Question 1

A nurse is preparing to form a group in an inpatient psychiatric setting for clients who have experienced trauma and determines that a small group would be best. In addition to the group leader, the nurse would anticipate including how many clients?

A) 3 or 4
B) 5 or 6
C) 7 or 8
D) 9 or 10

7 or 8

Accepted Answer

An ideal size for a small group is seven to eight clients. Clients with challenging behaviors should be carefully screened and assigned to smaller groups. Small groups (usually no more than seven to eight members) become more cohesive, are less likely to form subgroups, and can provide a richer interpersonal experience than large groups. Even though small groups cannot easily withstand the loss of members, they are ideal for clients who are highly motivated to deal with complex emotional problems (e.g., sexual abuse, eating disorders, or trauma) or for those who have cognitive dysfunction and require a more focused group environment with minimal distractions.

Question 2

While participating in a group therapy session, one group member consistently asks for clarification of the topic the group is discussing. The nurse leading the group interprets this behavior as reflecting which group role?

A) Coordinator
B) Recorder
C) Information seeker
D) Standard setter

Information seeker

Accepted Answer

For any group to be successful, it must have members who assume task roles. The task role of information seeker is one in which the group member asks for clarification. The coordinator shows or clarifies the relationships among various ideas and suggestions. The recorder writes suggestions, keeps minutes, and serves as the group memory. The standard setter expresses the standards for the group to achieve.

Question 3

While leading a small group, a nurse sets up the ground rules at the beginning of the first meeting. One of the rules established is that the group will always start at the specified time, rather than waiting until everyone has arrived to begin. This rule reflects which group characteristic?

A) Norms
B) Cohesion
C) Think
D) Process

Norms

Accepted Answer

Norms establish acceptable group behaviors and encourage conformity of behavior among group members. Group cohesion is the closeness or sticking together of the group. Group think is the tendency of group members to avoid conflict and adopt a normative pattern of thinking that is often consistent with the ideas of the group leader. Group process is the development and culmination of the session-to-session interactions of the members that move the group toward its goals.

Question 4

In an initial group therapy session, a nurse observes that one group member continually tries to monopolize the conversation. The nurse interprets this behavior as reflecting what in the client?&#10;A) Anxiety&#10;B) Anger&#10;C) Rebellion&#10;D) Fear

Accepted Answer

When one group member continually tries to monopolize the conversation in an initial session, the client is most likely experiencing anxiety. The monopolizer does not reflect anger, rebellion, or fear.

Question 5

A nurse is leading a small group of hospitalized clients diagnosed with psychiatric disorders. One group member has asked for advice and often agrees with suggestions by other group members but then adds, "Yes, but . . ." to every suggestion offered. Which response by the nurse would be most appropriate?

A) "Things would probably work out better if you joined a different group."
B) "Do you realize you say, 'Yes, but . . .' to every suggestion the group has for you?"
C) "I suggest you stop and think about why you always respond to suggestions with 'Yes, but . . .'"
D) "What solution do you think would work best for you?"

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Accepted Answer

With a client who agrees initially then continually says, "Yes, but . . .," the nurse should encourage that person to formulate his or her own solutions. The leader can serve as a role model of the problem-solving behavior for the other members and encourage them to let the member develop a solution that would work specifically for him or her. Telling the client to join a different group is demeaning and does not address the client's problem. Asking the client if he or she realizes the response, or telling the client to stop and think about why, could be threatening to the client's self-esteem.

Question 6

A client has been placed in an anger management group because the client has trouble controlling angry outbursts. The nurse interprets this as an example of what type of group?&#10;A) Psychotherapy&#10;B) Self-help&#10;C) Psychoeducation&#10;D) Supportive therapy

Accepted Answer

Learning how to manage a medication regimen or control angry outbursts is often the aim of teaching (psychoeducation) groups. Psychoeducation groups are formally planned, and members are purposefully selected so that the focus of the group will help them work on a specific problem or knowledge deficit. Psychotherapy groups treat individuals' emotional problems and can be implemented from various theoretic perspectives, including psychoanalytic, behavioral, and cognitive. These groups focus on examining emotions and helping individuals face their life situations. Self-help groups are led by people who are concerned about coping with a specific problem or life crisis. These groups do not explore psychodynamic issues in depth. Supportive therapy groups are usually less intense than psychotherapy groups and focus on helping individuals cope with their illnesses and problems.

Question 7

A nurse is leading a group in which members are encouraged to discuss their feelings and emotions. The group session is just starting when a client stomps into the room, slams a notebook on a table, and sits down. The client's affect is one of anger and hostility. Which response by the nurse would be most appropriate?

A) Keep the focus off the client so the client's anger has time to diminish.
B) Suggest the client make a private counseling appointment to address the anger issues.
C) Ask the client to leave the group until the client is calmer.
D) Encourage the client to discuss the client's anger with the group.

Accepted Answer

An effective group leader recognizes the effects of an individual's mood on the total group. Thus, an effective leader would realize that the client's intense anger could set the emotional tone of the entire group. If the purpose of the group is to deal with emotions, then choosing to discuss the member's problem at the beginning of the session would help limit the intense anger to the one person experiencing it. Keeping the focus off the client or asking the client to leave could disrupt the functioning of the group because the client's emotions can affect the entire group. Suggesting the client make a private counseling appointment may be appropriate later, after discussing the client's problem at the beginning of the session.

Question 8

A nurse is leading a group on an adolescent psychiatric unit. A new client in the group is from out of state. The new client's accent and way of dressing set the new client apart from the other clients, and it is obvious that the group, for the most part, dislikes this client. During the group session, the nurse has the members draw the emotion they are feeling and then has them present their drawings and explain them to the group. What would be the most effective way to address the group's dislike for the new client?

A) Skip the new client when it is the new client's turn to present the new client's drawing.
B) Let the new client talk last so the others will not have time to make fun of the new client.
C) Compliment the new client when the new client presents the new client's drawing.
D) Demand that each member of the group tell the new client why they dislike the new client.

Accepted Answer

In some groups, members clearly dislike one particular member. This situation can be challenging for the leader because it can result in considerable tension and conflict. This person could become the group's scapegoat. The group leader may have made a mistake by placing the person in this particular group, and another group may be a better match. One solution may be to move the person to a better-matched group. Whether the person stays or leaves, the group leader must stay neutral and avoid displaying negative verbal/nonverbal behaviors that indicate that there is dislike for this specific member (or that indicate displeasure with the other members for their behavior). Often, the group leader can manage the situation by showing respect for the disliked member and acknowledging his or her contribution. Skipping the client nonverbally indicates negative feelings. Allowing the client to talk last isolates the client from the group. Demanding that the other group members tell why they dislike the client would demonstrate displeasure with the rest of the group for their behavior.

Question 9

A group of psychiatric-mental health nurses is reviewing information about the different types of groups. The nurses demonstrate understanding of the information when they identify which as a characteristic of a self-help group that differentiates itself from a supportive therapy group?

A) The group is led by at least one health-care professional.
B) The group is led by people concerned with coping with a problem.
C) The group functions without any person assuming a leadership role.
D) The group is focused on a specific problem.

Accepted Answer

Self-help groups are led by people who are concerned about coping with a specific problem or life crisis. These groups do not explore psychodynamic issues in depth. Professionals usually do not attend these groups nor serve as consultants. Psychiatric nurses lead supportive therapy groups. Both types of groups focus on a specific problem.

Question 10

A nurse is preparing to lead an older adult group. Which would the nurse need to keep in mind when leading this group?&#10;A) Focus the group to promote learning of new information.&#10;B) Tailor the pace of the meetings to the group.&#10;C) Discourage the use of life-review strategies.&#10;D) Teach entirely new methods for coping.

Accepted Answer

When working with older adult groups, the nurse may need to tailor the pace of the group meetings and place greater emphasis on using wisdom and experience, rather than learning new information. The nurse should also encourage the group to use life-review strategies, such as autobiography and reminiscence. When teaching new skills, the nurse should place them within the context of previous attempts to resolve issues and problems.

Question 11

A group of nurses is reviewing information about open and closed groups. The nurses demonstrate understanding of the information when they decide on forming an open group for which situation?&#10;A) Outpatient smoking cessation&#10;B) Community clinic psychoeducation&#10;C) Ambulatory care psychotherapy&#10;D) Inpatient anger management

Accepted Answer

The answer of A group of nurses is reviewing information...

Question 12

A nurse is deciding about the size of the group. The nurse determines that a large group would be best based on the understanding about which characteristic associated with a large group?&#10;A) Transference and countertransference issues will be moderate to high.&#10;B) Group cohesiveness will be strong with greater interpersonal experiences.&#10;C) The number of potential interactions and relationships will be limited.&#10;D) The group is effective for dealing with a specific issue.

Accepted Answer

The answer of A nurse is deciding about the size...

Question 13

While leading a group, a nurse leader says to a client, "This is the fourth time that you've changed the subject when we have talked about child abuse. Is something going on?" The nurse is using which technique?

A) Support
B) Confrontation
C) Summarizing
D) Clarification

Accepted Answer

The answer of While leading a group, a nurse leader...

Question 14

A nurse leader has been observing the behavior of group members since the formation of the group. During the past few sessions, the leader has noticed a member often making derogatory statements about other members' issues and then attempting to take the credit for the work the group has achieved. The nurse leader interprets this behavior as indicating which role?

A) Recognition seeker
B) Group observer
C) Help-seeker
D) Aggressor

Accepted Answer

The answer of A nurse leader has been observing the...

Question 15

Near the end of a medication group session, the nurse leader says, "Okay, we've talked about the client's medication problems and will be following up with the health-care provider." The nurse leader is using which technique?

A) Reflecting feelings
B) Advice and suggestions
C) Summarizing
D) Clarification

Accepted Answer

The answer of Near the end of a medication group...

Question 16

A nurse is acting as the leader of a newly formed group that is in the beginning stage of development. Which would the nurse expect to do? Select all that apply.&#10;A) Develop rapport with the group members.&#10;B) Anticipate members testing one another.&#10;C) Work with members to develop norms.&#10;D) Promote sharing of feelings.&#10;E) Facilitate verbal and nonverbal communication.

Accepted Answer

The answer of A nurse is acting as the leader...

Question 17

After conducting a review class for a group of psychiatric-mental health nurses about formal and informal roles of group members, the psychiatric-mental health clinical nurse specialist determines that the education was successful when the class identifies which as a formal role? Select all that apply.

A) Coordinator
B) Leader
C) Member
D) Harmonizer
E) Information seeker

Accepted Answer

The answer of After conducting a review class for a...

Question 18

When leading a group, the nurse determines that several of the group members have assumed roles that may be interfering with the group's function. Which roles might be involved? Select all that apply.&#10;A) Self-confessor&#10;B) Follower&#10;C) Dominator&#10;D) Elaborator&#10;E) Playboy&#10;F) Compromiser

Accepted Answer

The answer of When leading a group, the nurse determines...

Question 19

A psychiatric-mental health nurse is preparing to lead a medication group. Which would be most important for the nurse to assess? Select all that apply.&#10;A) Cognitive abilities&#10;B) Medication knowledge&#10;C) Reading skills&#10;D) Writing abilities&#10;E) Medications being taken

Accepted Answer

The answer of A psychiatric-mental health nurse is preparing to...

Question 20

A psychiatric-mental health nurse is planning to use reminiscence with a group of older adults. The nurse chooses this intervention for which reasons? Select all that apply.&#10;A) Identify previous coping strategies that can be useful now&#10;B) Help promote self-esteem&#10;C) Support the natural healing process of life review&#10;D) Reduce the amount of thinking needed for problem solving&#10;E) Provide catharsis about current issues

Accepted Answer

The answer of A psychiatric-mental health nurse is planning to...

Deck 14: Group Interventions