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PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Pages 34-8, 9, 18 (Table 34-1), 26 (Table 34-6)

TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

22. A nurse leads a psychoeducational group for patients in the community diagnosed with schizophrenia. A realistic outcome for group members is that they will a. discuss ways to manage their illness. b. develop a high level of trust and cohesiveness. c. understand unconscious motivation for behavior. d. demonstrate insight about development of their illness.

ANS: A

Patients with schizophrenia almost universally have problems associated with everyday living in the community, so discussing ways to manage the illness would be an important aspect of psychoeducation. Discussing concerns about daily life would be a goal to which each could relate. Developing trust and cohesion is desirable but is not the priority outcome of a psychoeducational group. Understanding unconscious motivation would not be addressed. Insight would be difficult for a patient with residual schizophrenia because of the tendency toward concrete thinking.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 34-4, 22 (Table 34-4), 27 (Table 34-7)

TOP: Nursing Process: Outcomes Identification

MSC: Client Needs: Psychosocial Integrity

23. A patient in a detoxification unit asks, “What good it will do to go to Alcoholics Anonymous and talk to other people with the same problem?” The nurse’s best response would be to explain that self-help groups such as AA provide opportunities for a. newly discharged alcoholics to learn about the disease of alcoholism. b. people with common problems to share their experiences with alcoholism and recovery. c. patients with alcoholism to receive insight-oriented treatment about the etiology of their disease. d. professional counselors to provide guidance to individuals recovering from alcoholism.

ANS: B

The patient needs basic information about the purpose of a self-help group. The basis of self-help groups is sharing by individuals with similar problems. Self-help is based on the belief that an individual with a problem can be truly understood and helped only by others who have the same problem. The other options fail to address this or provide incorrect information.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 34-23 (Table 34-5), 34 (Box 34-4)

TOP: Nursing Process: Outcomes Identification

MSC: Client Needs: Psychosocial Integrity a. Psychodynamic/psychoanalytic group b. Medication education group c. Existential/Gestalt group d. Family therapy group

24. Which type of group is a staff nurse with 2 months’ psychiatric experience best qualified to conduct?

ANS: B

All nurses receive information about patient teaching strategies and basic information about psychotropic medications, making a medication education group a logical group for a beginner to conduct. The other groups would need a leader with more education and experience.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 34-8, 22 (Table 34-4), 23 (Table 34-5)

MSC: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Planning

Multiple Response

1. The next-to-last meeting of an interpersonal therapy group is taking place. The leader should take which actions? (Select all that apply.)

a. Support appropriate expressions of disagreement by the group’s members.

b. Facilitate discussion and resolution of feelings about the end of the group.

c. Encourage members to reflect on their progress and that of the group itself.

d. Remind members of the group’s norms and rules, emphasizing confidentiality.

e. Help members identify goals they would like to accomplish after the group ends.

f. Promote the identification and development of new options for solving problems.

ANS: B, C, E

The goals for the termination phase of groups are to prepare the group for separation, resolve related feelings, and prepare each member for the future. Contributions and accomplishments of members are elicited, post-group goals are identified, and feelings about the group’s ending are discussed. Group norms are the focus of the orientation phase, and conflict and problem solving are emphasized in the working phase.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 34-6, 7, 18 (Table 34-1), 26 (Table 34-6)

TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity a. “We use groups to provide treatment because it’s a more cost-effective use of staff in this time of budget constraints.” b. “When someone shares a personal experience, it’s important to keep the information confidential.” c. “Talking to family members about our group discussions will help us achieve our goals.” d. “Everyone is expected to share a personal experience at each group meeting.” e. “It is important for everyone to arrive on time for our group.”

2. A leader begins the discussion at the first meeting of a new group. Which comments should be included? (Select all that apply.)

ANS: B, E