Test bank for essentials of psychiatric mental health nursing 5th edition by townsend

Test Bank for Essentials of Psychiatric Mental Health Nursing 5th Edition by
Townsend
Essentials of Psychiatric Mental Health Nursing: 5th Edition Test Bank –
Townsend
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Chapter 9: Intervention in Groups
Multiple Response
Identify one or more choices that best complete the statement or answer the
question.
____ 1. Which client behaviors would lead a nurse to identify the group member
who has assumed the maintenance
role? (Select all that apply.)
A. A client decreases conflict within the group by encouraging compromise.
B. A client offers recognition and acceptance of others.
C. A client outlines the task at hand and proposes solutions.
D. A client listens attentively to group interaction.
E. A client uses the group to gain sympathy from others.
____ 2. Which behavioral skills should a nurse implement when leading a group
that is functioning in the orientation
phase of group development? (Select all that apply.)
A. Encouraging members to provide feedback to each other about individual
progress.
B. Ensuring that group rules do not interfere with goal fulfillment.
C. Working with group members to establish rules that will govern the group.
D. Emphasizing the need for and importance of confidentiality within the group.
E. Helping the leader to resolve conflicts and foster cohesiveness within the group.
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. During a therapeutic group, a client talks about personal accomplishments
in an effort to gain attention. A

nurse identifies this client as assuming which group role?
A. Gatekeeper


B. Recognition seeker
C. Dominator
D. Elaborator
____ 2. During a therapeutic group, two clients engage in an angry verbal
exchange. The nurse leader interrupts the
exchange and excuses both of the clients from the group. Which leadership style
has the nurse demonstrated?
A. Autocratic
B. Democratic
C. Laissez-faire
D. Bureaucratic
____ 3. In which situation does a nurse leader demonstrate a laissez-faire
leadership style?
A. Mandates that all group members reveal an embarrassing personal situation.
B. Asks for a show of hands to determine group topic preference.
C. Sits silently as the group members veer away from the assigned topic.
D. Shuffles through papers to determine the facility policy on length of group.
____ 4. During a community meeting, a nurse encourages clients to present unit
problems and discuss possible
solutions. Which type of leadership style is the nurse demonstrating?
A. Democratic
B. Autocratic
C. Laissez-faire
D. Bureaucratic
____ 5. Which situation should a nurse identify as an example of an autocratic
leadership style?

A. The president of Sigma Theta Tau assigns members to committees to research
problems.
B. Without faculty input, the dean mandates that all course content be delivered via
the
Internet.
C. During a community meeting, a nurse listens as clients generate solutions.
D. The student nurses’ association advertises for candidates for president.
____ 6. A single, pregnant teenager in a parenting class discloses her ambivalence
toward the pregnancy and the
subsequent guilt that these thoughts generate. A mother of three admits to having
felt that way herself. Which
of Yalom’s curative group factors does this illustrate?
A. Imparting of information
B. Instillation of hope


C. Altruism
D. Universality
____ 7. A man diagnosed with alcohol dependence experiences his first relapse.
During his AA meeting, another
group member states, “I relapsed three times, but now have been sober for 15
years.” Which of Yalom’s
curative group factors does this illustrate?
A. Imparting of information
B. Instillation of hope
C. Catharsis
D. Universality
____ 8. During a group discussion, members freely interact with each other. Which
member statement is an example
of Yalom’s curative group factor of imparting of information?

A. “I found a Web site explaining the different types of brain tumors and their
treatment.”
B. “My brother also had a brain tumor and now is completely cured.”
C. “I understand your fear and will be by your side during this time.”
D. “My mother was also diagnosed with cancer of the brain.”
____ 9. Prayer group members at a local Baptist church are meeting with a poor,
homeless family whom they are
supporting. Which member statement is an example of Yalom’s curative group
factor of altruism?
A. “I’ll give you the name of a friend that rents inexpensive rooms.”
B. “The last time we helped a family, they got back on their feet and prospered.”
C. “I can give you all of my baby clothes for your little one.”
D. “I can appreciate your situation. I had to declare bankruptcy last year.”
____ 10. During an inpatient educational group, a client shouts out, “This
information is worthless. Nothing you have
said can help me.” These statements indicate to a nurse leader that the client is
assuming which group role?
A. The group role of aggressor.
B. The group role of initiator.
C. The group role of gatekeeper.
D. The group role of blocker.
____ 11. A nurse believes that the members of a parenting group are in the initial,
or orientation, phase of group
development. Which group behaviors would support this assumption?
A. The group members manage conflict within the group.
B. The group uses denial as part of a grief response.


C. The group members compliment the leader and compete for the role of recorder.
D. The group members initially trust one another and the leader.

____ 12. During a group session, which client statement demonstrates that the
group has progressed to the middle, or
working, phase of group development?
A. “It’s hard for me to tell my story when I’m not sure about the reactions of
others.”
B. “I think Joe’s Antabuse suggestion is a good one and might work for me.”
C. “My situation is very complex, and I need professional, not peer, advice.”
D. “I am really upset that you expect me to solve my own problems.”
____ 13. Which group leader activity should a nurse identify as being most
effective in the final, or termination, phase
of group development?
A. The group leader establishes the rules that will govern the group after discharge.
B. The group leader encourages members to rely on each other for problem
solving.
C. The group leader presents and discusses the concept of group termination.
D. The group leader helps the members to process feelings of loss.
____ 14. A nursing instructor is teaching students about self-help groups like
Alcoholics Anonymous (AA). Which
student statement indicates that learning has occurred?
A. “There is little research to support AA’s effectiveness.”
B. “Self-help groups used to be the treatment of choice, but their popularity is
waning.”
C. “These groups have no external regulation, so clients need to be cautious.”
D. “Members themselves run the group, with leadership usually rotating among the
members.”
____ 15. Which group function should a nurse identify as helping an extremely
withdrawn, paranoid client increase
feelings of security?
A. Socialization
B. Support

C. Empowerment
D. Governance
____ 16. When planning group therapy, which configuration should a nurse
identify as most optimal for a therapeutic
group?
A. Open-ended membership; circle of chairs; group size of 5 to 10 members.
B. Open-ended membership; chairs around a table; group size of 10 to 15
members.


C. Closed membership; circle of chairs; group size of 5 to 10 members.
D. Closed membership; chairs around a table; group size of 10 to 15 members.
____ 17. During the 6th week of a 10-week parenting skills group, a nurse
observes as several members get into a
heated dispute about spanking. As a group, they decide to create a pros-and-cons
poster on the use of physical
discipline. At this time, what is the role of the group leader?
A. To referee the debate.
B. To adamantly oppose physical disciplining measures.
C. To redirect the group to a less controversial topic.
D. To encourage the group to solve the problem collectively.
____ 18. A 10-week, prenuptial counseling group composed of five couples is
coming to a close. At the last group
meeting, a nurse notices that the two most faithful and participative couples are
absent. When considering
concepts of group development, what might explain the two couples’ behavior?
A. They are experiencing problems with termination, leading to feelings of
abandonment.
B. They did not think any new material would be covered at the last session.
C. They were angry with the leader for not extending the length of the group.

D. They were bored with the material covered in the group.
____ 19. An experienced psychiatric registered nurse has taken a new position
leading groups in a day treatment
program. Which group is this nurse most qualified to lead?
A. A psychodrama group
B. A psychotherapy group
C. A parenting group
D. A family therapy group
____ 20. A nursing instructor is teaching about psychodrama, a specialized type of
therapeutic group. Which student
statement indicates that further teaching is necessary?
A. “Psychodrama provides a safe setting in which to discuss painful issues.”
B. “In psychodrama, the client is the protagonist.”
C. “In psychodrama, the client observes actor interactions from the audience.”
D. “Psychodrama facilitates resolution of interpersonal conflicts.”
Chapter 9: Intervention in Groups
Answer Section
MULTIPLE RESPONSE
1. ANS: A, B, D
The nurse should identify that a client who decreases conflict within the group,


offers recognition and
acceptance of others, and listens attentively to group interaction has assumed the
role of maintenance. There
are member roles within each group. Maintenance roles include the compromiser,
the encourager, the
follower, the gatekeeper, and the harmonizer.
PTS: 1 REF: Page: 172
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:

Analysis
2. ANS: B, C, D
During the orientation phase of group development, the nurse leader should work
together with members to
establish rules that will govern the group. The leader should ensure that group rules
do not interfere with goal
fulfillment and establish the need for and importance of confidentiality within the
group. Members need to
establish trust and cohesion to move into the working phase.
PTS: 1 REF: Page: 171
KEY: Cognitive Level: Application | Integrated Process: Nursing Process:
Implementation
MULTIPLE CHOICE
1. ANS: B
The nurse should evaluate that the client is assuming the role of the recognition
seeker. The recognition
seeker is an individual (personal) role within the group. Other individual roles
include the aggressor, the
blocker, the dominator, the help seeker, the monopolizer, and the seducer.
PTS: 1 REF: Page: 173
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
2. ANS: A
The nurse who excuses clients from the group has demonstrated an autocratic
leadership style. Autocratic
leaders have personal goals for the group and may withhold information from
group members that may
interfere with achievement of their own objective. Democratic leaders focus on the
members of the group and
group-selected goals. Laissez-faire leaders provide no direction to group members.

PTS: 1 REF: Page: 172
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:


Implementation
3. ANS: C
The nurse leader who sits silently and allows group members to veer away from
the assigned topic is
demonstrating a laissez-faire leadership style. This style allows people to do as
they please with no direction
from the leader. Group members often become frustrated and confused in reaction
to a laissez-faire leadership
style.
PTS: 1 REF: Page: 172
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Implementation
4. ANS: A
The nurse who encourages clients to present problems and discuss solutions is
demonstrating a democratic
leadership style. Democratic leaders share information with group members and
promote decision making by
the members of the group. The leader provides guidance and expertise as needed.
PTS: 1 REF: Page: 172
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Implementation
5. ANS: B
The nurse should identify that mandating decisions without consulting the group is
considered an autocratic
leadership style. Autocratic leadership increases productivity but often reduces
morale due to lack of member

input and creativity.
PTS: 1 REF: Page: 172
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Implementation
6. ANS: D
The scenario is an example of the curative group factor of universality.
Universality occurs when individuals
realize that they are not alone in the problems, thoughts, and feelings they are
experiencing. This realization
reduces anxiety by the support and understanding of others.
PTS: 1 REF: Page: 170
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
7. ANS: B


This scenario is an example of the curative group factor instillation of hope. This
occurs when members
observe the progress of others in the group with similar problems and begins to
believe that personal
problems can also be resolved.
PTS: 1 REF: Page: 170
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
8. ANS: A
Yalom’s curative group factor of imparting of information involves sharing
knowledge gained trough formal
instruction as well as by the sharing of advice and suggestions by other group
members.
PTS: 1 REF: Page: 170

KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
9. ANS: C
Yalom’s curative group factor of altruism occurs when group members provide
assistance and support to each
other that creates a positive self-image and promotes self-growth. Individuals gain
self-esteem through mutual
caring and concern.
PTS: 1 REF: Page: 170
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
10. ANS: A
The nurse should identify that the client is assuming the group role of the
aggressor. The aggressor expresses
negativism and hostility toward others in the group or to the group leader and may
use sarcasm in an effort to
degrade the status of others.
PTS: 1 REF: Page: 173
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
11. ANS: C
The nurse should anticipate that members in the initial, or orientation, phase of
group development often
compliment the leader and compete for the role of recorder. Members in this phase
have not yet established
trust and have a fear of not being accepted. Power struggles may occur as members


compete for their position
in the group.

PTS: 1 REF: Page: 171
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
12. ANS: B
The nurse should determine that group members have progressed to the working
phase of group development
when members begin to look to each other instead of to the leader for guidance.
Group members in the
working phase begin to accept criticism from each other and use it constructively
to create change.
PTS: 1 REF: Page: 171
KEY: Cognitive Level: Application | Integrated Process: Nursing Process:
Analysis
13. ANS: D
The most effective intervention in the final, or termination, phase of group
development would be for the
group leader to help the members to process feelings of loss. The leader should
encourage the members to
review the goals and discuss outcomes, reminisce about what has occurred, and
encourage members to
provide feedback to each other about progress.
PTS: 1 REF: Page: 171
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
14. ANS: D
The student indicates and understanding of self-help groups when stating,
“Member themselves run the group,
with leadership usually rotating among the members.” Nurses may or may not be
involved in self-help
groups. These groups allow members to talk about feelings and reduce feelings of

isolation, while receiving
support from others undergoing similar experiences.
PTS: 1 REF: Page: 169
KEY: Cognitive Level: Application | Integrated Process: Nursing Process:
Evaluation
15. ANS: B
The nurse should identify that the group function of support would initially help an
extremely withdrawn,


paranoid client increase feelings of security. The function of support is to assist the
members in gaining a
feeling of security from group involvement.
PTS: 1 REF: Page: 168
KEY: Cognitive Level: Application | Integrated Process: Nursing Process:
Planning
16. ANS: C
The nurse should identify that the most optimal conditions for a therapeutic group
is one in which the
membership is closed and in which the group size is between 5 to 10 members who
are arranged in a circle of
chairs. The focus of therapeutic groups is more on relations within the group and
the interactions among
group members.
PTS: 1 REF: Page: 170
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Planning
17. ANS: D
The role of the group leader is to encourage the group to solve the problem
collectively. A democratic

leadership style supports members in their participation and problem solving.
Members are encouraged to
solve issues that relate to the group cooperatively.
PTS: 1 REF: Page: 172
KEY: Cognitive Level: Application | Integrated Process: Nursing Process:
Analysis
18. ANS: A
The nurse should determine that the clients’ absence from the final group meeting
may indicate that they are
experiencing problems with termination. The termination phase of group
development may elicit feelings of
abandonment and anger. Successful termination may help members develop skills
to cope with future
unrelated losses.
PTS: 1 REF: Page: 171
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Analysis
19. ANS: C
A psychiatric registered nurse is qualified to lead a parenting group. A parenting
group can be classified as


either a teaching group or therapeutic group. Psychodrama, psychotherapy, and
family therapy are forms of
group therapy and must be lead by qualified leaders who generally have advanced
degrees in psychology,
social work, nursing, or medicine.
PTS: 1 REF: Page: 169
KEY: Cognitive Level: Application | Integrated Process: Nursing Process:
Implementation

20. ANS: C
The nurse should educate the student that in psychodrama the client plays the role
of him or herself in a
life-situation scenario and is called the protagonist. Other group members perform
the role of the audience
and discuss the situation they have observed, offer feedback, and express their
feelings. Leaders of
psychodrama must have specialized training to become a psychodramatist.
PTS: 1 REF: Page: 173
KEY: Cognitive Level: Comprehension | Integrated Process: Nursing Process:
Evaluation