Varacolis Mental Health Chapter 34
When a group member supports and encourages another group member and feels "good" about doing so, which group phenomenon is being demonstrated? Altruism Catharsis Cohesiveness Instillation of hope
Altruism Altruism involves putting another's needs before one's own. This is the only option that correctly identifies with the example provide in the question.REF: 612; Table 34-1
At what point in the life of a group lasting 12 sessions should confidentiality be explained and discussed? At the first session As the working phase begins Just before the group terminates At the time each client is interviewed
At the first session Confidentiality is part of the ground rules that are established at the beginning of the group sessions.REF: 613-614
When the group leader suggests that a client "choose the problem that is troubling you most at this time and tell us about it." The leader is promoting what action? Insight Focusing Reframing Feedback
Focusing Focusing helps the group consider one problem rather than trying to attend to multiple problems at one time. None of the other options are associated with selecting a particular focus.REF: 613
A client on the psychiatric unit who is scheduled to start group therapy asks the nurse, "What does group work mean? I was told I would be going to group and doing group work." How should the nurse respond to provide the best answer to the client's question? "You will attend group therapy and find solutions for each other's problems." "You will give and receive feedback from a group of your peers who may also have similar problems to work through." "You will share your issues with the group and then split up to work separately on solutions based on the ideas the other members provide." "Group work is the work that you do beforehand so you can present it to the group when you meet."
"You will give and receive feedback from a group of your peers who may also have similar problems to work through." Group work is a method whereby individuals with a common purpose come together and benefit by mutually giving and receiving feedback within the dynamic and unique group context. None of the other options accurately and adequately describe group work.DIF: Cognitive Level: Apply (Application)REF: Table 34-1TOP: Nursing Process: PlanningMSC: NCLEX: Psychosocial Integrity
A democratic group leadership style is most appropriate for which purpose? 30-minute meetings to discuss unit rules Creating meaningful trauma-related artwork A group directed toward anger management The organization the unit's holiday celebration
A group directed toward anger management Democratic leadership is best implemented when extensive group interaction is devoted to problem solving. None of the other options is problem solving in its focus.REF: 615
When a member tells the group, "I think the committee saw how unsure of myself I am. I felt all shaky inside during the promotion interview, just like I am feeling and acting right now." To present reality the leader should provide which response? Remain silent and nod slightly to signal that the client should continue. Say, "Tell us more about how you are feeling." Ask, "Does this shaky feeling occur often?" Ask the group to give feedback about how the client appears to them.
Ask the group to give feedback about how the client appears to them. This option is the only one that will result in present reality. The client will learn more about the reality of how he appears to others. The remaining options either give encouragement to continue or seek additional information.REF: 612; Table 34-1
A key quality indicator that might be identified for successful outcome in a medication education group could be that clients will engage in which activity? Stating they respected the leader Demonstrating a bond among members of the group Describe modes of transmission of sexually transmitted diseases Confer with health care provider before changing medication regimen
Confer with health care provider before changing medication regimen The key quality indicator that relates to successful outcomes in a medication education group is the client's recognition of the need to discuss medication changes with his or her physician rather than adjusting the dose or stopping the medication without consultation. None of the other options are associated with the focus of medication education.REF: 616; Table 34-5
What is the group leader's responsibility in the termination phase? Allowing members to exchange contact information so they may remain as a support for each other. Removing himself or herself from the group so they can function independently. Encouraging group members to reflect on progress made while providing group feedback. Encouraging group members to fill out evaluation forms so the group leader can further improve his or her therapeutic technique.
Encouraging group members to reflect on progress made while providing group feedback. In the termination phase, the group leader's role is to encourage members to reflect on progress they have made and identify posttermination goals. Contact with other members in the group outside of the group is not therapeutic and is usually discouraged. The group leader does not remove himself or herself from the group process. Group members do not fill out evaluation forms in group therapy.DIF: Cognitive Level: Apply (Application)REF: page 6TOP: Nursing Process: ImplementationMSC: NCLEX: Psychosocial Integrity
What are the advantages of therapy groups? Select all that apply. Feedback from peers Treatment of multiple people at one time Promotion of independence in problem solving Provision of an opportunity to practice communication Promotion of a feeling of belonging Promotion of confidentiality
Feedback from peers Treatment of multiple people at one time Provision of an opportunity to practice communication Promotion of a feeling of belonging Promotion of confidentiality All these options are advantages of groups. Since the members openly discuss and provide feedback, confidentiality is not possible.DIF: Cognitive Level: Analyze (Analysis)REF: Box 34-1TOP: Nursing Process: PlanningMSC: NCLEX: Psychosocial Integrity
The advanced practice nurse running a group on the adolescent unit makes no attempt to control the topic and makes no comment unless asked a direct question. What leadership style is the nurse implementing? Autocratic Authoritarian Democratic Laissez-faire
Laissez-faire A laissez-faire leader allows the group members to behave in any way they choose and does not attempt to control the direction of the group. Autocratic leaders control the group, pick the topic, and do not allow for much interaction. Authoritarian is another word for autocratic. A democratic leader involves the group members in decision making.DIF: Cognitive Level: Apply (Application)REF: page 9TOP: Nursing Process: ImplementationMSC: NCLEX: Psychosocial Integrity
The nurse reading in a group's protocol notes that it is a closed group understands that the group demonstrates which characteristic? Discussion topics will be restricted. Membership is limited to one gender. No new members will be allowed. The group is focused on demonstrating cohesiveness.
No new members will be allowed. A closed group is one to which no members are added once the group has begun. The term closed does not refer to any of the other options.REF: 612; Box 34-3
At what phase of group development would the nurse hear the following interchange? Client 1: "I do not feel comfortable here." Client 2: "I wonder what we are supposed to talk about." Client 3: "Let's ask the leader to explain things again." Preorientation Orientation Working Termination
Orientation During orientation the members get to know one another. Initially, they experience anxiety and are unsure of the expectations.REF: 613
Which group phase is most influenced and managed by the group leader? Orientation Working Termination Post-termination
Orientation The group leader often is most directive in the orientation phase, in which roles and ground rules are set. No other phase is so managed by the leader.REF: 612-613
The group goals are to learn to express feelings comfortably rather than keep them covert. When a group member shares with the group how expressing these feelings makes her feel, she is engaging in what activity? Group content Confrontation Subgrouping Providing feedback
Providing feedback Feedback includes letting the group know how they and the comments made in group make the individual feel. This form of sharing is not associated with any of the other options.REF: Box 34-2
A patient diagnosed with borderline personality disorder is attending a court-ordered therapy group. The patient projects an angry affect, does not speak much, except to make a snide comment about another member of the group or the group's leader. What is the best way for the leader to handle this patient's behavior? Remove the patient from the group because this behavior is disrupting the group process for other participants. Respond neutrally to the patient's comments, ask for group feedback, and talk privately with the patient to form a therapeutic connection. Spend an entire group session focused on that patient and try to get him/her to open up to other members in depth. Confront the patient firmly each time he/she makes a rude comment and let him/her know they will be taken out of group if the behavior continues.
Respond neutrally to the patient's comments, ask for group feedback, and talk privately with the patient to form a therapeutic connection. The group leader should listen to the comments objectively and without becoming defensive. The leader may choose to speak to the group member in private and ask what is causing the anger, to form a connection with the patient that may result in less disruptive behavior in group. In the group setting, the leader can focus on positive group members whose comments may reduce the hostility of the negative group member. Part of the group process includes problem-solving skills and getting group feedback for issues. Spending an entire session discussing one patient is inappropriate in a group setting. Confrontation done on a continual basis would disrupt the group process and focus heavily on the hostile client.DIF: Cognitive Level: Apply (Application)REF: page 12TOP: Nursing Process: PlanningMSC: NCLEX: Psychosocial Integrity
When several group members always sit together and nod or smirk as others are talking, the leader assesses this behavior using which term? Confronting Blocking Subgrouping Imitating
Subgrouping Subgrouping involves formation of a splinter group within the larger group. Members of the subgroup show more loyalty to each other than to the larger group. None of the other options are associated with behavior.REF: 612; (Box 34-3)
When a client is encouraged to talk with others who have had similar problems, the nurse is suggesting a which type of group? Cognitive-behavioral Time-limited Support group Milieu group
Support group Support groups are composed of members who have had or are currently sharing similar experiences, such as a bereavement group or a group of women with breast cancer. None of the other options have this specific purpose as its focus.REF: 616; Table 34-5
Which phase of group therapy does the group deal with feelings associated with separation and loss? Orientation Working Termination Post-termination
Termination During termination, the group members must face the fact that they are at a parting of the ways. Unresolved feelings associated with other terminations and separations may surface and need to be addressed. None of the other options are focused on the emotions associated with the ending of the group experience.REF: 613
Sharing similar experiences in a group setting is referred to using which term? Universality Imparting information Socializing Catharsis
Universality The phenomenon of understanding that one's problems are not unique helps group members feel secure and understood. No other option is used to describe this group behavior.REF: 611
What response demonstrates an effective strategy to encourage a nonparticipating member to speak during a group session? "You are letting the group down when you fail to contribute." "Your opinions about what just happened are important." "You must be feeling safe enough to enter the discussion by now." "What you are thinking is very important to the group."
What you are thinking is very important to the group." Options A, B, and C place the client on the defensive and encourage further withdrawal. Option D is less threatening. The leader needs to be patient and, in a nonthreatening manner, encourage members to make contributions.REF: 617
