Chapter 14: Group Interventions

Children's groups should be structured to accommodate which level of functioning? a) Developmental b) Social c) Psychological d) Motor

a) Developmental

Which incorporates all the verbal and nonverbal interactions of the group? a) Groupthink b) Group dynamics c) Group cohesion d) Group process

b) Group dynamics

During which stage of group development may the group grieve the loss of group cohesiveness? a) Working b) Intermittent c) Beginning d) Termination

d) Termination

A group is in the working stage and developing the rules and standards for acceptable behavior in the group. The group is developing group: a) process. b) norms. c) cohesiveness. d) themes.

b) norms.

Which maintenance role is responsible for mediating differences among group members and relieves tension in conflict situations? a) gatekeeper b) compromiser c) harmonizer d) encourager

c) harmonizer

Group themes reflect the underlying concerns or feelings of the members. Identification of group themes is important for ... a) establishing future group sessions. b) evaluating outcomes of the group. c) understanding the group dynamics. d) determining the central communicator.

c) understanding the group dynamics.

A psychiatric-mental health nurse is preparing to lead a group of individuals experiencing anxiety. Which information would be most important for the nurse to keep in mind when determining the amount of structure and types of activities? a) degree of socialization permitted b) needs of the potential members c) purpose of the group d) size of the group

c) purpose of the group

During a group session, a nurse leader observes a member look down at the floor and change position in the chair, each time the topic of anger and violence comes up. The nurse leader says to the member, "I've noticed that any time the discussion involves anger and violence you look away and change your position. Is something going on?" The nurse leader is using which technique? a) Summarizing b) Reflecting feelings c) Clarification d) Reflecting behavior

b) Reflecting feelings

Which action reflects group development in the initial stage? a) Focusing on group accomplishments b) Seeking similarities c) Evaluating the group experience d) Engaging in conflicts

b) Seeking similarities

Individual psychotherapy consists of three phases. Which statement by the group therapist would reflect that the group is in the working phase of therapy? a) "James, when Shane speaks, it seems you become angry and tend to withdraw." b) "Each of you has shared ideas and thoughts about your personal development. This has been a difficult process, and you have all grown tremendously." c) "We will be meeting once each week for 90 minutes here at this office." d) "Shane has asked the group if it is acceptable that he be 5 minutes late to each group session because of his job."

a) "James, when Shane speaks, it seems you become angry and tend to withdraw."

During a group session, the nurse leader uses clarification to check the meaning of a member's statement. Which statement would be most appropriate? a) "What I'm hearing you say is that you feel quite overwhelmed today." b) "Can you tell me more about your feelings of being overwhelmed?" c) "You might be experiencing an interaction between your medicine and the food you're eating." d) "We've talked about your medicine and you'll follow up with your provider."

a) "What I'm hearing you say is that you feel quite overwhelmed today."

A group member is describing some of the painful events experienced during childhood. The member does not elaborate on the feelings surrounding the events apart from saying that they made the member feel "upset." How should the group leader best apply the leadership technique of probing? a) "When you say that these things made you 'upset,' how exactly did you feel?" b) "It sounds like the events you're describing were very upsetting." c) "It's important that you know that these events were in no way your fault." d) "Do you feel like someone else in similar circumstances would have felt that way too?"

a) "When you say that these things made you 'upset,' how exactly did you feel?"

A nurse is leading a medication group and is exhibiting direct leadership. Which behavior would the nurse most likely demonstrate? Select all that apply. a) Allowing little discussion b) Reflecting the discussion c) Giving directions d) Instructing what to do e) Offering minimal guidance

a) Allowing little discussion c) Giving directions d) Instructing what to do

Which is a purpose of a medication group? Select all that apply. a) Compliance b) Management of side effects c) Reviewing insurance d) Ordering medications e) Lifestyle adjustments

a) Compliance b) Management of side effects c) Reviewing insurance

A nurse is conducting a medication group. Which role would the nurse interpret as an example of a maintenance role for a group member? Select all that apply. a) Compromiser b) Playboy c) Harmonizer d) Standard setter e) Aggressor

a) Compromiser c) Harmonizer d) Standard setter

Which group role is best reflected by the client who consistently validates members' contributions, tries to be the "mediator" between members, and interprets the group's procedures? a) Group building and maintenance b) Task c) Group cohesion d) Individual

a) Group building and maintenance

Which of the following is an example of a verbal communication technique? a) Group theme b) Posture c) Mood d) Eye contact

a) Group theme

A nurse is planning to start a new group on the During a group session, a member says, "I believe the group should try to focus on the feelings that we are all experiencing, not the end result of the behavior." Based on this statement, the nurse leader determines that this member is assuming which role? a) Opinion giver b) Energizer c) Initiator-contributor d) Information giver

a) Opinion giver

A basic function of psychiatric nurses is to implement a group that focuses on helping individuals coping with their illness. This refers to ... a) a supportive therapy group. b) a psychoeducational group. c) a cognitive behavior therapy group. d) an interactive group.

a) a supportive therapy group.

The nurse leader of a group observes a group member attempting to stimulate the group to action or decision. The nurse interprets this member as fulfilling which role? a) energizer b) orienter c) coordinator d) recorder

a) energizer

A nurse is trying to manage the situation of a disliked member in the group and is encountering difficulties in managing the situation. The best action of the nurse is to ... a) get supervision from an experienced group leader. b) disband the group. c) ask the person to leave the group. d) identify another leader to take over the group.

a) get supervision from an experienced group leader.

Which type of group is usually associated with clients who have dementia and have difficulty with recent memory? a) self-care groups b) medication groups c) reminiscence groups d) anger management groups

c) reminiscence groups

The nurse is counseling a group of clients in a closed group system. The nurse should explain to the group members that one advantage of a closed group system is that the ... a) group can be led by only one person. b) participants become more cohesive as a group. c) focus of the group's work can be more specific. d) group can be functioning on an ongoing basis.

b) participants become more cohesive as a group.

A psychiatric-mental health nurse will soon begin a medication group for clients who have been prescribed atypical antipsychotics. What is the nurse's best initial action? a) perform a mini mental state examination (MMSE) with each member. b) assess each member's knowledge of his or her drug regimen. c) partner each member with another member to hold each other accountable for adherence to treatment. d) educate the members about the roles of nutrition and exercise in managing adverse effects

b) assess each member's knowledge of his or her drug regimen.

During which phase of group development does the group leader develop rapport with the members? a) pre-interaction b) beginning c) working d) termination

b) beginning

A client with post-traumatic stress disorder is referred to a group to help the client deal with the issues associated with the trauma and its aftereffects. Which group would be most appropriate for this person? a) task group b) psychotherapy group c) self-help group d) psychoeducation group

b) psychotherapy group

The nurse is leading an open stress management group that began with nine participants but that has grown in size to between 16 and 18. Because of this increase in size,which action would be most appropriate? a) disband the group temporarily to differentiate between committed and casual members. b) choose interventions that promote engagement by attendees. c) divide the group into separate subgroups for men and for women. d) divide the group into four smaller groups, based on age.

b) choose interventions that promote engagement by attendees.

Within a group, facilitating verbal and nonverbal communication to meet treatment goals individually and with the entire group refers to the ... a) maintenance role. b) group leader. c) individual role. d) gatekeeper.

b) group leader.

Which therapeutic factor refers to the group members' relationships to the therapist and other group members? a) catharsis b) universality c) group cohesion d) altruism

c) group cohesion

Client 1 has been talking to Client 2 about Client 2's frequent denial in the group for two weeks. On the third week, Client 2 comes late to the group. When they begin to discuss Client 2's lateness, Client 2 gets up and leaves. The content of this exchange is the discussion. The process that is occurring may be that ... a) other group members are not very strong. b) Client 2 is angry with Client 1 for the confrontation. c) the group leader is not meeting Client 1's dependency needs. d) Client 1 is taking out individual frustrations.

b) Client 2 is angry with Client 1 for the confrontation.

The working stage of group therapy is marked by which characteristic? a) Group members' concern about confidentiality issues. b) Conflict and cooperation among group members. c) Therapists' tendency to "back off" to allow the group to work. d) Members' propensity to leave the group

b) Conflict and cooperation among group members.

A nurse leader identifies that the group is experiencing a conflict. When addressing the situation, which action would be most important for the nurse leader to do first? a) Implement conflict resolution strategies b) Determine the source of the conflict c) Suspend the group sessions for a time d) Terminate the group

b) Determine the source of the conflict

A psychiatric-mental health nurse has just reviewed the group rules at the first session. During this time, the nurse observed the verbal and nonverbal interactions among the group. The nurse is assessing for which group concept? a) Groupthink b) Group dynamics c) Group themes d) Group process

b) Group dynamics

In group, Client 1 talks about how stressful and important Client 1's job is. Client 2 comments that Client 1 seems to think Client 1 is "better than the rest of us." Client 3 supports Client 1's comment and says Client 3 doesn't understand why everyone wants Client 1 to "break down and cry." This dynamic illustrates what? a) Transference b) Group process c) Countertransference d) Content communication

b) Group process

Which is the interaction that moves the group toward its goals? a) Group dynamics b) Group process c) Group cohesion d) Groupthink

b) Group process

During which type of leadership does the group leader offer little guidance to the group? a) Autocratic b) Indirect c) Co-leadership d) Direct

b) Indirect

Which indicates that the nurse, acting as a leader for a group of recovering clients with alcohol abuse, is addressing the responsibility of maintaining the group's process? a) Determining that the group's format will be closed b) Keeping the group on task by restating goals c) Deciding how often the group will meet d) Selecting individuals for membership in the group

b) Keeping the group on task by restating goals

Which is an example of group cohesiveness? a) Using a member as a scapegoat b) Members wearing T-shirts that they made to a group session c) Monopolizing the therapy session d) Discussing a client's personal issues in front of other group members

b) Members wearing T-shirts that they made to a group session

The nurse is beginning a group counseling session with an open group system. The nurse should explain to the group members that one advantage of an open group system is that ... a) relationships are more easily established in the group. b) new members can join the group at any time. c) it can offer the best treatment outcomes. d) the topics for the group can be controlled.

b) new members can join the group at any time.

A psychiatric-mental health nurse is working to ensure that the decision-making group the nurse is leading is effective. The nurse implements an open leadership style and ensures that time pressures are avoided. The nurse is working to prevent which situation? a) group process b) group dynamics c) groupthink d) group themes

c) groupthink

A group member arrives at a group session visibly upset. The member is attending a medication group that meets once a week. The group leader observes the member's appearance. Which response by the leader would be most appropriate? a) "It's best that we deal with how you're feeling right here and right now." b) "It's okay to be upset. How do other members of the group feel right now?" c) "I can see you're upset right now. Let's take some time to talk after group." d) "If there is something wrong, maybe you should go home and come back next week."

c) "I can see you're upset right now. Let's take some time to talk after group."

A group has been given the assignment of completing the arrangements for a day trip to the aquarium. This is an example of which type of group? a) decision making b) psychotherapy c) task d) supportive therapy

c) task

Which client would the nurse assess as having the priority need for attendance at a life and social skills group? a) A 46-year-old mother of two teenage children recently divorced and entering the dating scene b) A 20-year-old university student who has difficulty speaking in front of large groups c) A 38-year-old homeless man with a history of chronic paranoid schizophrenia d) A 29-year-old waitress who works two jobs and plans to go back to college

c) A 38-year-old homeless man with a history of chronic paranoid schizophrenia

A support group member talks at length about the situations that trigger the member's anxiety. Other group members offer thoughtful suggestions from time to time, and the member consistently agrees with them but then goes on to explain why they would be ineffective. What is the nurse leader's best action? a) Confront the member with the fact that the member's responses devalue the contributions of the other members b) Remind the member that the ultimate purpose of the group is to offer solutions to other members c) Ask the member to suggest specific alternatives to what the other members suggest d) Ask the member whether the member believes the situation to be unsolvable

c) Ask the member to suggest specific alternatives to what the other members suggest

The nurse has been asked to sit in and observe a support group for individuals who were once addicted to drugs. The nurse notices that one group member disagrees with statements made by all other group members. What role is this individual playing in the group? a) Gatekeeper b) Dominator c) Blocker d) Follower

c) Blocker

A psychiatric-mental health nurse is forming a group and deciding on the group's size. Which characteristic would support the nurse's decision to form a large group? Select all that apply. a) Increased level of cohesiveness b) Decreased chance for subgroup formation c) Decreased risk for transference d) Increased level of engagement e) Increased opportunities for conflicts

c) Decreased risk for transference e) Increased opportunities for conflicts

A nurse is planning to start a new group on the unit. To ensure a well-functioning and successful group, the nurse needs to consider individual suitability for membership and consider: a) Can the potential member lead the group in case the leader is unable to attend? b) Can a potential member bring anything that will benefit the rest of the group? c) Does the purpose of the group match the treatment goals of the potential member? d) Does the purpose of the group suit the potential member's needs and, if not, could the client observe by sitting outside of the actual group and watching?

c) Does the purpose of the group match the treatment goals of the potential member?

During a group session, one of the members states, "Let's keep this discussion going so that everyone can participate, but let's keep the time each person speaks to about 3 minutes." The leader interprets this member as acting in which role? a) Group observer b) Energizer c) Gatekeeper d) Encourager

c) Gatekeeper

When leading a medication group, which educational method is least effective? a) Handouts b) Videotapes c) Lecture d) Audiovisual materials

c) Lecture

A nurse is observing a group session. The group consists of a leader and six other members. Member A sits directly next to the leader. Member B sits directly across from the leader. Member C sits to the right of member B and member D sits to the left of member B. Which member would the nurse identify as having the most power in the group? a) Member C b) Member D c) Member A d) Member B

c) Member A

A newly admitted client has joined an anger management group as part of treatment in the hospital. Which type of group would be appropriate for this client? a) Closed b) Dyad c) Open d) Cohesion

c) Open

A psychiatric-mental health nurse is preparing to conduct a symptom management group at the community mental health center. When planning the location and arrangement of the room, which setting would be most effective? a) A corner of the waiting room with members sitting on a sofa and some chairs b) Dining area with members sitting around a rectangular table and the leader at the head of the table c) Small conference room with members sitting on chairs arranged in a circle d) A day room with members sitting along one side of the wall with the leader standing

c) Small conference room with members sitting on chairs arranged in a circle

When acting as the nurse leader for a group, the nurse implements a technique that creates a climate for members to express unpopular ideas while at the same time informs the group about what the leader thinks is important. The nurse is using which technique? a) Summarizing b) Clarification c) Support d) Confrontation

c) Support

During which group may the client learn how to avoid relapse? a) Reminiscence b) Anger management c) Symptom management d) Self-care

c) Symptom management

The initiator-contributor, information seeker, information giver, and coordinator are examples of what? a) Group building roles b) Group cohesion roles c) Task roles d) Individual roles

c) Task roles

An ongoing support group for new mothers of high-risk babies has been meeting for 3 months. A new member comments that she doesn't have time to come to a group "just to talk." Other members meet the woman's comments with silence. Which statement best explains this situation? a) The new member is rude. b) The group is unfriendly. c) The new member has violated group norms. d) The group has not accepted the new member.

c) The new member has violated group norms.

Which is an accurate characteristic of small groups? a) They usually form subgroups. b) They tend to be less cohesive than large groups. c) They are usually no more than seven to eight members. d) They have fewer interpersonal experiences than large groups.

c) They are usually no more than seven to eight members.

The nurse leads a small group that is discussing the impact of eating disorders on everyday life. Which action does the nurse implement as the group recorder? a) defining group position in relation to goals b) stimulating the group to action c) documenting group suggestions d) offering the group facts or generalizations

c) documenting group suggestions

The psychiatric-mental health nurse will be leading a group that will consist exclusively of older adults. When leading this group, the nurse should: a) limit the group size to five or six members, if possible. b) encourage members' children and caregivers to attend. c) encourage the therapeutic use of reminiscence. d) avoid topics that may cause members anxiety.

c) encourage the therapeutic use of reminiscence.

A therapy group is in session, and one member shares feelings of hopelessness about the member's future. A second member responds by saying, "I felt hopeless once, but then I went back to school and worked and raised kids to put myself in a better position. It was hard; sometimes I don't know how I did it. But I got great grades, the kids turned out well, and I have a well-paying job." The nurse interrupts and acknolwedges the second member's contribution of information and then redirects the discussion to the first member and others in the group. The nurse identifies the second member as having assumed which role? a) Coordinator b) Energizer c) Follower d) Monopolizer

d) Monopolizer

A group is trying to handle issues related to dominance, control, and power within the group. In what stage of group development is this group? a) Initial b) Termination c) Mature d) Working

d) Working

A nurse at a local senior center is forming a group whose members are all older adults. When working with this group, which action would be most important for the nurse to do? a) Avoid using life review strategies b) Emphasize learning new information c) Maintain a quick-paced meeting d) Conduct a self-assessment

d) Conduct a self-assessment

A nurse is preparing to lead a newly formed group at the community mental health center. When setting the tone of the group, the nurse understands that it is the responsibility of which person? a) Referring provider b) Individual group members c) Facility hosting the group d) Leader

d) Leader

A client has been attending a closed medication group since its formation several weeks ago. The client attends faithfully but has never contributed to any of the discussions during group meetings. The nurse who is leading the group should: a) gently encourage the client to participate by citing the benefits of participation. b) propose an agreement with the client that the client participate at least once during each meeting. c) begin directly asking the client for responses from time to time during meetings. d) engage with the client privately to determine the motivation behind the silence.

d) engage with the client privately to determine the motivation behind the silence.

A psychiatric-mental health nurse is responsible for leading a newly formed group. Which individual would be responsible for determining an individual's suitability for the group? a) the client b) referring provider c) treatment team d) group leader

d) group leader

A nurse leading group therapy identifies an individual's participation of self-disclosure with personal problems that are inconsistent with the purpose of the group. Which action by the nurse would be most appropriate? a) tell the client that this behavior is unacceptable. b) ask the individual to leave the group. c) explore the individual's thoughts and feelings with the group. d) limit repeated episodes and redirect discussion

d) limit repeated episodes and redirect discussion

Clients learn about relapse prevention in the context of ... a) psychoeducational groups. b) anger management groups. c) reminiscence groups. d) symptom management groups.

d) symptom management groups.

Which concept should the nurse consider prior to a formal client referral to a therapeutic group? a) the median age of the group members b) the size of the group c) the client's ethnicity d) the client's social skills

d) the client's social skills