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PrepU- Ch. 14 Groups & Group Interventions

question

Arranging seating for a group, the nurse needs to consider … a) Using three semicircles, with one or two chairs outside the circles to seat the monopolizers of the group b) Arranging chairs in a circle with chairs close to one another c) Using a room without doors to promote the openness of the group d) Arranging chairs at a rectangular table with chairs close to one another
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Arranging chairs in a circle with chairs close to one another Explanation: Arranging a group in a circle with chairs comfortably close to one another without a table focuses group work on relations with each other and on communication.
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Which of the following is the key to being a good leader? a) Firmly disciplining negative behavior b) Using autocratic leadership strategies c) Integrating group leadership with nursing interventions d) Conducting meetings based on personality attributes
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Integrating group leadership with nursing interventions Explanation: The key to being a good leader is to integrate group leadership, knowledge, and skills with nursing interventions that fit a selected group. Firmly disciplining negative behavior, using autocratic leadership strategies, and conducting meetings based on personality attributes are not keys to being a good leader.
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The following statements are heard in a group: “You can’t say that because you don’t really know me.” “I wonder if the therapist is going to leave?” and “I’m not sure whether or not I can really talk freely.” These best reflect which of the following group themes? a) Fear for safety b) Guilt and punishment c) Loss and abandonment d) Trust and belonging
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Trust and belonging Explanation: The theme expressed in these statements represents the latent lack of trust in the leader or other group members. These statements are not related to guilt and punishment, fear for safety, or loss and abandonment.
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The nurse has begun group counseling sessions for several hospitalized patients in the psychiatric facility. Which of the following would be most effective for the nurse to do to promote group cohesiveness? a) Use team-building exercises. b) Be consistent with the group themes. c) Spend time with each member individually. d) Encourage task completion by members.
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Use team-building exercises. Explanation: To encourage group cohesiveness, the nurse should use team-building exercises or encourage socialization with minimal supervision. Task completion helps to promote achievement of the group’s work but does not necessarily foster group cohesiveness. Spending time with each member may be important to facilitate communication and develop a relationship, but this would not promote group cohesiveness. Each group develops its own group themes.
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The working stage of group therapy is marked by … a) therapists’ tendency to “back off” to allow the group to work. b) Group members’ concern about confidentiality issues. c) conflict and cooperation among group members. d) members’ propensity to leave the group.
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conflict and cooperation among group members. Explanation: The group accomplishes its real work during the working phase. Conflict and cooperation indicate that trust has been established and group members are taking risks and working together to create behavior changes. In this stage, conflict and cooperation surface during the group’s work.
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A nurse is trying to manage the situation of a disliked member in her or his group and is encountering difficulties in managing the situation. The best action of the nurse is to … a) Ask the person to leave the group b) Identify another leader to take over the group c) Get supervision from an experienced group leader d) Disband the group
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Get supervision from an experienced group leader Explanation: The group leader can manage the situation by showing respect for the disliked member and acknowledging his or her contribution. In some instances, getting supervision from a more experienced group leader is useful.
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The group leader should remain attuned to the nonverbal behavior of group members during each session and monitor the effect on … a) Low complexity tasks b) Group participation c) Group climate and process d) High complexity tasks
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Group climate and process Explanation: The leaders should remain attune to the nonverbal behavior of group members during each session and the effect on group climate and process.
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A group leader is requesting input regarding the scheduling of a group meeting. The leader is exhibiting which leadership style? a) Autocratic b) Democratic c) Republican d) Laissez-faire
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Democratic Explanation: Democratic group leaders encourage active participation, value the input and feedback of group members, and promote cohesiveness among the group members. Autocratic leaders do not encourage active participation or interaction among group members. Republican is not a group leadership style. Laissez-faire group leaders allow much freedom in the group setting.
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A basic function of psychiatric nurses is to implement a group that focuses on helping individuals coping with their illness. This refers to … a) Supportive therapy group b) Psychoeducational group c) Interactive group d) Cognitive behaviour therapy group
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Supportive therapy group Explanation: Supportive therapy groups are usually less intense than psychotherapy groups and focus on helping individuals cope with their illnesses and problems as well as build interpersonal connections. Implementing supportive therapy groups is one of the basic functions of the psychiatric nurse.
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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) Standard setter b) Coordinator c) Information seeker d) Recorder
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Information seeker Explanation: 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.
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Several members of a self-help group are making T-shirts for the group to wear in a parade. This is an example of which element of group therapy? a) Group cohesiveness b) Universality c) Catharsis d) Altruism
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Group cohesiveness Explanation: Group cohesiveness is the development of a strong sense of group membership and alliance. Catharsis involves members relating to one another through the verbal expression of positive and negative feelings. Altruism is the process in which clients have the experience of learning to help others, and in the process, they begin to feel better about themselves. Universality can be defined as the sense of realizing that one is not completely alone in any situation.
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By analyzing the content and patterns of communication, the leader can determine the existence of which of the following? a) Enablers b) Monopolizers c) Harmonizers d) Pathways
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Pathways Explanation: By analyzing the content and patterns, the leader can determine the existence of communication pathways—who is most liked in the group, who occupies a position of power, what subgroups have formed, and who is isolated from the group.
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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) Energizer b) Gatekeeper c) Group observer d) Encourager
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Gatekeeper Explanation: The statement reflects the role of the gatekeeper, who attempts to keep communication channels open by encouraging or facilitating the participation of others or proposes regulation of the flow of communication through limiting time. The group observer keeps records of various aspects of the group processes and interprets data to the group. The encourager praises, agrees with, and accepts the contributions of others. The energizer attempts to stimulate the group to action or decision.
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Which of the following is a purpose of a medication group? Select all that apply. a) Compliance b) Lifestyle adjustments c) Management of side effects d) Reviewing insurance e) Ordering medications
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• Compliance • Management of side effects • Lifestyle adjustments Explanation: A medication group can be used primarily to transmit information about medications, such as action, dosage, and side effects. It can also focus on issues related to medications, such as compliance, management of side effects, and lifestyle adjustments. Ordering medications and reviewing insurance are not purposes of a medication group.
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Which of the following is an example of a maintenance role for a group member? Select all that apply. a) Aggressor b) Harmonizer c) Playboy d) Standard setter e) Compromiser
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• Harmonizer • Compromiser • Standard setter Explanation: The harmonizer, compromiser, and standard setter are examples of maintenance roles. The playboy and aggressor are examples of individual roles of group members.
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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) Does the purpose of the group suit the needs and if not could they observe by sitting outside of the actual group and observing? b) Does the purpose of the group match the treatment goals of the potential member? c) Can a potential member bring anything that will benefit the rest of the group? d) Can the potential member lead the group in case the leader is unable to attend?
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Harmonizer Explanation: In a group, the harmonizer mediates differences among members and relieves tension in conflict situations. The encourager praises, agrees with, and accepts the contributions of others. The compromiser operates from within a conflict and may yield status or admit error to maintain group harmony. The gatekeeper attempts to keep communication channels open by encouraging or facilitating the participation of others, or proposes regulation of the flow of communication through limiting time.
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Which of the following maintenance roles is responsible for mediating differences among group members and relieves tension in conflict situations? a) Compromiser b) Gatekeeper c) Encourager d) Harmonizer
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Harmonizer Explanation: In a group, the harmonizer mediates differences among members and relieves tension in conflict situations. The encourager praises, agrees with, and accepts the contributions of others. The compromiser operates from within a conflict and may yield status or admit error to maintain group harmony. The gatekeeper attempts to keep communication channels open by encouraging or facilitating the participation of others, or proposes regulation of the flow of communication through limiting time.
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Group themes reflect the underlying concerns or feelings of the members. Identification of group themes is important for … a) determining the central communicator b) establishing future group sessions c) evaluating outcomes of the group d) understanding the group dynamics
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understanding the group dynamics Explanation: Identification of group themes is important for understanding the group dynamics.
question

While conducting a group therapy session, the nurse observes that one participant consistently mediates differences among the participants. The nurse determines that this client is performing a group role termed … a) gatekeeper b) task c) individual d) maintenance
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maintenance Explanation: This client is performing the informal role of harmonizer; this is a group maintenance role.
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A member of the group is clarifying the goals of the group. The member is exhibiting which role? a) Recorder b) Evaluator-critic c) Orienter d) Coordinator
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Orienter Explanation: The orienter defines the position of the group with respect to its goals. The coordinator shows or clarifies the relationships among various ideas and suggestions. Measuring the outcome of the group against some standard is a role of the evaluator-critic. The recorder writes suggestions, keeps minutes, and serves as group memory.
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Large groups are often used in which environment? a) Clinic b) Workplace c) Prompt care d) Hospital
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Workplace Explanation: Large groups (more than 8 to 10 members) are effective for specific problems or issues, such as smoking cessation or medication information.
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When leading a medication group, which educational method is least effective? a) Audiovisual materials b) Handouts c) Videotapes d) Lecture
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Lecture Explanation: Using a lecture method of teaching is less effective than involving the members in the learning process. The nurse should expose the members to various audio and visual educational materials, including workbooks, videotapes, and handouts.
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Cohesiveness is an important factor that correlates with outcomes and must be balanced because too much cohesiveness can result in a) Increased dropout rates b) Lack of participation c) Decreased job satisfaction d) Increased social pressure to conform to group standards
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Increased social pressure to conform to group standards Explanation: Too much cohesiveness can exert powerful social pressure to conform to group standards with low tolerance for difference.
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Enhancing knowledge and improving skills to solve problems, including task groups, refer to … a) Psychoeducational groups b) Self-help groups c) Intensive groups d) Cognitive behaviour groups
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Psychoeducational groups Explanation: Psychoeducational groups include task groups that focus on completion of specific activities (e.g., planning a week’s menu) and teaching groups that are used to enhance knowledge, improve skills, or solve problems.
question

Which of the following statements would indicate that the group is in the working phase of development? a) “What have you learned, and how will you take this out into your life?” b) “I don’t understand why Mary doesn’t see my point of view, and frankly it really irritates me when she does that!” c) “I’m not sure what we are supposed to be talking about.” d) “Let’s go around the circle and tell one thing that you enjoy doing.”
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“I don’t understand why Mary doesn’t see my point of view, and frankly it really irritates me when she does that!” Explanation: In the working phase members confront each other with constructive feedback and honesty to gain insight into dysfunction. The initial stage of group development occurs when members are becoming acquainted and searching for similarity between themselves and others. The mature stage of the group demonstrates positive characteristics such as empathy, effective communication, and a definite, inclusive group culture. The termination stage encompasses when the group evaluates and explores members’ feelings about it and the impending separation.
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During which group may the client learn how to avoid relapse? a) Reminiscence b) Anger management c) Self-care d) Symptom management
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Symptom management Explanation: Within the context of a symptom management group, clients can learn how to avoid relapse.
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A client diagnosed with antisocial personality disorder is exhibiting aggressive behavior. Which of the following interventions would be most appropriate for this client? a) Anger management b) Reminiscence therapy c) Self-care group d) Symptom management
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Anger management Explanation: The purposes of an anger management group are to discuss the concept of anger, identify antecedents to aggressive behavior, and develop new strategies to deal with anger other than verbal and physical aggression.
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At his wife’s request, Gordon has presented to the therapist with his wife to begin couples therapy. In light of the fact that Gordon is profoundly reluctant to begin therapy, how can the therapist best put Gordon at ease about the process? a) Remind Gordon that most men tend to be similarly afraid of their feelings. b) Articulate some of the tangible benefits that Gordon may experience. c) Create a reward system whereby Gordon receives a benefit for each therapy session he attends. d) Present some of the consequences for his marriage if he does not participate in therapy.
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Articulate some of the tangible benefits that Gordon may experience. Explanation: Male clients may have a reluctance to participate in therapy, and this may be addressed by articulating benefits of participation. A reward system is likely ineffective and patronizing, while accusing the man of being afraid of his feelings is likely to create further resistance. The therapist should normally avoid making threats of negative consequences.
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The nurse-therapist who is leading a support group has emphasized a free-flowing, hands-off style of leadership in which the members determine the flow and content of each meeting. How best may the therapist’s leadership be described? a) Democratic b) Laissez-faire c) Autocratic d) Pragmatic
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Laissez-faire group leaders allow much freedom in the group setting. Autocratic group leaders generally do not encourage active participation or interaction among group members. Such leaders maintain authority and control over group members. Democratic group leaders encourage active participation, value the input and feedback of group members, and promote cohesiveness among the group members.
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Which of the following clients would the nurse assess as having the priority need for attendance at a life and social skills group? a) A 38-year-old homeless man with a history of chronic paranoid schizophrenia b) A 46-year-old mother of two teenage children recently divorced and entering the dating scene c) A 29-year-old waitress who works two jobs and plans to go back to college d) A 20-year-old university student who has difficulty speaking in front of large groups
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A 38-year-old homeless man with a history of chronic paranoid schizophrenia Explanation: The homeless man with a history of chronic paranoid schizophrenia could learn activities of daily living, communication, and other social skill deficits caused by his chronic illness. The waitress is able to work and plan for her future without professional assistance. The 20-year-old university student who is afraid to speak in front of large groups is incorrect, because this is a common phobia that can be overcome with experience or by taking a public speaking class. The woman re-entering the dating scene is incorrect because she does not have a longstanding disability that interferes with social skills.
question

Which of the following is the key to being a good leader? a) Integrating group leadership with nursing interventions b) Firmly disciplining negative behavior c) Conducting meetings based on personality attributes d) Using autocratic leadership strategies
answer

Integrating group leadership with nursing interventions Explanation: The key to being a good leader is to integrate group leadership, knowledge, and skills with nursing interventions that fit a selected group. Firmly disciplining negative behavior, using autocratic leadership strategies, and conducting meetings based on personality attributes are not keys to being a good leader.
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During which stage of group development may the group grieve the loss of group cohesiveness? a) Intermittent b) Termination c) Beginning d) Working
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Termination Explanation: During the final stage, members begin to grieve for the loss of the group’s closeness and begin to reestablish themselves as individuals.
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When the group is attempting to determine a time and place for meetings, the leader, states, “We can discuss when it is best for most members, and then find a place that you would be comfortable with.” This demonstrates which of the following leadership styles? a) Democratic b) Group norms c) Autocratic d) Laissez-faire
answer

Democratic Explanation: The democratic leader encourages group interaction and participation in group problem-solving and decision-making. The leader solicits opinions and tailors the group’s work to common goals. In a laissez-faire leadership style, the group members are free to operate as they choose. In an autocratic leadership style, the leader exercises significant authority and control over the group members. Group norms are the patterns of interaction that develop within the group.
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Some research has indicated that groups with more centralized communication were those groups that worked on a) conflict management. b) low complexity tasks. c) specific themes. d) issues related to biases.
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low complexity tasks. Explanation: Some research (Brown & Miller, 2000) has indicated that groups with more centralized communication worked on low complexity tasks.
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Which of the following is a common problem of the members of an anger management group? a) Timidity b) Shyness c) Lack of conflict d) Impulsiveness
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Impulsiveness Explanation: Impulsiveness and emotional lability are problems for many of the group members.
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Which of the following maintenance roles is responsible for mediating differences among group members and relieves tension in conflict situations? a) Gatekeeper b) Compromiser c) Encourager d) Harmonizer
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Harmonizer Explanation: In a group, the harmonizer mediates differences among members and relieves tension in conflict situations. The encourager praises, agrees with, and accepts the contributions of others. The compromiser operates from within a conflict and may yield status or admit error to maintain group harmony. The gatekeeper attempts to keep communication channels open by encouraging or facilitating the participation of others, or proposes regulation of the flow of communication through limiting time.
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Within a group, facilitating verbal and nonverbal communication to meet treatment goals individually and with the entire group refers to the … a) Individual role b) Maintenance role c) Gate keeper d) Group leader
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Group leader Explanation: One of the responsibilities of group leadership is to facilitate both verbal and nonverbal communication to meet the treatment goals of the individual members and the entire group.
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Cohesiveness is an important factor that correlates with outcomes and must be balanced because too much cohesiveness can result in a) Lack of participation b) Increased social pressure to conform to group standards c) Increased dropout rates d) Decreased job satisfaction
answer

Increased social pressure to conform to group standards Explanation: Too much cohesiveness can exert powerful social pressure to conform to group standards with low tolerance for difference.
question

Enhancing knowledge and improving skills to solve problems, including task groups, refer to … a) Cognitive behaviour groups b) Self-help groups c) Intensive groups d) Psychoeducational groups
answer

Psychoeducational groups Explanation: Psychoeducational groups include task groups that focus on completion of specific activities (e.g., planning a week’s menu) and teaching groups that are used to enhance knowledge, improve skills, or solve problems.
question

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. The nurse should … a) Tell the client that this behavior is unacceptable b) Limit repeated episodes and redirect discussion c) Explore the individual’s thoughts and feelings with the group d) Ask the individual to leave the group
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Limit repeated episodes and redirect discussion Explanation: If the group’s purpose is inconsistent with self-disclosure of personal problems, the nurse should acknowledge the individual members’ distress yet set limits while maintaining the group focus. In this instance, the nurse would limit repeated episodes of self-disclosure from that member or others and redirect discussion to the group task.
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When the group leader uses team-building exercises, the leader is trying to promote which of the following? a) Conflict b) Scapegoating c) Group cohesiveness d) Monopolizing
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Group cohesiveness Explanation: Leaders can encourage cohesiveness by placing participants in situations that promote social interaction with minimal supervision, such as refreshment periods and team-building exercises. Group cohesiveness does not promote scapegoating, monopolizing, or conflict.
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During a group therapy session, a nurse restates the interaction with the client to check the client’s meaning. The nurse is using which technique? a) Clarification b) Support c) Summarizing d) Confrontation
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Clarification Explanation: When the nurse uses clarification, he or she is restating the interaction to check the meaning of the interaction and communication. Summarizing is the use of statements at the end of sessions that highlight the session’s discussion, any problem resolution, and unresolved problems. Support is the giving of feedback that provides a climate of emotional support. Confrontation is challenging a participant to help the individual learn something about him- or herself.
question

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

understanding the group dynamics Explanation: Identification of group themes is important for understanding the group dynamics.
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The nurse acting as a leader for a group of recovering male alcoholics addresses the responsibility of maintaining the group’s process by … a) Selecting individuals for membership in the group b) Determining that the group’s format will be closed c) Deciding how often the group will meet d) Keeping the group on task by restating goals
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Keeping the group on task by restating goals Explanation: In a therapy group, the nurse-therapist has both task and maintenance role functions. Group task functions are concerned with the practical issues of leading a group, whereas group maintenance functions focus on less-tangible group processes. Keeping the group focused on their goals is “maintenance” in its nature. Deciding how often the group will meet, selecting individuals for membership in the group, and determining the group’s format are considered tasks rather than maintenance items.
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The following statements are heard in a group: “You can’t say that because you don’t really know me.” “I wonder if the therapist is going to leave?” and “I’m not sure whether or not I can really talk freely.” These best reflect which of the following group themes? a) Fear for safety b) Loss and abandonment c) Trust and belonging d) Guilt and punishment
answer

Trust and belonging Explanation: The theme expressed in these statements represents the latent lack of trust in the leader or other group members. These statements are not related to guilt and punishment, fear for safety, or loss and abandonment.
question

Individual psychotherapy consists of three phases. Which of the following statements by the group therapist would reflect that the group is in the working phase of therapy? a) “Shane has asked the group if it is acceptable that he be 5 minutes late to each group session because of his job.” b) “We will be meeting once each week for 90 minutes here at this office.” c) “James, when Shane speaks, it seems you become angry and tend to withdraw.” d) “Each of you has shared ideas and thoughts about your personal development. This has been a difficult process, and you have all grown tremendously.”
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“James, when Shane speaks, it seems you become angry and tend to withdraw.” Explanation: During the working phase, client behaviors and feelings are shared, and conflicts may become apparent and be talked about in the group.
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In group counseling sessions, one critical element in both maintaining an individual’s existing behaviors and attitudes and changing them are the group’s … a) themes b) norms c) leadership d) cohesiveness
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norms Explanation: In a group counseling session, one critical element in both maintaining an individual’s existing behaviors and attitudes and changing them are the group’s norms. Norms are rules or standards that establish acceptable behaviors and encourage conformity
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Which type of group is usually associated with clients who have dementia and have difficulty with recent memory? a) Anger management groups b) Reminiscence groups c) Medication groups d) Self-care groups
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Reminiscence groups Explanation: Reminiscence groups are usually associated with clients who have dementia who are having difficulty with recent memory. Recalling distant memories is comforting to patients and improves their well-being. In self-care groups, the leader not only reinforces basic self-care skills but also, more importantly, helps identify strategies that can motivate the clients and provide structure to their daily lives. The purposes of anger management groups are to discuss the concept of anger, identify antecedents to aggressive behavior, and develop new strategies to deal with anger other than verbal and physical aggression. A medication group can be used primarily to transmit information related to medications, such as compliance, management of side effects, and lifestyle adjustments.
question

While conducting a group therapy session, the nurse observes that one participant consistently mediates differences among the participants. The nurse determines that this client is performing a group role termed … a) task b) maintenance c) individual d) gatekeeper
answer

maintenance Explanation: This client is performing the informal role of harmonizer; this is a group maintenance role.
question

The group leader should remain attuned to the nonverbal behavior of group members during each session and monitor the effect on … a) Low complexity tasks b) Group participation c) Group climate and process d) High complexity tasks
answer

Group climate and process Explanation: The leaders should remain attune to the nonverbal behavior of group members during each session and the effect on group climate and process.
question

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) Gatekeeper c) Energizer d) Encourager
answer

Gatekeeper Explanation: The statement reflects the role of the gatekeeper, who attempts to keep communication channels open by encouraging or facilitating the participation of others or proposes regulation of the flow of communication through limiting time. The group observer keeps records of various aspects of the group processes and interprets data to the group. The encourager praises, agrees with, and accepts the contributions of others. The energizer attempts to stimulate the group to action or decision.
question

A basic function of psychiatric nurses is to implement a group that focuses on helping individuals coping with their illness. This refers to … a) Cognitive behaviour therapy group b) Supportive therapy group c) Psychoeducational group d) Interactive group
answer

Supportive therapy group Explanation: Supportive therapy groups are usually less intense than psychotherapy groups and focus on helping individuals cope with their illnesses and problems as well as build interpersonal connections. Implementing supportive therapy groups is one of the basic functions of the psychiatric nurse.
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During which phase of group development does the group realize its purpose? a) Beginning b) Termination c) Working d) Pre-interaction
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Working Explanation: During the working phase, the group realizes its purpose. If the purpose is education, the participants engage in learning new content or skills. In the beginning, the group leader acknowledges each member; constructs a working environment; develops rapport with the members; begins to build a therapeutic relationship; and clarifies outcomes, processes, and skills related to the group’s purpose. In group development, there is not a pre-interaction phase. In the termination phase, members begin to grieve for the loss of the group’s closeness and begin to reestablish themselves as individuals.
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During which phase of group development does the group leader develop rapport with the members? a) Working b) Termination c) Beginning d) Pre-interaction
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Beginning Explanation: In the beginning, the group leader acknowledges each member; constructs a working environment; develops rapport with the members; begins to build a therapeutic relationship; and clarifies outcomes, processes, and skills related to the group’s purpose. In group development, there is not a pre-interaction phase. The working phase of groups involves a real sharing of ideas and the development of closeness. The group develops norms, which are rules and standards that establish acceptable behavior. In the termination phase, members begin to grieve for the loss of the group’s closeness and begin to reestablish themselves as individuals.
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A member of the group is clarifying the goals of the group. The member is exhibiting which role? a) Recorder b) Evaluator-critic c) Orienter d) Coordinator
answer

Orienter Explanation: The orienter defines the position of the group with respect to its goals. The coordinator shows or clarifies the relationships among various ideas and suggestions. Measuring the outcome of the group against some standard is a role of the evaluator-critic. The recorder writes suggestions, keeps minutes, and serves as group memory.
question

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) Recorder b) Information seeker c) Standard setter d) Coordinator
answer

Information seeker Explanation: 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.
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Which of the following group roles 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) Task b) Group building and maintenance c) Individual d) Group cohesion
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Group building and maintenance Explanation: Group building and maintenance roles are oriented toward overall group functioning. They alter or maintain the way of working to strengthen, regulate, and perpetuate the group. Individually oriented behavior, which often stems from anxiety, distracts from and temporarily stymies the group and its progress. Task roles promote growth and productivity. Group cohesion relates to bonding and solidarity, the feeling of “we” instead of “I.”
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The working stage of group therapy is marked by … a) Group members’ concern about confidentiality issues. b) members’ propensity to leave the group. c) therapists’ tendency to “back off” to allow the group to work. d) conflict and cooperation among group members.
answer

conflict and cooperation among group members. Explanation: The group accomplishes its real work during the working phase. Conflict and cooperation indicate that trust has been established and group members are taking risks and working together to create behavior changes. In this stage, conflict and cooperation surface during the group’s work.
question

The nurse has begun group counseling sessions for several hospitalized patients in the psychiatric facility. Which of the following would be most effective for the nurse to do to promote group cohesiveness? a) Encourage task completion by members. b) Use team-building exercises. c) Be consistent with the group themes. d) Spend time with each member individually.
answer

Use team-building exercises. Explanation: To encourage group cohesiveness, the nurse should use team-building exercises or encourage socialization with minimal supervision. Task completion helps to promote achievement of the group’s work but does not necessarily foster group cohesiveness. Spending time with each member may be important to facilitate communication and develop a relationship, but this would not promote group cohesiveness. Each group develops its own group themes.
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A group has been given the assignment of planning their weekend trip. This is an example of which type of group? a) Psychotherapy b) Task c) Supportive therapy d) Decision making
answer

Task Explanation: Task groups focus on the completion of specific activities, such as planning a week’s menu. When members are strongly committed to completing a task and the leader encourages equal participation, cohesiveness promotes satisfaction and higher performance. A psychiatric nurse often leads decision-making groups that plan activities, develop unit rules, and select learning materials. Supportive therapy groups are usually less intense than psychotherapy groups and focus on helping individuals cope with their illnesses and problems. Psychotherapy groups treat individuals’ emotional problems and can be implemented from various theoretical perspectives, including psychoanalytic, behavioral, and cognitive.
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A nurse leader is responsible for mobilizing issues depending on the developmental stage of the group, and to prevent stagnation and support healthy group development. This refers to … a) Decision making b) Task functions c) Therapeutic factors d) Maintenance functions
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Therapeutic factors Explanation: Nurse leaders are responsible for mobilizing therapeutic factors to support healthy group development and prevent a stagnating groupthink. Which factors to mobilize and when depend on the type, purpose, and developmental stage of the group. (less)
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Which of the following is accurate when dealing with older people in groups? a) The pace of the group should be slowed because of possible memory deficits b) Emphasis should be placed on learning new information c) The group should avoid using reminiscence d) The pace of the group should move fast because of memory deficits
answer

The pace of the group should be slowed because of possible memory deficits Explanation: The pace of the group meetings should be slowed. Greater emphasis should be placed on using wisdom and experience rather than learning new information. The group should be encouraged to use life review strategies such as autobiography and reminiscence.
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The nurse is beginning a small group session in an inpatient psychiatric setting. During the initial session, the nurse can anticipate that the members will most likely be a) close b) angry c) polite d) confident
answer

polite Explanation: During the initial session or “honeymoon phase,” the nurse can anticipate that the members of the group will behave in a polite manner. Conflict may occur later.
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A client, John, has been talking to another client, Marcy, about her frequent denial in group for two weeks. On the third week, Marcy comes late to group. When they begin to discuss her lateness, Marcy gets up and leaves. The content of this exchange is the discussion. The process that is occurring may be .. a) John is taking out his frustrations on himself. b) Other group members are not very strong. c) Marcy is angry with John for his confrontation. d) The group leader is not meeting John’s dependency needs.
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Marcy is angry with John for his confrontation. Explanation: A group is three or more people with related goals. Factors that influence these goals include interpersonal and intrapersonal needs, physical environment, and unique group dynamics. Group process involves the underlying feeling, tone, and messages within the group’s interactions.
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Which of the following is a purpose of a medication group? Select all that apply. a) Compliance b) Reviewing insurance c) Lifestyle adjustments d) Ordering medications e) Management of side effects
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• Compliance • Lifestyle adjustments • Management of side effects Explanation: A medication group can be used primarily to transmit information about medications, such as action, dosage, and side effects. It can also focus on issues related to medications, such as compliance, management of side effects, and lifestyle adjustments. Ordering medications and reviewing insurance are not purposes of a medication group.
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The nurse is preparing to form a small group in an inpatient psychiatric setting. In addition to the group leaders, the nurse should select … a) three to four clients. b) nine to ten clients. c) seven to eight clients. d) five to six clients.
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seven to eight clients. Explanation: An ideal size for a small group is seven to eight clients.
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According to Yalom (2005), there are 11 therapeutic factors through which changes occur in group psychotherapy. Which of the following factors correlates with learning to give to others? a) Group cohesiveness b) Altruism c) Catharsis d) Universality
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Altruism Explanation: Altruism is learning to give to others. Universality refers to finding out that others have similar problems. Catharsis is the open expression of affect to purge or “cleanse” oneself. Group cohesiveness is the group members’ relationship to the therapist and other group members.
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Which of the following is an example of a maintenance role for a group member? Select all that apply. a) Standard setter b) Harmonizer c) Aggressor d) Playboy e) Compromiser
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• Harmonizer • Compromiser • Standard setter Explanation: The harmonizer, compromiser, and standard setter are examples of maintenance roles. The playboy and aggressor are examples of individual roles of group members.
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During which group may the client learn how to avoid relapse? a) Anger management b) Self-care c) Reminiscence d) Symptom management
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Symptom management Explanation: Within the context of a symptom management group, clients can learn how to avoid relapse.
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A client diagnosed with antisocial personality disorder is exhibiting aggressive behavior. Which of the following interventions would be most appropriate for this client? a) Self-care group b) Anger management c) Reminiscence therapy d) Symptom management
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Anger management Explanation: The purposes of an anger management group are to discuss the concept of anger, identify antecedents to aggressive behavior, and develop new strategies to deal with anger other than verbal and physical aggression.
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A nurse-therapist has organized group therapy for clients who have been diagnosed with anxiety disorders. The expressed goal of the group is to learn and practice social skills and communication skills for those who have been socially withdrawn due to their anxiety. What type of therapy group is this nurse-therapist seeking to create? a) Support group b) Reeducation and remotivation group c) Insight without reconstruction group d) Problem-solving therapy group
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Reeducation and remotivation group Explanation: Reeducation and remotivation groups are often beneficial for clients who are withdrawn or socially isolated because they attempt to increase communication and interaction among members to foster more acceptable and appropriate behaviors. This is not a central goal of support groups, problem-solving therapy groups, or insight without reconstruction groups.
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Which group member attempts to stimulate the group to action or decision? a) Energizer b) Orienter c) Recorder d) Coordinator
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Group leader Explanation: One of the responsibilities of group leadership is to facilitate both verbal and nonverbal communication to meet the treatment goals of the individual members and the entire group.
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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 needs and if not could they observe by sitting outside of the actual group and observing?
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Does the purpose of the group match the treatment goals of the potential member? Explanation: In instances when a new group is forming, the leader pre-plans, sets criteria for group membership, and invites members so that the group can be well functioning and successful. The leader should consider: Does the purpose of the group match the treatment goals of the potential member?
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Some research has indicated that groups with more centralized communication were those groups that worked on a) issues related to biases. b) conflict management. c) low complexity tasks. d) specific themes.
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low complexity tasks. Explanation: Some research (Brown & Miller, 2000) has indicated that groups with more centralized communication worked on low complexity tasks.
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The advantage of group therapy over individual therapy for a client with a borderline personality disorder is that a) Group theory provides such clients with the personal attention they crave b) Individual therapy is too easily manipulated by such clients c) Individual theory make’s countertransference an extremely likely outcome when such a client is involved d) Group therapy provides the client with relationship opportunities upon which to test behavior modifications
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Group therapy provides the client with relationship opportunities upon which to test behavior modifications Explanation: Group therapy differs from individual therapy in that it is more effective for treating problems with interpersonal relationships such as the client with a borderline personality disorder. It offers multiple relationships to assist the individual in growth and problem solving and allows psychiatric clients a greater opportunity for reality testing and experiencing mutual concern and support.
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A client has recently joined a group and presented a scenario in which she ran out of funds to pay her rent this month. The therapist states, “Has anyone else in the group had this experience? Can you share any ideas about how you resolved this situation when it happened to you?” The therapist’s intervention reflects that she may be utilizing which of the following theories to intervene? a) Reeducational group b) Personality reconstruction group c) Problem-solving group d) Support group
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Problem-solving group Explanation: The intervention attempts to engage the entire group in a problem-solving approach to the client’s current problem.
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A nurse is trying to manage the situation of a disliked member in her or his group and is encountering difficulties in managing the situation. The best action of the nurse is to … a) Identify another leader to take over the group b) Ask the person to leave the group c) Disband the group d) Get supervision from an experienced group leader
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Get supervision from an experienced group leader Explanation: The group leader can manage the situation by showing respect for the disliked member and acknowledging his or her contribution. In some instances, getting supervision from a more experienced group leader is useful.
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Which of the following group characteristics is reflective of the statement: “Our group never talks about really emotional issues. I mean, no one ever cries.” a) Group climate b) Group cohesiveness c) Imparting of information d) Countertransference
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Group climate Explanation: Group climate refers to the emotional tones of the group, such as warm, friendly, cold, or aloof. Group climate is the development, over time, of a pattern of interaction with certain attached behavioral expectations. Countertransference occurs when the therapist responds negatively to the client’s transference, further complicating communication. Group cohesiveness is related to bonding and solidarity, the feeling of “we” instead of “I.” Imparting information is the use of data in a planned, structured manner, such as didactic instruction given in a lecture format.
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While participating in a group therapy session, one group member consistently asks for clarification of the topic the group is discussing. The nurse should identify this participant as performing a group role termed … a) maintenance b) evaluation c) task d) formal
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task Explanation: The client who consistently asks for clarification of topics the group is discussing is an information seeker and is performing an informal group role termed “task.”
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Which of the following statements would indicate that the group is in the working phase of development? a) “I’m not sure what we are supposed to be talking about.” b) “What have you learned, and how will you take this out into your life?” c) “I don’t understand why Mary doesn’t see my point of view, and frankly it really irritates me when she does that!” d) “Let’s go around the circle and tell one thing that you enjoy doing.”
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“I don’t understand why Mary doesn’t see my point of view, and frankly it really irritates me when she does that!” Explanation: In the working phase members confront each other with constructive feedback and honesty to gain insight into dysfunction. The initial stage of group development occurs when members are becoming acquainted and searching for similarity between themselves and others. The mature stage of the group demonstrates positive characteristics such as empathy, effective communication, and a definite, inclusive group culture. The termination stage encompasses when the group evaluates and explores members’ feelings about it and the impending separation.
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When assuming the responsibility for leading a couples therapy group, the nurse-therapist helps clients deal appropriately with their emotions, behaviors, and beliefs as well as a) Understanding the importance of accepting the personality traits of their partner b) Changing these characteristics if they are the cause of problems with their partner c) Being aware of how they affect the relationship with their partner d) Learning to negotiate for their wants fairly and effectively with their partner
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Being aware of how they affect the relationship with their partner Explanation: The role of the nurse-therapist in couples therapy is to assist clients in dealing constructively with thoughts, emotions, and behaviors and to persuade each partner in the relationship to take responsibility in understanding the psychodynamic makeup of the personality.
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A group has been given the assignment of planning their weekend trip. This is an example of which type of group? a) Supportive therapy b) Decision making c) Psychotherapy d) Task
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Task Explanation: Task groups focus on the completion of specific activities, such as planning a week’s menu. When members are strongly committed to completing a task and the leader encourages equal participation, cohesiveness promotes satisfaction and higher performance. A psychiatric nurse often leads decision-making groups that plan activities, develop unit rules, and select learning materials. Supportive therapy groups are usually less intense than psychotherapy groups and focus on helping individuals cope with their illnesses and problems. Psychotherapy groups treat individuals’ emotional problems and can be implemented from various theoretical perspectives, including psychoanalytic, behavioral, and cognitive.
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Which of the following is an example of a verbal communication technique? a) Mood b) Eye contact c) Posture d) Group theme
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Group theme Explanation: Verbal communication includes the communication network and group themes. Nonverbal communication is more complex and involves eye contact, body posture, and the mood of the group.
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In group counseling sessions, one critical element in both maintaining an individual’s existing behaviors and attitudes and changing them are the group’s … a) norms b) leadership c) themes d) cohesiveness
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norms Explanation: In a group counseling session, one critical element in both maintaining an individual’s existing behaviors and attitudes and changing them are the group’s norms. Norms are rules or standards that establish acceptable behaviors and encourage conformity.
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All except which of the following are therapeutic factors identified by Yalom? a) Universality b) Regulation c) Existentialism d) Altruism
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Regulation Explanation: Universality, altruism, and existential awareness are all factors that operate within a group to make group work therapeutic. Regulation refers to an individual’s self efforts in relation to others, not a process between group members.
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The psychiatric nurse-therapist shows attention to the primary role of a group leader when a) Providing various activities to promote group respect and loyalty b) Congratulating individual members when they show improvement with their issues c) Agreeing to reschedule the weekly meetings when the group suggests a more acceptable time d) Anticipating that the group will need support in mastering new coping skills
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Anticipating that the group will need support in mastering new coping skills Explanation: The primary role of the nurse-therapist in group therapy is to guide individuals through a problem-solving process by anticipating and responding to the needs and concerns of group members. The primary role of nurse-therapist in group therapy is not to reschedule meetings, provide activities, or congratulate members, though these may all be important responsibilities.