Question 1

A member of a support group is concerned that the group has not been ending on time and that some members have been pairing off to discuss group issues after the meetings.The concerned group member expresses these concerns during a group meeting.This is an example of which maintenance function?

Accepted Answer

Setting standards calls for the group to reassess or confirm implicit and explicit group norms when appropriate.Group norms refer to the behavioral rules of conduct expected of group members.Norms provide needed predictability for effective group functioning and make the group safe for its members.There are two types of group norms: (1)universal and (2)group specific.Universal norms are stated behavioral standards,which must be present in all groups for effective outcomes.Examples include confidentiality,regular attendance,and not socializing with members outside of the group.Unless group members can trust that personal information will not be shared outside the group setting (confidentiality),trust will not develop.Regular attendance at group meetings is critical to group stability and goal achievement.Personal relationships between group members outside of the group threaten the integrity of the group as the therapeutic arena for the group's work.Group-specific norms evolve from the group itself in the storming phase.They represent the shared beliefs,values,and unspoken operational rules governing group function.Examples include tolerance for latecomers,use of humor or confrontation,and talking directly to other group members rather than about them.Maintenance functions are behaviors that help the group maintain harmonious working relationships.Consensus taking checks to see whether the group has reached a conclusion,and asks the group to test a possible decision.Consensus taking is an example of a task function.Seeking information or opinion involves requesting facts from other members,asking other members for opinions,and seeking suggestions or ideas for task accomplishment.Seeking information is an example of a task function.Initiating involves identifying tasks or goals,defining the group problem,and suggesting relevant strategies for solving the problem.Initiating is an example of a task function.

Question 2

During a support group meeting,a group member makes several sexually provocative remarks toward the group leader.The best response by the group leader is,

Accepted Answer

Members who test boundaries through sexually provocative,flattering,or insulting remarks should have limits set promptly.The group leader should refer to the work of the group as being of the highest priority and tactfully ask the person to align remarks with the group purpose.Limits need to be set promptly within the group.The group member should not be excused at this stage.

Question 3

A member of a support group frequently whispers to other members of the group and appears indifferent and passive during group meetings.Which of the following nonfunctional self-roles is represented in this situation?

Accepted Answer

An example of a nonfunctional self-role is the role of avoider,which is characterized by whispering to others,daydreaming,doodling,and acting indifferent and passive.Another example of a nonfunctional self-role is the role of aggressor,which is characterized by criticizing or blaming others,personally attacking other members,and using sarcasm and hostility in interactions.Another nonfunctional self-role is the role of blocker,which is characterized by instantly rejecting ideas or arguing an idea to death,citing tangential ideas and opinions,and obstructing decision making.A final example of a nonfunctional self-role is the role of self-confessor,which is characterized by using the group to express personal views and feelings unrelated to the group task.

Question 4

The group leader states,"Today we discussed some of the issues about taking medications,and each one of you developed a goal in relation to some of the problems you were experiencing.I think it was helpful that some of you were able to share your experiences with other group members." The leader is using the technique of

Accepted Answer

Summarizing pulls related ideas together; restates key ideas; offers a group solution or suggestion for other members to accept or reject.Harmonizing attempts to reconcile disagreements; helps members reduce conflict and explore differences in a constructive manner.Encouraging indicates by words and body language unconditional acceptance of others; agrees with contributions of other group members; and is warm,friendly,and responsive to other group members.Compromising admits mistakes; offers a concession when appropriate; and modifies position in the interest of group cohesion.

Question 5

A long-standing group therapy meeting has been in process for 1/2 hour when a member arrives late.Another member says,"I thought we agreed as a group to come on time." This statement represents which of the following?

Accepted Answer

Group norms refer to the unwritten behavioral rules of conduct expected of group members.Norms provide needed predictability for effective group functioning and make the group safe for its members.There are two types of group norms: (1)universal and (2)group specific.Universal norms are stated behavioral standards,which must be present in all groups for effective outcomes.Examples include confidentiality,regular attendance,and not socializing with members outside of the group.Unless group members can trust that personal information will not be shared outside the group setting (confidentiality),trust will not develop.Regular attendance at group meetings is critical to group stability and goal achievement.Personal relationships between group members outside of the group threaten the integrity of the group as the therapeutic arena for the group's work.Group-specific norms evolve from the group itself in the storming phase.They represent the shared beliefs,values,and unspoken operational rules governing group function.Examples include tolerance for latecomers,use of humor or confrontation,and talking directly to other group members rather than about them.Regulation,law,and role are not examples of behavioral standards set by the group.

Question 6

A breast cancer support group is an example of a

Accepted Answer

Homogeneous groups share common characteristics,for example,diagnosis (e.g.,breast cancer support group)or a personal attribute (e.g.,gender or age).Closed groups have a predefined selected membership with an expectation of regular attendance for an extended time period,usually at least 12 sessions.Group members may be added,but their inclusion depends on a match with group-defined criteria.Most psychotherapy groups fall into this category.A breast cancer support group is not an example of a private group but is an example of an open group in which individuals can come and go depending on their needs.Heterogeneous groups represent a wider diversity of human experience and problems.Members vary in age,gender,and psychodynamics.Most psychotherapy and insight-oriented personal growth groups have a heterogeneous membership.Educational groups held on inpatient units (e.g.,medication groups)may have a homogeneous membership related to diagnosis or specific learning needs.

Question 7

The nurse is caring for a client who has a large extended family.The nurse recognizes the client is part of a group known as a

Accepted Answer

A group is a social unit that can satisfy a person's need for belongingness.Groups are categorized as primary or secondary.Primary groups are formed early in life and are characterized by an informal structure and close personal relationships.Primary groups have a lifelong influence on self-identity and social behaviors.Group membership is automatic (e.g.,in a family)or voluntarily chosen because of a common interest (e.g.,long term friendship)and is open ended.Secondary groups are described as purposeful,planned,time-limited relationships with an established beginning and end.Secondary groups differ from primary groups in purpose and function because they have a prescribed structure; a designated leader; and specific goals.When the group completes its task or achieves its goals,the group disbands.People join secondary groups to meet personally established goals,to develop knowledge and skills,or because it is required by the larger community system to which the individual belongs.Work groups,social action,and health-related therapeutic or support groups are good examples.

Question 8

When leading a group meeting,the nurse notices two group members talking.Which of the following represents the best intervention by the nurse?

Accepted Answer

Self-roles are roles a person uses to meet self-needs at the expense of other members' needs,group values,and goal achievement.Self-roles detract from the group's work and compromise goal achievement by taking time away from group issues and creating discomfort among group members.Challenging the talkers does not foster a safe environment in which to express feelings.With group communication strategies,the desired communication flow is from member to member,rather than from nurse leader to client.

Question 9

When members of a group experience controversy,conflict,and disagreements,the nurse leading the group recognizes the importance of

Accepted Answer

The storming phase helps group members move to a deeper level.In the storming phase,the gloves come off and communication can become controversial.The leader plays an important facilitative role in the storming phase by accepting differences in member perceptions as being normal and growth producing.By affirming genuine strengths in individual members,leaders model handling conflict with productive outcomes.Linking constructive themes while stating the nature of the disagreement is an effective modeling strategy.Once initial conflict is resolved in the storming phase,the group moves into the norming phase.Group-specific norms have developed from discussions in the previous phase.The leader encourages member contributions and emphasizes cooperation in recognizing each person's talents related to group goals.In the performing stage of group development,members focus on problem solving.Working together and participating in another person's personal growth allows members to experience one another's personal strengths and the collective caring of the group.The forming stage is an orientation phase.Communication is tentative and structured to allow members to learn about each other and develop trust.The leader takes an active role in helping group members feel accepted during the forming stage.Members are asked to introduce themselves and share a little of their background or their reason for coming to the group.

Question 10

A staff nurse is assigned to lead a community group meeting comprised mostly of psychotic clients.When setting up this type of group meeting,the nurse recognizes that

Accepted Answer

Staff nurses are sometimes called upon to lead or co-lead unit-based group psychotherapy on inpatient units.Other times staff nurses participate in community group meetings comprised mostly of psychotic clients.Although acutely psychotic clients usually cannot participate until they are stabilized,community groups and small structured therapy groups can be useful.A directive but flexible leadership approach is needed.Because the demands of leadership are so intense with psychotic clients,co-leadership is recommended.Co-therapists can share the group process interventions,model healthy behaviors,offset negative transference from group members,and provide useful feedback to each other.An introductory format for support group leaders includes potentially allowing time for informal networking through providing a 10-minute break with or without refreshments in order to allow members to interact informally with each other.If a group topic is not forthcoming from members,the leader can introduce a relevant,concrete,problem-centered topic of potential interest to the group.

Question 11

Which of the following is a characteristic of a secondary group?

Accepted Answer

Secondary groups differ from primary groups in purpose and function because they have a prescribed structure; a designated leader; and specific goals.When the group completes its task or achieves its goals,the group disbands.

Question 12

Which of the following statements is true in relation to task functions?

Accepted Answer

Functional roles differ from positional roles group members assume in that they are related to the type of member contributions needed to achieve group goals.Constructive role functions are the behaviors members use to move toward goal achievement (task functions)and behaviors designed to ensure personal satisfaction (maintenance functions).When task functions predominate,member satisfaction decreases.When maintenance functions override task functions,members have trouble reaching goals.

Question 13

The nurse recognizes an effective group includes which of the following characteristics?

Accepted Answer

Characteristics of effective groups include having goals that are clearly identified and collaboratively developed.Unshared leader power,guarded communication and feelings,and vague goals are examples of ineffective group characteristics.

Question 14

During the first session of an Alzheimer disease support group for family members,the nurse recognizes the need to

Accepted Answer

The forming phase in therapeutic groups focuses on helping clients establish trust in the group and with each other.Communication is tentative.Members are asked to introduce themselves and share a little of their background or their reason for coming to the group.Once initial conflict is resolved in the storming phase,the group moves into the norming phase.Group-specific norms have developed from discussions in the previous phase.The leader encourages member contributions and emphasizes cooperation in recognizing each person's talents related to group goals.The storming phase helps group members move to a deeper level.In the storming phase,the gloves come off and communication can become controversial.The leader plays an important facilitative role in the storming phase by accepting differences in member perceptions as being normal and growth producing.By affirming genuine strengths in individual members,leaders model handling conflict with productive outcomes.Linking constructive themes while stating the nature of the disagreement is an effective modeling strategy.

Question 15

When a group leader encourages the group members to express their feelings about one another with the stipulation that any concerns the group may have about an individual member or suggestions for future growth should be stated in a constructive way and the group leader summarizes goal achievement,the group has reached which phase of group development?

Accepted Answer

The final phase of group development,termination or adjournment,ideally occurs when the group members have achieved desired outcomes.This phase is about task completion and disengagement.The leader encourages the group members to express their feelings about one another with the stipulation that any concerns the group may have about an individual member or suggestions for future growth should be stated in a constructive way.The leader closes the group with a summary of goal achievement.By waiting until the group ends to share closing comments,the leader has an opportunity to soften or clarify previous comments and to connect cognitive and feeling elements that need to be addressed.Engagement occurs during the forming stage,and active interventions occur during the performing stage.

Question 16

Which of the following describes group think?

Accepted Answer

Extreme cohesiveness can result in a negative group phenomenon referred to as group think.Group think occurs when the approval of other group members becomes so important that group members support a decision they fundamentally don't agree with,just for the sake of harmony.Individual members are afraid to express conflicting ideas and opinions for fear of being excluded from the group.The group exerts pressure on members to act as one voice in decision making.Realistic evaluation of issues doesn't occur because group members minimize conflict in an effort to reach consensus.

Question 17

The nurse notices that a group member is quiet during support group meetings.What is the best intervention by the nurse for involving the quiet group member in the group process?

Accepted Answer

Group participation on an equal basis should be a group expectation.Although the level of participation is never quite equal,discussion groups in which only a few members actively participate are disheartening to group members and limited in learning potential.Because the primary purpose of a discussion group is to promote the learning of all group members,other members are charged with the responsibility of encouraging the participation of more silent members.Sometimes,when more verbal participants keep quiet,the more reticent group member begins to speak.

Quiz 8: Therapeutic Communication in Groups