern of behavior and self-expression, performed by or expected of an individual within a given society. People develop social, work and professional roles throughout life. Some roles are conferred at birth (ascribed roles) and some are attained through circumstance during a lifetime (acquired roles). Personal ascribed role performance standards reflect social, cultural, gender, and family expectations.

Question 10

A nurse, who has been practicing for 4 years, demonstrates competence, speed, and flexibility when performing clinical skills. According to Benner, the nurse is practicing at which developmental stage?

Accepted Answer

The proficiency stage occurs 3 to 5 years into practice. Nurses in this stage are self-confident about their clinical skills and perform them with competence, speed, and flexibility. The proficient nurse sees the clinical situation as a whole, has well-developed psychosocial skills, and knows from experience what needs to be modified in response to a given situation.

Question 11

According to the Dreyfus model of skill acquisition, which of the following includes the correct names and order of the developmental stages demonstrating increasing proficiency in implementing the professional nursing role??

Accepted Answer

Several authors have developed models designed to describe the role transition process undergone by all new nurses during their first year of work. Based on the Dreyfus model (1980) of skill acquisition, each developmental stage demonstrates increasing proficiency in implementing the professional nursing role: novice, advanced beginner, competence, proficiency, and expert.

Question 12

A novice nurse decides to attend a diabetes workshop after a patient was admitted to the unit with an insulin pump that the nurse was not familiar with. This is an example of

Accepted Answer

Professional self-awareness promotes recognition of the need for continuing education, the acceptance of accountability for one's own actions, the capacity to be assertive with professional colleagues, and the capability to serve as a patient advocate when the situation warrants it, even if it is uncomfortable to do so. Role performance is role functioning. Patient advocacy is protecting patient rights. Collaboration is sharing responsibility.

Question 13

The new graduate nurse is unsure how to operate a new intravenous pump. After reading the directions, the nurse seeks the assistance of a more experienced nurse and asks for a demonstration on how to operate the pump. The behavior exhibited by the new graduate nurse is

Accepted Answer

Professional role clarity is an essential quality of effective leadership. If nurses aren't clear about their professional roles, it becomes very difficult for them communicate their value as health care providers to other professionals. Role clarity about professional competencies is necessary to support patient safety initiatives and lead to improved patient outcomes. Influencing change and making difficult decisions becomes easier when nurses have a clear vision that emanates from their understanding of their professional role because they are better able to stimulate confidence in others.

Question 14

The nurse offers a patient's family a list of community resources and support groups and encourages them to become involved in the local Lupus chapter. This is an example of which professional nursing role responsibility?

Accepted Answer

Nursing actions that constitute patient advocacy include facilitating access to essential health care services for patients, ensuring high-quality care, protecting patient rights, and acting as a liaison between patients and the health care system to procure high-quality care.

Quiz 22: Role Relationship Communication Within Nursing