Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain the purposes that therapeutic groups fulfill.

Question 16

Type: MCSA

The nurse is planning a psychoeducation group for substance abusers and is conducting selection interviews. Which of the following individuals with substance abuse issues would not be an appropriate member?

1. A client who has attended AA meetings in the past

2. A client who has been court ordered to attend group therapy

3. A client who has recently been promoted to district manager

4. A client who is also being treated for a psychiatric illness

Correct Answer: 3

Rationale 1: Major life changes may prevent the clients full and continued participation in the group. The client who has been court ordered to attend group may be in denial but has an external motivation to attend group. Clients being treated for a psychiatric illness and who have attended AA meetings in the past have a history of group involvement and know what to expect from group therapy.

Rationale 2: Major life changes may prevent the clients full and continued participation in the group. The client who has been court ordered to attend group may be in denial but has an external motivation to attend group. Clients being treated for a psychiatric illness and who have attended AA meetings in the past have a history of group involvement and know what to expect from group therapy.

Rationale 3: Major life changes may prevent the clients full and continued participation in the group. The client who has been court ordered to attend group may be in denial but has an external motivation to attend group. Clients being treated for a psychiatric illness and who have attended AA meetings in the past have a history of group involvement and know what to expect from group therapy.

Rationale 4: Major life changes may prevent the clients full and continued participation in the group. The client who has been court ordered to attend group may be in denial but has an external motivation to attend group. Clients being treated for a psychiatric illness and who have attended AA meetings in the past have a history of group involvement and know what to expect from group therapy.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design a therapeutic group based on the needs and personality characteristics of potential members.

Question 17

Type: MCSA

The nurse is planning a group to rehabilitate sex offenders in a forensic psychiatric hospital. Which of the following factors would most likely decrease the degree of trust and cohesion among the members?

1. One hour weekly sessions

2. Addition of new members

3. Confidentiality rights of victims

4. Member interaction outside the group

Correct Answer: 2

Rationale 1: Closed groups with a stable membership experience a higher degree of trust and cohesion. If new members or outsiders are allowed to attend, a new dynamic occurs and time is needed to rebuild trust. One hour weekly sessions would encourage trust and cohesion. There are no confidentiality rights of victims to consider. Member interaction outside the group cannot be avoided in a locked environment such as a prison or forensic psychiatric hospital and would most likely not be an issue in the development of trust and cohesion.

Rationale 2: Closed groups with a stable membership experience a higher degree of trust and cohesion. If new members or outsiders are allowed to attend, a new dynamic occurs and time is needed to rebuild trust. One hour weekly sessions would encourage trust and cohesion. There are no confidentiality rights of victims to consider. Member interaction outside the group cannot be avoided in a locked environment such as a prison or forensic psychiatric hospital and would most likely not be an issue in the development of trust and cohesion.

Rationale 3: Closed groups with a stable membership experience a higher degree of trust and cohesion. If new members or outsiders are allowed to attend, a new dynamic occurs and time is needed to rebuild trust. One hour weekly sessions would encourage trust and cohesion. There are no confidentiality rights of victims to consider. Member interaction outside the group cannot be avoided in a locked environment such as a prison or forensic psychiatric hospital and would most likely not be an issue in the development of trust and cohesion.

Rationale 4: Closed groups with a stable membership experience a higher degree of trust and cohesion. If new members or outsiders are allowed to attend, a new dynamic occurs and time is needed to rebuild trust. One hour weekly sessions would encourage trust and cohesion. There are no confidentiality rights of victims to consider. Member interaction outside the group cannot be avoided in a locked environment such as a prison or forensic psychiatric hospital and wouldmost likely not be an issue in the development of trust and cohesion.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Design a therapeutic group based on the needs and personality characteristics of potential members.

Question 18

Type: MCSA

A few members of an outpatient group have begun meeting socially in a local restaurant for coffee and donuts before going to work each day. What should the group therapist leader do in this situation?

1. Discourage social meetings outside regular group sessions

2. Encourage all members to meet for coffee and donuts each morning

3. Join the members a few mornings a week

4. Suggest meeting for dinner once a week instead

Correct Answer: 1

Rationale 1: Members in outpatient groups are discouraged from having relationships with other members outside the meetings. Relationships outside of the group are likely to interfere with the group dynamics because of the formation of social coalitions or dyads.

Rationale 2: Members in outpatient groups are discouraged from having relationships with other members outside the meetings. Relationships outside of the group are likely to interfere with the group dynamics because of the formation of social coalitions or dyads.

Rationale 3: Members in outpatient groups are discouraged from having relationships with other members outside the meetings. Relationships outside of the group are likely to interfere with the group dynamics because of the formation of social coalitions or dyads.

Rationale 4: Members in outpatient groups are discouraged from having relationships with other members outside the meetings. Relationships outside of the group are likely to interfere with the group dynamics because of the formation of social coalitions or dyads.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design a therapeutic group based on the needs and personality characteristics of potential members.

Question 19

Type: MCSA

The nursing student knows that group interaction requires the therapist to focus attention on each members feelings toward other group members, the therapists, and the group to illuminate relationship implications of interpersonal transactions. This process is known as:

1. Interactional group therapy.

2. The here-and-now.

3. Process illumination.

4. Objective family burden.

Correct Answer: 2

Rationale 1: The core of interactional group therapy is the here-and-now. According to Yalom (2005), the here-and-now work of the interactional group therapist occurs on two levels: focusing attention on each members feelings toward other group members, the therapists, and the group and illuminating the process (the relationship implications of interpersonal transactions).

Objective family burden refers to the impact on the family of a person with mental illness. The here-and-now is an aspect of interactional group therapy.

Rationale 2: The core of interactional group therapy is the here-and-now. According to Yalom (2005), the here-and-now work of the interactional group therapist occurs on two levels: focusing attention on each members feelings toward other group members, the therapists, and the group and illuminating the process (the relationship implications of interpersonal transactions).

Objective family burden refers to the impact on the family of a person with mental illness. The here-and-now is an aspect of interactional group therapy.

Rationale 3: The core of interactional group therapy is the here-and-now. According to Yalom (2005), the here-and-now work of the interactional group therapist occurs on two levels: focusing attention on each members feelings toward other group members, the therapists, and the group and illuminating the process (the relationship implications of interpersonal transactions).

Objective family burden refers to the impact on the family of a person with mental illness. The here-and-now is an aspect of interactional group therapy.

Rationale 4: The core of interactional group therapy is the here-and-now. According to Yalom (2005), the here-and-now work of the interactional group therapist occurs on two levels: focusing attention on each members feelings toward other group members, the therapists, and the group and illuminating the process (the relationship implications of interpersonal transactions).

Objective family burden refers to the impact on the family of a person with mental illness. The here-and-now is an aspect of interactional group therapy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Apply the process of here-and-now activation to a therapeutic group.

Question 20

Type: MCSA

During a group session, a client becomes very angry at a comment by another member of the group. The therapist asks why the client became so angry. The group is using:

1. Events for emotional awareness.

2. Interpersonal conflict issues to resolve personal issues.

3. The self-reflective loop.

4. Fear.

Correct Answer: 3

Rationale 1: The self-reflective loop considers what happened and reflects back on why it happened. The self-reflective loop process may result in emotional awareness and resolution of personal issues. Fear is not a factor in the self-reflective loop.

Rationale 2: The self-reflective loop considers what happened and reflects back on why it happened. The self-reflective loop process may result in emotional awareness and resolution of personal issues. Fear is not a factor in the self-reflective loop.

Rationale 3: The self-reflective loop considers what happened and reflects back on why it happened. The self-reflective loop process may result in emotional awareness and resolution of personal issues. Fear is not a factor in the self-reflective loop.

Rationale 4: The self-reflective loop considers what happened and reflects back on why it happened. The self-reflective loop process may result in emotional awareness and resolution of personal issues. Fear is not a factor in the self-reflective loop.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Apply the process of here-and-now activation to a therapeutic group.

Question 21

Type: MCSA

The nurse knows that the primary task of the interactional group therapist is to make sure events in the session take precedence over:

1. Outside events.

2. Illness prevention.

3. Family matters.

4. Individual therapy.

Correct Answer: 1

Rationale 1: A primary task of the therapist is to actively steer the group discourse toward events in the session (the here-and-now) over those that occur outside or have occurred outside (the there-and-then).The work of the interactional group is not intended to displace individual therapy, prevent illness, or place priority on outside family matters.

Rationale 2: A primary task of the therapist is to actively steer the group discourse toward events in the session (the here-and-now) over those that occur outside or have occurred outside (the there-and-then).The work of the interactional group is not intended to displace individual therapy, prevent illness, or place priority on outside family matters.

Rationale 3: A primary task of the therapist is to actively steer the group discourse toward events in the session (the here-and-now) over those that occur outside or have occurred outside (the there-and-then).The work of the interactional group is not intended to displace individual therapy, prevent illness, or place priority on outside family matters.

Rationale 4: A primary task of the therapist is to actively steer the group discourse toward events in the session (the here-and-now) over those that occur outside or have occurred outside (the there-and-then).The work of the interactional group is not intended to displace individual therapy, prevent illness, or place priority on outside family matters.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Apply the process of here-and-now activation to a therapeutic group.

Question 22

Type: MCSA

The therapist for an interactive therapy group has noticed some behaviors among the members that need to be made overt. The therapist would be concerned about:

1. Expressing affection and sorrow.

2. Suggesting alternatives and denigrating each other.

3. Power struggles and attention-seeking.

4. Seeking social support and increasing conflict.

Correct Answer: 3

Rationale 1: Power struggles between members in therapy groups should be made overt. Seeking social support, suggesting alternatives, and expressing affection are usually appropriate activities in therapy groups. Increasing conflict and denigrating other group members is inappropriate behavior. Expressing sorrow may or may not be appropriate behavior.

Rationale 2: Power struggles between members in therapy groups should be made overt. Seeking social support, suggesting alternatives, and expressing affection are usually appropriate activities in therapy groups. Increasing conflict and denigrating other group members is inappropriate behavior. Expressing sorrow may or may not be appropriate behavior.

Rationale 3: Power struggles between members in therapy groups should be made overt. Seeking social support, suggesting alternatives, and expressing affection are usually appropriate activities in therapy groups. Increasing conflict and denigrating other group members is inappropriate behavior. Expressing sorrow may or may not be appropriate behavior.

Rationale 4: Power struggles between members in therapy groups should be made overt. Seeking social support, suggesting alternatives, and expressing affection are usually appropriate activities in therapy groups. Increasing conflict and denigrating other group members is inappropriate behavior. Expressing sorrow may or may not be appropriate behavior.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Develop process commentary appropriate to the level and purposes of the group.

Question 23

Type: MCSA

During group therapy, a male client laughs inappropriately and rolls his eyes when another male client discusses his feelings about coming out as a homosexual. The group therapist asks the first client to explain his reaction to the rest of the group. This process is an example of:

1. Taboo behavior.

2. Clearing the air.

3. Hidden homosexuality.

4. Attention-seeking and power struggles.

Correct Answer: 2

Rationale 1: Clearing the air (making covert interpersonal difficulties overt) is an integral partof illuminating the process. The group must move beyond a focus on content toward a focus on processthe how and the why of an interaction. The members must recognize, examine, and understand the process and be willing to self-disclose to avoid future conflicts and detrimental behaviors.

Rationale 2: Clearing the air (making covert interpersonal difficulties overt) is an integral partof illuminating the process. The group must move beyond a focus on content toward a focus on processthe how and the why of an interaction. The members must recognize, examine, and understand the process and be willing to self-disclose to avoid future conflicts and detrimental behaviors.

Rationale 3: Clearing the air (making covert interpersonal difficulties overt) is an integral part of illuminating the process. The group must move beyond a focus on content toward a focus on processthe how and the why of an interaction. The members must recognize, examine, and understand the process and be willing to self-disclose to avoid future conflicts anddetrimental behaviors.

Rationale 4: Clearing the air (making covert interpersonal difficulties overt) is an integral partof illuminating the process. The group must move beyond a focus on content toward a focus on processthe how and the why of an interaction. The members must recognize, examine, and understand the process and be willing to self-disclose to avoid future conflicts and detrimental behaviors.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Develop process commentary appropriate to the level and purposes of the group.

Question 24

Type: MCSA

Which of the following group therapies would be most helpful for clients diagnosed with severe and persistent schizophrenia who are living in a nursing home?

1. Bible-study groups

2. Dialectical behavior groups

3. Mutual-help groups

4. Social skills training groups

Correct Answer: 4

Rationale 1: Older people with severe and persistent schizophrenia can learn and maintain new skills and report improved functioning after cognitive behavioral social skills training. Mutual help groups do not provide enough structure for schizophrenic clients. Bible study groups may increase religious delusions. Dialectical behavior groups require understanding of abstract concepts that may be too difficult for severe and persistent schizophrenic clients to grasp.

Rationale 2: Older people with severe and persistent schizophrenia can learn and maintain new skills and report improved functioning after cognitive behavioral social skills training. Mutual help groups do not provide enough structure for schizophrenic clients. Bible study groups may increase religious delusions. Dialectical behavior groups require understanding of abstract concepts that may be too difficult for severe and persistent schizophrenic clients to grasp.

Rationale 3: Older people with severe and persistent schizophrenia can learn and maintain new skills and report improved functioning after cognitive behavioral social skills training. Mutual help groups do not provide enough structure for schizophrenic clients. Bible study groups may increase religious delusions. Dialectical behavior groups require understanding of abstract concepts that may be too difficult for severe and persistent schizophrenic clients to grasp.

Rationale 4: Older people with severe and persistent schizophrenia can learn and maintain new skills and report improved functioning after cognitive behavioral social skills training. Mutual help groups do not provide enough structure for schizophrenic clients. Bible study groups may increase religious delusions. Dialectical behavior groups require understanding of abstract concepts that may be too difficult for severe and persistent schizophrenic clients to grasp.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Maintain a therapeutic group based on the needs of a specific population in inpatient or community settings.

Question 25

Type: MCSA

Clients with chronic persistent mental illness have been attending a creative activities group which focuses on expression of feelings through poetry, music, and art. What client behaviors would be expected?

1. Increased paranoid delusions

2. Increased physical activity

3. Increased auditory hallucinations

4. Increased social interaction and self-esteem

Correct Answer: 4

Rationale 1: Activity therapies are manual, recreational, and creative techniques tofacilitate personal experiences and increase social responses and self-esteem.

Rationale 2: Activity therapies are manual, recreational, and creative techniques tofacilitate personal experiences and increase social responses and self-esteem.

Rationale 3: Activity therapies are manual, recreational, and creative techniques tofacilitate personal experiences and increase social responses and self-esteem.

Rationale 4: Activity therapies are manual, recreational, and creative techniques tofacilitate personal experiences and increase social responses and self-esteem.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Maintain a therapeutic group based on the needs of a specific population in inpatient or community settings.

Question 26

Type: MCSA

You are a nurse manager of an ICU in a local hospital and have lost two nurses on your staff. One nurse quit and the other nurse is receiving treatment in a center for alcohol abuse. What type of group would you recommend to your staff before considering a transfer or quitting?

1. Nurse-to-nurse support group

2. Nurse storytelling group

3. Nurse bibliotherapy group

4. Nurse Alcoholics Anonymous group

Correct Answer: 1

Rationale 1: Nurses who work together may form discussion and counseling groups to help reduce their job-related stress and to help them deal with problems of interpersonal relationships in more satisfying ways. Nurses in various intensive care and other high-pressure settings identify with increasing frequency the need for group work services that the psychiatricmental health nurse can provide.

Rationale 2: Nurses who work together may form discussion and counseling groups to help reduce their job-related stress and to help them deal with problems of interpersonal relationships in more satisfying ways. Nurses in various intensive care and other high-pressure settings identify with increasing frequency the need for group work services that the psychiatricmental health nurse can provide.

Rationale 3: Nurses who work together may form discussion and counseling groups to help reduce their job-related stress and to help them deal with problems of interpersonal relationships in more satisfying ways. Nurses in various intensive care and other high-pressure settings identify with increasing frequency the need for group work services that the psychiatricmental health nurse can provide.

Rationale 4: Nurses who work together may form discussion and counseling groups to help reduce their job-related stress and to help them deal with problems of interpersonal relationships in more satisfying ways. Nurses in various intensive care and other high-pressure settings identify with increasing frequency the need for group work services that the psychiatricmental health nurse can provide.

Chapter 12. Family Therapy

Question 1

Type: MCSA

A client with a diagnosis of bipolar disorder lives with his family and discontinues taking medication when he begins feeling his symptoms are under control. Family members express their concern to the clients therapist whenever they realize the client is off his meds. The therapist understands that within the clients family, each persons behavior is contingent on and:

1. Reflects the characteristics of the clients family.

2. Affects the behavior of others.

3. Is affected by the functionality of the group.

4. Is reflective of the clients mental illness.

Correct Answer: 2

Rationale 1: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Rationale 2: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Rationale 3: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Rationale 4: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub: