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Chapter 05: Becoming a Professional Nurse: Defining Nursing and Socialization into Practice
Black: Professional Nursing: Concepts & Challenges, 8th Edition
MULTIPLE CHOICE
1.Which early nursing theorist recognized therapeutic milieu, assessment skills, and a unique body of knowledge in her definition of nursing?
| a. | Dorothea Orem |
| b. | Virginia Henderson |
| c. | Hildegard Peplau |
| d. | Florence Nightingale |
ANS: D
| Feedback | |
| A | Orem was known for her self-care theory. |
| B | Henderson was best known for her definition of nursing as assisting the sick to do those things that they would do for themselves if they were able and for her list of 14 patient problems. |
| C | Peplau is known for her theory of therapeutic nurse-patient relationships. |
| D | Nightingale was the first nurse to realize the importance of environment and assessment skills and that nursing care should be delivered by a professional nurse with a unique body of knowledge, not a layperson. |
DIF: Cognitive Level: Knowledge REF: Page 89
2.Which early nursing theorist defined nursing in interpersonal terms by stating that nursing is a significant, therapeutic, and interpersonal process?
| a. | Virginia Henderson |
| b. | Hildegard Peplau |
| c. | Martha Rogers |
| d. | Dorothea Orem |
ANS: B
| Feedback | |
| A | Henderson’s definition of nursing did not focus on the interpersonal relationship. |
| B | Peplau defined nursing in interpersonal terms. |
| C | Rogers is known for including nursing process in her definition of nursing. |
| D | Orem is known for her theory on self-care. |
DIF: Cognitive Level: Knowledge REF: Page 89
3.Which of the following is an example of Orem’s self-care theory?
| a. | Assuring proper fresh air and ventilation |
| b. | Demonstrating good handwashing techniques |
| c. | Assisting a disoriented patient with a bath |
| d. | Performing a visual screening exam |
ANS: C
| Feedback | |
| A | Proper ventilation was described by Nightingale. |
| B | Good handwashing was described by Nightingale. |
| C | Providing adequate patient hygiene is described in Orem’s theory of nursing as providing assistance to a person because of the person’s inabilities for self-care. |
| D | Preventive services are not addressed in Orem’s theory. |
DIF: Cognitive Level: Application REF: Page 90
4.Which of the following is an example of Henderson’s definition of nursing?
| a. | Performing a hearing screening in preschool children |
| b. | Interacting with depressed men to learn new strategies for reducing their symptoms |
| c. | Setting goals for weight loss with a patient |
| d. | Teaching a person with frequent constipation about high-fiber foods |
ANS: D
| Feedback | |
| A | Henderson’s definition does not speak to preventive services. |
| B | Henderson’s definition does not focus on interpersonal relationship. |
| C | Goal setting is part of King’s definition of nursing, not Henderson’s. |
| D | Henderson’s definition states that “the unique function of the nurse is to assist the individual … in the performance of those activities contributing to health … that he would perform unaided if he had the necessary … knowledge.” |
DIF: Cognitive Level: Analysis REF: Page 90
5.The legal definition of nursing for any particular state can be found in the
| a. | state legislature’s official newsletter. |
| b. | state board of nursing’s bylaws. |
| c. | governor’s official papers. |
| d. | state’s nurse practice act. |
ANS: D
| Feedback | |
| A | The legal definition of nursing is not found in the state legislature’s official newsletter. |
| B | The state board of nursing administers the nurse practice act of that state, and its bylaws govern its internal functioning. |
| C | The governor’s office does not determine the legal definition of nursing. |
| D | Each state’s nurse practice act contains the legal definition of nursing for a particular state. |
DIF: Cognitive Level: Comprehension REF: Page 91
6.Which of the following is an example of formal socialization into the profession of nursing?
| a. | Unplanned observation of a nurse comforting a child after a painful procedure |
| b. | Hearing two nurses discussing how to organize patient care more effectively |
| c. | Starting an intravenous (IV) line in the simulation laboratory under faculty guidance |
| d. | Participating in a student nurses’ association meeting |
ANS: C
| Feedback | |
| A | “Unplanned observation of a nurse comforting a child after a painful procedure” is an example of an incidental learning experience. |
| B | “Hearing two nurses discussing how to organize the care of a patient more effectively” is an example of an incidental learning experience. |
| C | Formal socialization includes planned activities to gain knowledge and skills needed by the nurse. |
| D | “Participating in a student nurses’ association meeting” is an example of an incidental learning experience. |
DIF: Cognitive Level: Application REF: Page 92
7.Which of the following is an example of informal socialization into a profession?
| a. | Nurses discussing a patient care issue in the presence of other nurses |
| b. | Taking an extra class for an elective |
| c. | Performing your first physical assessment in a client |
| d. | Teaching a patient about warfarin (Coumadin) |
ANS: A
| Feedback | |
| A | Informal socialization into the role of a nurse occurs when the student learns from the nurse in an informal, unplanned way. |
| B | Taking an extra class for an elective is an example of formal, planned education. |
| C | Performing your first physical assessment in a client is part of the formal learning process. |
| D | Teaching a patient about Coumadin is part of a planned clinical experience and therefore falls under the category of formal socialization. |
DIF: Cognitive Level: Application REF: Page 92
8.A nursing student says to the clinical faculty, “I know I will be able to care for this patient given your directions.” In which stage of Cohen’s model of professional socialization is this student?
| a. | Stage I: Unilateral dependence |
| b. | Stage II: Negativity/independence |
| c. | Stage III: Dependence/mutuality |
| d. | Stage IV: Interdependence |
ANS: A
| Feedback | |
| A | In stage I, students rely on external controls and teachers, absorbing information given by the faculty. |
| B | In stage II, students begin to question authority figures versus accepting the patient assignment without questioning. |
| C | The student has developed better critical thinking skills at stage III. |
| D | In stage IV, the student has learned to make decisions in collaboration with others. |
DIF: Cognitive Level: Application REF: Page 94
9.A nursing student asks, “Why do I have to go to clinical in obstetrics when I know I’ll never work with women and children?” In which stage of Cohen’s model of professional socialization is this student?
| a. | Stage I: Unilateral dependence |
| b. | Stage II: Negativity/independence |
| c. | Stage III: Dependence/mutuality |
| d. | Stage IV: Interdependence |
ANS: B
| Feedback | |
| A | Students in stage I rely on external controls and teachers. |
| B | In stage II, students begin to question authority figures and overestimate their ability to care for complex patients. |
| C | Students develop better critical thinking skills in stage III. |
| D | In stage IV, students learn to make decisions in collaboration with each other. |
DIF: Cognitive Level: Application REF: Page 95
10.A nursing student says, “I can now see how developing care plans helps organize my thoughts and patient care.” In which stage of Cohen’s model of professional socialization is this student?
| a. | Stage I: Unilateral dependence |
| b. | Stage II: Negativity/independence |
| c. | Stage III: Dependence/mutuality |
| d. | Stage IV: Interdependence |
ANS: C
| Feedback | |
| A | In stage I, students follow directions without questioning or understanding the reasoning behind the activity. |
| B | In stage II, the student would question authority figures and overestimate his or her abilities. |
| C | Students in stage III have a more reasoned evaluation of others’ ideas. |
| D | Students in stage IV learn to make decisions in collaboration with others. |
DIF: Cognitive Level: Application REF: Page 95
11.A nursing student asks, “Since I work as a nurse technician in psychiatric nursing, may I spend part of my clinical rotation with a psychiatric home visiting nurse?” In which stage of Cohen’s model of professional socialization is this student?
| a. | Stage I: Unilateral dependence |
| b. | Stage II: Negativity/independence |
| c. | Stage III: Dependence/mutuality |
| d. | Stage IV: Interdependence |
ANS: D
| Feedback | |
| A | Students in stage I are dependent on faculty. |
| B | In stage II, students begin to question authority. |
| C | In stage III, students begin to develop critical thinking skills. |
| D | Students in stage IV often are self-directed and seek out appropriate learning opportunities that better round out their educational experience. |
DIF: Cognitive Level: Application REF: Page 95
12.Benner describes five stages of nursing proficiency as students develop into expert nurses. Which of the following is not a stage of development described by Benner?
| a. | Novice |
| b. | Inexpert beginner |
| c. | Competent practitioner |
| d. | Expert practitioner |
ANS: B
| Feedback | |
| A | Novice is the first stage in the theory. |
| B | The stages identified by Benner in her theory From Novice to Expert do not include inexpert beginner. |
| C | Competent practitioner is the third stage in Benner’’s theory. |
| D | Expert practitioner is the fifth stage in Benner’s theory. |
DIF: Cognitive Level: Knowledge REF: Pages 95-96
13.A mother asks the nurse if her 5-year-old can visit his twin brother in the pediatric intensive care unit (PICU) after cardiac surgery. The nurse denies the request because hospital policy states that children younger than 12 years of age are not allowed to visit the PICU. This illustrates which of Benner’s stages of nursing proficiency?
| a. | Novice |
| b. | Advanced beginner |
| c. | Competent practitioner |
| d. | Proficient practitioner |
ANS: A
| Feedback | |
| A | At the novice stage, nurses have little background on which to base clinical behavior and therefore depend rather rigidly on established rules. |
| B | Nurses at the advanced beginner stage base decisions on both theory and principles but may have difficulty formulating priorities or alternative actions. |
| C | Nurses at the competent practitioner stage have feelings of mastery and can examine the needs of everyone in the situation before making decisions. |
| D | Nurses at the proficient practitioner stage see patient situations holistically and easily recognize priorities of care. |
DIF: Cognitive Level: Application REF: Page 95
14.A mother asks the nurse if her 5-year-old can visit his twin brother in the PICU after cardiac surgery. The nurse denies the request because hospital policy states that children younger than 12 years of age are not allowed to visit the PICU but suggests that the mother visit with the child in the visitor’s lounge and talk to him about what is happening with his brother. This illustrates which of Benner’s stages of nursing proficiency?
| a. | Novice |
| b. | Advanced beginner |
| c. | Competent practitioner |
| d. | Proficient practitioner |
ANS: B
| Feedback | |
| A | Nurses at the novice stage would deny the request on the basis of the established rules. |
| B | Nurses at the advanced beginner stage base their decisions on theory and principles but have difficulty viewing many nursing actions as equally important. The nurse would still likely deny the request but, knowing the needs of the mother and child, suggest an alternative means of visiting. |
| C | Nurses at the competent practitioner stage have feelings of mastery and can examine the needs of everyone in the situation before making decisions. |
| D | Nurses at the proficient practitioner stage see patient situations holistically and easily recognize priorities of care. |
DIF: Cognitive Level: Application REF: Pages 95-96
15.A mother asks the nurse if her 5-year-old can visit his twin brother in the PICU after cardiac surgery. The nurse knows that hospital policy states that children younger than 12 years of age are not allowed to visit the PICU. After considering the needs of the patient and his brother, the nurse suggests that the brother can visit for 5 minutes. This illustrates which of Benner’s stages of nursing proficiency?
| a. | Advanced beginner |
| b. | Competent practitioner |
| c. | Proficient practitioner |
| d. | Expert practitioner |
ANS: B
| Feedback | |
| A | Nurses at the advanced beginner stage base their decisions on theory and principles but may have difficulty viewing many nursing actions as equally important. |
| B | Nurses at the competent practitioner stage will examine the needs of everyone in the situation before making a decision. The nurses may or may not allow the visit, but only after examining the needs of everyone and other exigencies involved. |
| C | Nurses at the proficient practitioner stage see patient situations holistically and easily recognize priorities of care. |
| D | Nurses at the expert practitioner stage have expertise that allows them to select actions based on the patient’s complete experience. |
DIF: Cognitive Level: Application REF: Page 96
16.A mother asks the nurse if her 5-year-old can visit his twin brother in the PICU after cardiac surgery. The nurse knows that hospital policy states that children younger than 12 years of age are not allowed to visit the PICU. The nurse grants the request. This illustrates which of Benner’s stages of nursing proficiency?
| a. | Advanced beginner |
| b. | Competent practitioner |
| c. | Proficient practitioner |
| d. | Expert practitioner |
ANS: C
| Feedback | |
| A | Nurses at the advanced beginner stage base their decisions on theory and principles but may have difficulty viewing many nursing actions as equally important. |
| B | Nurses at the competent practitioner stage will examine the needs of everyone, as well as other exigencies involved, before making a decision. |
| C | Nurses at the proficient practitioner stage see the patient situations holistically and easily recognize the priorities of care. The nurse is more concerned about patient outcomes than institutional rules. |
| D | Nurses at the expert practitioner stage have expertise that allows them to select actions based on the patient’s complete experience. |
DIF: Cognitive Level: Application REF: Page 96
17.A 5-year-old with a twin brother is admitted to the PICU after cardiac surgery. Hospital policy does not allow individuals younger than 12 years of age to visit the PICU. The nurse recognizes the needs of the patient and his brother and suggests that the mother bring her son to visit his brother briefly in the afternoon when the unit is usually quiet. This illustrates which of Brenner’s stages of nursing proficiency?
| a. | Advanced beginner |
| b. | Competent practitioner |
| c. | Proficient practitioner |
| d. | Expert practitioner |
ANS: D
| Feedback | |
| A | Nurses at the advanced beginner stage base their decisions on theory and principles but may have difficulty viewing many nursing actions as equally important. |
| B | Nurses at the competent practitioner stage will examine the needs of everyone, as well as other exigencies involved, before making a decision. |
| C | Although nurses at the proficient practitioner stage see patient situations holistically, easily recognize the priorities of care, and allow rules to be bent, they may not suggest bending rules for the desired patient outcome. |
| D | Nurses at the expert practitioner stage have expertise that allows them to select actions based on the entire patient’s complete situation, including the needs of family members. |
DIF: Cognitive Level: Application REF: Page 96
18.Which of the following illustrates an effective strategy for a registered nurse student returning for a bachelor’s of science in nursing (BSN)?
| a. | Get reacquainted with the library; expect to spend many hours there doing research. |
| b. | Be open to information that does not seem to be readily applicable to your current position. |
| c. | Start a program only if you have a great deal of free time to devote to classes on campus. |
| d. | Use your co-workers as a sounding board to relieve frustration. |
ANS: B
| Feedback | |
| A | Many BSN courses use online learning and are user-friendly for working students; research today is much easier with the Internet. |
| B | Nurses returning to school for the BSN degree need to keep an open mind for information that might not seem readily applicable to their work setting. |
| C | Many courses are online or web assisted; nurses cannot wait for conditions to be perfect to return to school. |
| D | Staying positive and open to feedback from instructors will pay more dividends than complaining. |
DIF: Cognitive Level: Comprehension REF: Page 92
19.A nurse observes a new graduate nurse being harassed by co-workers when asking questions or requesting help. What action by the nurse is best?
| a. | Do not intervene, because it will only invite more harassment. |
| b. | Ask the nursing manager to intervene on behalf of the new nurse. |
| c. | Respectfully confront the staff and explain that this behavior is not part of nursing. |
| d. | Teach the new nurse to stand up for himself or herself when harassed. |
ANS: C
| Feedback | |
| A | By not getting involved, the nurse is silently accepting that this behavior is alright. |
| B | The manager may need to become involved, but not as the first step. The responsible, professional nurse would try to intervene first. |
| C | Harassment and bullying is antithetical to nursing and should not be tolerated; however, colleagues should be addressed respectfully. |
| D | The new nurse may need to learn self-assertive skills; however, the nurse should intervene to stop the behavior. |
DIF: Cognitive Level: Application REF: Page 101
20.A new graduate nurse is in the fifth week of working on a busy surgical unit. The nurse tells a friend about witnessing some patient care that was “appalling.” What should the nurse do?
| a. | Return to school to obtain a master’s of science in nursing (MSN) and leave bedside nursing. |
| b. | Talk to the other nurses involved in the situation about the concerns. |
| c. | Report the behavior to the nurse manager of the unit. |
| d. | Accept that this is the reality of nursing in a busy unit. |
ANS: B
| Feedback | |
| A | Returning to school will not help the nurse resolve the reality of this situation. |
| B | Talking to the other nurses involved allows this nurse to take responsibility for feelings and get support. |
| C | Reporting the behavior without attempting to resolve it with the nurses involved appears to be overreacting and may appear as if the nurse is not a team player. |
| D | Disengaging mentally and emotionally may result in dropout. |
DIF: Cognitive Level: Analysis REF: Page 102
21.Which of the following strategies may help to overcome reality shock in the novice nurse?
| a. | Participating in a preceptorship |
| b. | Returning to school immediately after graduation |
| c. | Moving frequently from job to job |
| d. | Becoming emotionally involved with patients |
ANS: A
| Feedback | |
| A | Participating in a preceptor program can help a novice assimilate more smoothly into the registered nurse (RN) role. |
| B | Prematurely returning to school is often an avoidance mechanism. |
| C | Moving frequently from job to job can increase the risk of burnout. |
| D | Nurses should not become overly emotionally involved with patients. |
DIF: Cognitive Level: Comprehension REF: Page 102
22.Black illustrates concepts of preventing burnout by using the example of a flight attendant instructing persons to “put your own oxygen mask on first.” What does this statement mean?
| a. | Oxygen is the most important element of life. |
| b. | Airway is always a priority in patient care. |
| c. | Taking care of yourself will enable you to be a better nurse. |
| d. | Ask others for help if you feel overwhelmed by your first position as a nurse. |
ANS: C
| Feedback | |
| A | “Putting your own oxygen mask on first” is about self-care, not oxygen. |
| B | “Putting your own oxygen mask on first” is a metaphor for self-care. |
| C | Taking care of yourself will allow you to better care for others. |
| D | Although finding a mentor is important to self-care, “putting your own oxygen mask on first” does not specifically address this concern. |
DIF: Cognitive Level: Comprehension REF: Page 103
MULTIPLE RESPONSE
1.A definition of nursing is essential because it (Select all that apply.)
| a. | differentiates nursing from other health occupations. |
| b. | guides educational preparation and theory development. |
| c. | helps state nurse practice acts reflect the changing roles of nurses. |
| d. | clarifies the purposes and functions of the nurses. |
| e. | informs potential students of exactly what nurses do. |
ANS: A, B, C, D
| Feedback | |
| Correct | A definition is important because it allows nurses, other health care providers, faculty, policy makers, and others in the community to better understand what nurses do. |
| Incorrect | Although a definition clarifies the role of nursing, no definition can be so explicit that it explains everything a nurse does. |
DIF: Cognitive Level: Comprehension REF: Page 88
2.Which of the following behaviors of a student indicate that the student has taken responsibility for his or her own professional socialization? (Select all that apply.)
| a. | Projecting a professional appearance in class |
| b. | Attending class, quietly listening to the lectures |
| c. | Taking responsibility to request alternative dates for examinations in order to work |
| d. | Taking responsibility to learn the expectations of the faculty in each course |
| e. | Accepting constructive criticism without becoming defensive |
ANS: A, D, E
| Feedback | |
| Correct | Part of being a professional is to look and behave like a professional. Each teacher may have different expectations and it is the student’s responsibility to seek clarification as a professional. It is through feedback that one is able to improve as a professional. If students become defensive, they may not hear all the feedback, positive and negative. |
| Incorrect | Although class attendance is important, asking questions and initiating discussions create a dynamic learning environment. A professional is not merely an academic spectator. Taking responsibility for organizing one’s work to meet deadlines reflects professional behavior. |
DIF: Cognitive Level: Comprehension REF: Page 99
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