Lone Star College System, North Harris - PSYC 1301

Chapter 31: Therapeutic Groups Test Bank

MULTIPLE CHOICE

1)Which question should a nurse pose initially to a patient being considered for inclusion into a therapeutic group that focuses on the management of bipolar disorder?

1. 1. “Do you find it difficult to talk to people about your manic periods?”
   2. “Can you share with me what it is you hope to gain from this group?”
   3. “Can you tell me how this diagnosis has affected your daily life?”
   4. “What is your opinion about joining a therapeutic group?”

2. Which statement should a nurse make in the orientation stage of the initial phase of a therapeutic group?
   1. “I’d like to take this opportunity to review the goals for this group.”
   2. “You all are experiencing similar challenges, and this group will help you develop a support network.”
   3. “The group is about sharing both your challenges and your successes with each other.”
   4. “Please be sure to attend as many meetings as possible; it is important that you be here for yourself and the group.”

3. Which statement by the nurse reflects the best understanding of the issues that are addressed when establishing the contract for a therapeutic group?
   1. “What is said in this group is confidential and will not be discussed outside the meeting.”
   2. “The group contract cannot be broken and will not be altered once it is agreed on by the entire group.”
   3. “You may bring food and beverages to the meeting, but we will be responsible for cleaning up the room when we are finished.”
   4. “In order to best think about what we learn in this group each of you will be asked to write your thoughts in a personal journal.”

4. One patient in a social skills group shares, “I feel like I’m the only one who says anything in here.” Which statement made by the nurse facilitator would have the greatest therapeutic effect on the group?
   1. “Can anyone in this group respond to the statement?”
   2. “The reason you feel this way is because you do all the talking.”
   3. “Does everyone agree that no other members have participated in discussion?”
   4. “I agree that you have contributed greatly to the discussion in today’s group.”

5. A patient in a therapeutic group expresses resistance by stating, “I need to drop out of this group because I don’t think I’m getting enough from it.” Which outcome would be most appropriate for this patient?
   1. The patient stays in the group and works out problems.
   2. The patient leaves the group and enters individual therapy.
   3. The patient stays in the group but enters long-term psychotherapy.
   4. The patient leaves the group and enters one that provides more one-on-one time.

6. A group member says to a nurse facilitator, “Why don’t you say something? It’s not just me; there are others in this group who feel that you could do more in here.” Which statement shows the best therapeutic communication on the part of the nurse?
   1. “So, you and others feel that I ‘could do more in here’?”
   2. “You sound enraged. Let’s discuss what is making you so angry with me.”
   3. “I don’t remember the group contract requiring that I actively participate in the discussions.”
   4. “If I understand you correctly, you and others in this group feel that I should take a more active role in group sessions?”

7. Which of these observations would indicate to the nurse facilitator that some members of a therapeutic anger management group are demonstrating resistance?
   1. Four of the group members share that the discussion is making them sad.
   2. Three members claim, “We don’t have problems controlling our tempers.”
   3. Two of the members are overheard discussing their fear of “disappointing the nurse.”
   4. Several members share that they have physically and verbally abused their significant others in the past.

8. A member of a social skills group says, “I’m leaving town. I’ve been offered a better job, and I want to create new memories with new friends.” Which nursing intervention would initially be the most therapeutic facilitation of this member’s termination from the group?
   1. Thank the member for sharing before focusing on the group’s agenda.
   2. Provide adequate time for the members to exchange goodbyes with each other.
   3. Direct group reflection regarding the ultimate termination of the group itself.
   4. Allow the members to share any negative feelings regarding the termination.

9. After facilitating a therapeutic group, the nurse leader separately documents both individual and group data. Which observation would the nurse leader include in an individual note?
   1. Group focused on results of medication noncompliance.
   2. Member successfully identified the likely causes for recent relapse.
   3. Three group members asked to change the time of scheduled sessions.
   4. Decision was made to discuss reasons for acceptable absenteeism at next session.

10. Which nursing intervention would the nurse employ to help reduce group resistance?
    1. Review accepted guidelines in the group’s orientation stage.
    2. Make group acceptance criteria as nonrestricting as possible.
    3. Employ pretesting and posttesting regarding each session topic.
    4. Avoid personal consequences for member absenteeism and tardiness.

Clear group guidelines that have been reviewed during the screening process and with the group will help reduce group resistance.

11. A nurse who facilitates a group for parents of children diagnosed with schizophrenia joins a peer support group for advanced practice psychiatric nurses. Which comment indicates that the nurse is using this group appropriately?
    1. “I love my work, but if you measure your success by the money you earn, nursing is not the profession for you.”
    2. “Are any of you married or have young children? Working as a nurse is certainly challenging if you have children at home.”
    3. “I am feeling so ineffective since a member’s child was found dead after having spent the night sleeping outside in the cold.”
    4. “Do any of you have a family member or friend who has been diagnosed with schizophrenia? We can talk about your concerns after the meeting.”

12. Which length of time should a nurse allocate for a session focusing on the drug fluphenazine (Prolixin) with a medication group for cognitively impaired patients diagnosed with schizophrenia?

1. 1. 20 minutes
   2. 50 minutes
   3. 60 minutes
   4. 130 minutes

13. The nurse is leading a therapy session dealing with group guidelines. The nurse is confident that a chronically late patient is demonstrating a maintenance role when she states:
    1. “I guess the reason I’m chronically late is that I don’t particularly value what we do in here. Who believes that this stuff really works outside this group?”
    2. “I know that I struggle to be on time, too. Can we agree to try to be on time and that we will start the group session after waiting only 5 minutes?”
    3. “Although the rules were agreed on by everyone when the group was formed, I believe we should review them now.”
    4. “I thought we agreed last week that the rule was that everyone needed to be on time if possible.”

14. During a group session one member accuses another of making fun of him to a nonmember. The other member denies the claim, adding, “I wasn’t talking about you at all.” Which response by the nurse would have the greatest therapeutic value to the issue of group confidentiality?
    1. “I’m very disappointed to hear that confidentiality is not taken seriously by members of this group.”
    2. “It sounds as though neither of you are acting in a manner that is mutually respectful. What do the rest of you think?”
    3. “It appears that we need to revisit the guidelines for group meetings. Do we all agree that what is discussed in this group needs to stay in the group?”
    4. “While there may be times when we are tempted to talk with others about things discussed in group, it is not allowed because it could result in hurt feelings.”

15. Which comment by the nurse would be most therapeutic when a group member challenges a nurse leader’s authority?
    1. “Who do you think should be the group leader, if not me?”
    2. “So you’re asking, ‘Who made me the leader?’”
    3. “Do you want to be the group leader?”
    4. “You resist my authority?”

16. Which goal applies to a brief therapy group?
    1. Determine the underlying cause of the chief problem.
    2. Identify maladaptive behaviors that hinder recovery.
    3. Substitute ineffective strategies with effective ones.
    4. Facilitate members’ abilities to effectively manage self-care.

17. What outcome would be most important for a nurse facilitator to include in a plan of care for a support group for parents of children with attention-deficit/hyperactivity disorder (ADHD)? Parents will be able to:
    1. parent all children in the family with equality.
    2. share feelings with other members of the group.
    3. assist hyperactive children to modify their behavior.
    4. discipline all children with equal negative reinforcement.

18. A member in a psychotherapy group tells another member, “I’m tired of hearing you whine all the time. Why won’t you just try to stick with the topic we are trying to discuss?” The nurse recognizes that the criticized member of the group best understands the goal of group work when he is heard stating:
    1. “You are always criticizing me. Don’t talk to me like that.”
    2. “I understand that you have a hard time talking with people. I do too.”
    3. “You seem to always say nasty things that will hurt people’s feelings. Maybe you should think before you speak.”
    4. “I’ve learned that speaking without thinking often results in hurt feelings. We all need to think before we speak.”

19. Which is an appropriate nurse-led educational group?
    1. Smoking cessation group
    2. Parents without partners
    3. A medication group
    4. Grieving a loss

20. Which documentation by a nurse leader best indicates that the group was demonstrating an appropriate pattern of interaction during the group process?
    1. Not all group members chose to communicate equally on the topics discussed.
    2. Members removed unused chairs because they felt the chairs were a distraction.
    3. Group members shared today while the group was in session.
    4. The absence of one member was noted by the group.