NUR-450 Transition to Professional Practice

Correct Answer:

B. Implementing a self-scheduling model for staff

C. Promoting a positive work environment

E. Encouraging staff to engage in self-care

Explanation:

B. Implementing a self-scheduling model for staff

Allowing nurses to participate in scheduling empowers them to balance work and personal life. This demonstrates advocacy by giving staff more control over their time, reducing burnout, and supporting work-life harmony.

C. Promoting a positive work environment

A healthy, supportive work culture improves morale, teamwork, and retention. Advocacy here involves addressing workplace issues, fostering respect, and creating an atmosphere where staff feel valued and supported.

E. Encouraging staff to engage in self-care

Promoting self-care shows concern for staff well-being, both physically and mentally. This advocacy helps prevent fatigue, supports resilience, and ensures that staff can deliver quality patient care consistently.

Why Other Options Are Incorrect:

A. Assigning a rigid schedule for staff lunch breaks

Rigidly controlling breaks may not meet individual needs and can hinder rest, especially during demanding shifts. This approach prioritizes structure over staff autonomy, which does not reflect advocacy.

D. Reprimanding a nurse for refusing to administer an unsafe dosage of an ordered medication

Punishing a nurse for following safety protocols undermines advocacy. Advocates protect staff who speak up about unsafe practices, rather than disciplining them for prioritizing patient safety.

Correct Answer A. The nursing staff knew about their desires and allowed them to make their own decisions.

Explanation:

Patient advocacy in the QSEN Patient-Centered Care competency involves respecting the patient’s values, preferences, and expressed needs. Allowing patients to make their own decisions after understanding their desires reflects advocacy by supporting autonomy, informed decision-making, and self-determination. This approach ensures care is tailored to the patient’s individual goals and preferences, which is central to patient-centered care.

Why Other Options Are Incorrect:

B. The nurses made all my care decisions for me so I didn’t have to worry.

This is incorrect because making all decisions without patient input removes autonomy and is not consistent with advocacy.

C. The nursing staff provided care quickly but did not explain the procedures.

This is incorrect because failing to explain procedures denies the patient informed consent and limits their ability to participate in care decisions.

D. The nurses told me what was best for me and discouraged my input.

This is incorrect because discouraging patient input directly opposes the concept of advocacy and patient-centered care.

Correct Answer A. Outcomes identification

Explanation:

This is correct because outcomes identification involves setting measurable and specific goals that guide the nursing plan of care or improvement initiatives. In this scenario, the nurse manager’s target of reducing medication errors by 50% is a clearly defined outcome that can be measured over time to assess progress.

Why Other Options Are Incorrect:

B. Planning

This is incorrect because planning involves determining the strategies and interventions needed to achieve the identified outcomes, not the step of defining the outcome itself.

C. Implementation

This is incorrect because implementation is the phase where the planned interventions are carried out, not the stage where goals are set.

D. Evaluation

This is incorrect because evaluation involves reviewing and assessing whether the identified outcomes have been met after interventions are implemented.

Correct Answers:

A. Assess the sites for relative strengths and weaknesses.

C. Evaluate Web sites for use of credible information supported by evidence-based practice.

Explanation:

A. Assess the sites for relative strengths and weaknesses

This is correct because a systematic appraisal helps determine whether a site is trustworthy and fit for patient education. A thorough assessment examines scope (what topics are covered and what’s excluded), depth (how detailed the explanations are), and transparency (clear authorship, credentials, and contact information). It also looks at disclosures (funding sources, sponsorships, potential conflicts of interest), readability (patient-friendly language, plain-language summaries), and accessibility (clear navigation, working links). Considering these dimensions together allows the nurse to weigh trade-offs—e.g., a site may be highly readable but weak on citations—so that only the most balanced and reliable resources are recommended.

C. Evaluate Web sites for use of credible information supported by evidence-based practice

This is correct because accuracy hinges on whether claims are anchored in quality evidence. Credible sites cite primary research, systematic reviews, or reputable guidelines; distinguish facts from opinions; and reference dates of guideline versions. They should link to sources, describe how information is developed or reviewed (e.g., editorial policy, peer review), and correct errors transparently. Evidence-based content also reflects consensus guidance from recognized bodies and uses precise, qualified language that avoids overgeneralization, helping patients receive safe, current, and verifiable advice.

Why Other Options Are Incorrect:

B. Make sure that there is a physician documented as providing the information

This is incorrect because accuracy depends on verifiable credentials, editorial oversight, and evidence citations—not on a single profession. High-quality content may be authored or reviewed by multidisciplinary teams (nurses, pharmacists, dietitians, public health researchers). What matters is disclosed qualifications and rigorous sourcing, not a physician label alone.

D. Web sites that require a paid subscription typically provide more accurate information

This is incorrect because paywalls are not a proxy for quality. Some paid sites are excellent, but many free resources (government, academic, major nonprofit) meet high evidentiary and editorial standards. The decisive factors are transparent authorship, references to peer-reviewed evidence, conflict-of-interest disclosures, and sound editorial processes, not whether the user pays.

E. Web sites that are updated regularly provide more accurate information

This is incorrect because recency without rigor can still propagate inaccuracies. Currency is necessary but insufficient. A frequently updated site must also show how content is vetted (editorial board, methodological standards), cite high-quality sources, and correct errors. Without these safeguards, frequent updates do not guarantee accuracy.

Correct Answer A. Most employers who read résumés spend little time reviewing the document.

Explanation:

Recruiters and hiring managers often scan résumés quickly—sometimes in less than a minute—to determine if the applicant meets key qualifications. A well-organized, concise résumé that highlights relevant skills, education, and accomplishments ensures important information is noticed right away. This means prioritizing clarity, brevity, and alignment with the job description rather than overloading the résumé with unnecessary details.

Why Other Options Are Incorrect:

B. All activities should be included in the document regardless of whether they relate to the job position

Including unrelated activities clutters the résumé and can distract from the applicant’s most relevant qualifications. Only experiences that directly or indirectly demonstrate skills applicable to the nursing role should be included.

C. The document should be presented in a comprehensive narrative format

Narrative or essay-style résumés are time-consuming to read and make it harder for hiring managers to quickly identify key qualifications. Bullet points and clear section headings are preferred for scanning.

D. Language style used is not important

Language style is important because strong, action-oriented language conveys professionalism and competence. Weak or unclear language can make the résumé less impactful, even if the applicant is well-qualified.

Correct Answer A. Sense of empowerment

Explanation:

This is correct because a shared decision-making model gives nurses an active voice in decisions that affect their work and patient care. This involvement increases their sense of ownership, value, and professional respect, which leads to greater empowerment. Empowered nurses are more engaged, confident, and motivated to contribute to positive patient and organizational outcomes.

Why Other Options Are Incorrect:

B. Reduced workload and patient assignments

This is incorrect because shared decision-making focuses on participation in decisions, not on reducing patient assignments or workload.

C. Guaranteed promotion to leadership positions

This is incorrect because while participation may help develop leadership skills, it does not guarantee a promotion.

D. Elimination of mandatory continuing education requirements

This is incorrect because continuing education is a professional requirement and is not eliminated through shared decision-making models.

Correct Answer C. Discuss your concerns with your direct supervisor and make noted comments on the form stating that you disagree and then sign the form.

Explanation:

The best approach is for the nurse to address the disagreement directly with the Unit Nurse Manager, providing clear examples or evidence to support their perspective. Writing a formal comment on the appraisal ensures that the disagreement is documented in the official record. Signing the form in this context does not mean the nurse agrees—it simply acknowledges that the appraisal has been reviewed. This approach maintains professionalism, preserves open communication, and ensures that the nurse’s viewpoint is formally recorded in accordance with facility policy.

Why Other Options Are Incorrect:

A. Sign the form as indicated and then talk to the chief nursing officer of the facility.

This bypasses the appropriate chain of command and may be perceived as undermining the immediate supervisor. Concerns should be addressed first with the person who completed the appraisal. Escalating too early can damage workplace relationships and limit collaborative problem-solving.

B. Do not sign the form and ask for a copy so that you can bring it home to discuss it with your family.

Refusing to sign may be viewed as noncompliance with policy and could negatively impact the nurse’s personnel file. While seeking outside advice is understandable, this approach fails to document the disagreement formally and can appear unprofessional.

D. Sign the form indicating that you agree because there are no designated restrictions on your role on the unit and this is just personally motivated.

Signing as if in agreement when there is genuine disagreement is misleading and allows inaccurate information to stand unchallenged. This can affect future evaluations, promotions, and even legal documentation. It also fails to advocate for oneself in a constructive way.

Correct Answers:

A. Health-care professionals are to be transparent in all activities

B. The patient is the source of control over their own care

C. Health-care professionals anticipate needs of the patient

Explanation:

A. Health-care professionals are to be transparent in all activities

This is correct because transparency builds trust, promotes safety, and ensures patients are fully informed about their care, aligning with IOM rules.

B. The patient is the source of control over their own care

This is correct because patient-centered care requires that patients’ values and preferences guide all clinical decisions, a key IOM principle.

C. Health-care professionals anticipate needs of the patient

This is correct because anticipating patient needs promotes proactive care, reducing errors and delays, and aligns with the IOM’s focus on responsiveness.

Why Other Options Are Incorrect:

D. Health-care decisions are based solely on provider convenience

This is incorrect because IOM rules emphasize patient needs and evidence-based care over provider convenience.

E. Care is standardized without considering patient preferences

This is incorrect because while standardization supports safety, it must be balanced with individual patient needs and preferences for true patient-centered care.

Correct Answer A. Appreciative inquiry

Explanation:

This is correct because appreciative inquiry focuses on identifying and building upon an organization’s strengths rather than concentrating solely on problems. By asking staff to highlight what works best, the nurse manager encourages a positive outlook, fosters collaboration, and lays the foundation for expanding successful practices across the unit.

Why Other Options Are Incorrect:

B. Root cause analysis

This is incorrect because root cause analysis seeks to identify the underlying causes of problems, not highlight strengths.

C. Brainstorming

This is incorrect because brainstorming generates a wide range of ideas—both positive and negative—without focusing specifically on what is already working well.

D. Gap analysis

This is incorrect because gap analysis compares current performance to desired outcomes to identify areas needing improvement, not existing strengths to build upon.