Question 1

A patient asks the nurse manager to help resolve a situation between her and another patient.Which action would best support the patient's feelings of safety when experimenting with new ways of being?

Accepted Answer

Offering to be with the patient affords her a safe nonthreatening opportunity to assume responsibility for meeting her own needs assertively by encouraging skills that affect positive communication.Intervening removes the responsibility from the patient.Ignoring supports passive behavior.There is no need to bring in another person.The patient is capable of addressing the problem herself.

Question 2

Which statement would the nurse use to describe the primary purpose of boundaries?

Accepted Answer

Boundaries are the social,physical,and emotional limits of the interaction.As such,they serve to define the responsibilities and duties of the nurse in relation to the patient.Objectives and roles are determined during the orientation stage.Emergence of undesired material may be a significant issue for the patient.

Question 3

The patient and the nurse have agreed on problems to be addressed during a short course of outpatient therapy.At the beginning of the appointment,the patient states,"I'd like to work on the issue of relationships today." Which assessment can be made?

Accepted Answer

Once the patient and nurse have collaborated to define and prioritize problems,the relationship moves from orientation to working phase.The remaining options have no relevance to the scenario since there is no reference to roles,alternative behaviors,or managing behaviors.

Question 4

When sharing her feelings about separating from a therapy group,the patient stated,"I feel a bit sad and empty that I won't be seeing you folks again." What is the most accurate evaluation of the patient's statement?

Accepted Answer

The patient is expressing feelings of sadness over the loss of the therapeutic group relationships that have been helpful to her.Such feelings are considered normal,just as they are considered normal when the nurse-patient relationship terminates.The feelings expressed are normal,not regressive.No hidden meaning is present; the patient openly expressed genuine feelings.Further evaluation is not needed.

Question 5

Which statement best defines the nurse's initial role as the patient's source of help in addressing interpersonal problems?

Accepted Answer

This statement clearly specifies the nurse's purpose as a helping professional,and establishes the relationship as therapeutic,rather than social.The nurse has independent functions and does not work exclusively with the doctor.Identifying only medication overlooks the contributions of staff and the therapeutic milieu.Giving information is appropriate,but this statement does not define the nurse's role as resource.

Question 6

Which action will best facilitate the development of trust between a nurse and patient?

Accepted Answer

Being consistent in keeping one's word implies that the nurse is trustworthy and does what is agreed upon.Being responsive to demands may not be therapeutic.Instead,the patient will need to learn new techniques for meeting needs.Clarification is important but is not the best method for promoting trust.Trust is better served by shorter contacts at agreed-upon intervals.

Question 7

To plan care for a patient with a psychiatric disorder,the nurse keeps in mind that the primary nursing role related to therapeutic activities is:

Accepted Answer

The nurse's role in therapeutic activities is that of a professional observer and participant who works with the therapist to enhance the patient's capabilities and functioning within the parameters of the assigned activity.Assuring accomplishment,compliance,or providing failure support are not nursing roles.

Question 8

By the end of the orientation phase,which outcome can be identified for a newly admitted patient? The patient will demonstrate:

Accepted Answer

Establishing trust in the nurse is a fundamental task of the orientation phase of the relationship; thus it is an appropriate outcome to identify.When trust is present,the patient is free to focus on the work and tasks of therapy.The ability to problem solve is an outcome appropriate for the working phase.Positive transference would not be an identified outcome.The ability to ask for help would not be an identified outcome for the orientation phase.

Question 9

A nurse,leading an inpatient group dealing with women's issues,identifies a patient who is assuming the role of aggressor.Which behavior characterizes this role?

Accepted Answer

An aggressor acts in negative ways,displaying hostility,attacking the group,or criticizing the members.Seeking a position between contending sides describes the compromiser.Mediating conflicts and disagreements describes the harmonizer.Attempting to manipulate others describes the dominator.

Question 10

A patient tells the nurse,"I really like you.You're the only true friend I have." The patient's remarks call for the nurse to revisit the issue of:

Accepted Answer

The patient's remarks call for the nurse to remind the patient of the parameters of the nurse-patient relationship.The remark would also give the nurse the opening to go on to discuss the matter of friendship.The patient's remarks do not suggest the need to deal with trust,safety,or countertransference.

Question 11

During the first family therapy session,the mother of a child being treated for truancy and emotional outbursts asks the nurse,"Why are you bothering to ask the rest of us questions? My son is the one with the problems." The best response for the nurse would be:

Accepted Answer

This response orients the family to the idea that each person's opinion will be valued.Having the family present for assessment prepares them for working together to identify family issues,identify outcomes,and solve problems.It may or may not be true that this will result in accurate information.Getting better results doesn't convey the real reason.Referring to the family as sick is pessimistic and conveys a threatening message.

Question 12

The treatment team was engaged in planning how group therapy could be included as a part of the structured daily activities of the unit.A new team member asked,"Why is it so important to include group therapy for the patients?" The most accurate response would be based on the assumption that:

Accepted Answer

A key assumption of group therapy is that psychopathology has its source in disordered relationships.It follows that individuals will behave in the group as they do in other settings,so group provides an opportunity to help individuals develop more functional relationships.Ability to relate is not relevant to group work.It is dealt with in one-to-one therapy.Hidden agenda is not a reason to offer group therapy.Cost-effectiveness is not an assumption about the reason group therapy is effective.

Question 13

Which statement by a 16-year-old is considered as positive evidence that the family's involvement in therapy is moving them towards effective functioning?

Accepted Answer

This statement shows the family has made an effort to improve communication and deal with alienation without any one member bearing complete responsibility.Withdrawing from the team suggests he felt solely responsible for the family problem.Quitting the job suggests the mother saw herself as responsible; however,being home does not guarantee unification.A lack of advisement suggests withdrawal of the father from participation in family matters.

Question 14

In response to the nurse's statement,"Tell me about your family," the patient became silent and displayed nonverbally that he is uncomfortable.Which statement by the nurse reflects sensitivity to the patient?

Accepted Answer

This response acknowledges the situation,is respectful,and allows the patient to choose when to refocus the therapeutic interaction.Referring to the family as a problem is not sensitively worded.Offering false reassurance implies that feelings are negative.Suggesting postponing the discussion represents avoidance of dealing with the patient's feelings.

Question 15

Which patient would the group co-leaders determine is demonstrating Yalom's therapeutic factor termed universality?

Accepted Answer

Universality is the factor that refers to understanding that one is not unique,that others share thoughts,reactions,and discomforts like your own.Dysfunctional interaction refers to corrective recapitulation of the family group.A strong sense of belonging provides an example of cohesiveness.Display of anger is an example of catharsis.

Question 16

A patient attending group therapy mentions,"In the beginning,I was so sick that everyone had to help me.For the last few days,it's felt good to be able to give something back to the group." This statement can be assessed as an example of Yalom's factor of:

Accepted Answer

Altruism refers to the experience of being helpful to others and is clearly what the patient is displaying in the scenario.The other factors are not applicable.

Question 17

The nurse is determining whether the patient's needs could be best met in a task or a process group.The decision is based on the understanding that a task group focuses on:

Accepted Answer

Content-oriented groups focus on goals and tasks of the group.Thus a task-oriented group would focus on content issues.Process groups focus on interpersonal relationships.Communication styles are not relevant to describing task-oriented groups."Here and now" refers to dealing with issues that are taking place at the present time.

Question 18

Which intervention best reflects the nursing role regarding effective implementation of behavioral therapy goals?

Accepted Answer

The primary role of the nurse who is involved in behavioral therapy is to assess and identify the patient's problem behaviors in collaboration with the multidisciplinary team.A token economy is a system of behavior reinforcements in which patients earn tokens by performing predetermined desired behaviors.The remaining options are generalized responsibilities that are relevant to any therapy format.

Question 19

A new nurse asks the mentor,"How can I be sure I'm developing a therapeutic environment for my unit?" The mentor uses as a basis for the response the fact that a therapeutic milieu is characterized by:

Accepted Answer

Factors that determine the therapeutic effectiveness of the social environment includes the presence of two-way communication between the patients and the members of the multidisciplinary team for purposes of goal setting.In a therapeutic relationship,boundaries are established early and maintained throughout and although adherence to routine is important,there is room for adjustment when it benefits the therapeutic nature of the milieu.Although short-term attention may require focus on the patient in crisis,attention of the staff is equally shared.

Question 20

A nurse and patient are entering the termination phase in the group experience.An important nursing intervention will be to:

Accepted Answer

Healthy termination is facilitated when the group and nurse express reactions to termination.The nurse serves as a role model by being open and genuine as the feelings about the losses incurred with ending are discussed.On a positive note,accomplishments and growth are acknowledged and the transfer of safety and trust to the group members is accomplished.Describing goals is accomplished in the orientation phase.Accomplishing goals is part of the working phase in a relationship that does not have a strict time limit.Exploring alternative coping strategies would be part of the working stage.

Quiz 26: Therapies: Theory and Clinical Practice