UNIT III MENTAL HEALTH TEST BANK
PRACTICE EXAM QUESTIONS AND
ANSWERS
A 10-week, prenuptial counselling group composed of five couples is terminating. 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 this behaviour?
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. - Answer-ANSWER: A
RATIONALE: 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.
An experienced psychiatric registered nurse has taken a new position leading groups
in a day treatment program. Without further education, 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 - Answer-ANSWER: C
RATIONALE: 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 that
must be facilitated by qualified leaders who generally have advanced degrees in
psychology, social work, nursing, or medicine.
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. - Answer-ANSWER:
C
RATIONALE: The nurse should educate the student that in psychodrama the client
plays the role of himself or herself in a life-situation scenario and is called the
protagonist. During psychodrama, the client does not observe interactions from the
audience. 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.
Which of the following observed client behaviors would lead a nurse to evaluate a
member as assuming a maintenance group 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. - Answer-ANSWER: A, B, D
RATIONALE: The nurse should identify clients who decrease conflict within the
group, offer recognition and acceptance of others, and listen attentively to group
interaction as assuming a maintenance group role. There are member roles within
each group. Maintenance roles include the compromiser, the encourager, the
follower, the gatekeeper, and the harmonizer.
Which of the following 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 rules established by the group 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 members to resolve conflicts and foster cohesiveness within the
group - Answer-ANSWER: B, C, D
RATIONALE: During the orientation phase of group development, the nurse leader
should work together with members to establish rules that will effectively 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 of group development.
A fatherless, 11-year-old African American girl lives with her grandmother after the
death of her mother. Her older stepbrother is very involved in her life. How should
the community health nurse view this family constellation, and why?
A. Abnormal; the grandmother should be concerned with issues other than
childrearing.
B. Abnormal; a two-parent household is the most advantageous arrangement for
parenting.
C. Normal; cultural variations exist in the family life cycle.
D. Normal; because of their wisdom, older adults make better parenting figures. -
Answer-ANSWER: C
,RATIONALE: The nurse should be aware that cultural differences and specific
events may lead to variety in family constellations. This is normal.
In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and
gets a tattoo. According to Bowens family systems theory, how should the
community health nurse interpret the teenagers action?
A. The teenager is attempting to differentiate self.
B. The teenager is triangulating self.
C. The teenager is cutting self off emotionally.
D. The teenager is exhibiting antisocial traits. - Answer-ANSWER: A
RATIONALE: The teenager is taking on some of the cultural values of peers and is
beginning to develop a unique identity. This process is called differentiation and is a
normal task of adolescence.
A home health nurse is visiting an Asian family. A married couple, their three
children, and the maternal grandparents all live in the home. How should the nurse
interpret the presence of the grandparents in the home?
A. The parents have diffuse boundaries and have allowed the grandparental
subsystem to be present.
B. The grandparental subsystem is not successfully managing separation from the
parental subsystem.
C. Extended family living arrangements are common in some cultures.
D. The nuclear family living arrangement is the preferred environment for
childrearing. - Answer-ANSWER: C
RATIONALE: The Asian culture highly respects the elderly. Having the grandparents
living in the home is not uncommon in this culture.
During a group session, which client statement demonstrates that the group has
progressed to the middle, or working, phase of group development?
A. Its 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. - Answer-
ANSWER: B
RATIONALE: 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 then use it constructively to foster change.
Which group leader activity should a nurse identify as being most important 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. - Answer-
ANSWER: D
RATIONALE: 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.
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 AAs 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. - Answer-ANSWER: D
RATIONALE: The student indicates an understanding of self-help groups when
stating, Members 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.
The nurse should utilize which group function to help an extremely withdrawn,
paranoid client increase feelings of security?
A. Socialization
B. Support
C. Empowerment
D. Governance - Answer-ANSWER: B
RATIONALE: The nurse should identify that the group function of support would help
an extremely withdrawn, paranoid client increase feelings of security. Support assists
group members in gaining a feeling of security from group involvement.
When planning group therapy, a nurse should identify which configuration 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 -
Answer-ANSWER: C
RATIONALE: The nurse should identify that the most optimal conditions for a
therapeutic group are when the membership is closed and the group size is between
5 and 10 members who are arranged in a circle of chairs. The focus of therapeutic
PRACTICE EXAM QUESTIONS AND
ANSWERS
A 10-week, prenuptial counselling group composed of five couples is terminating. 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 this behaviour?
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. - Answer-ANSWER: A
RATIONALE: 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.
An experienced psychiatric registered nurse has taken a new position leading groups
in a day treatment program. Without further education, 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 - Answer-ANSWER: C
RATIONALE: 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 that
must be facilitated by qualified leaders who generally have advanced degrees in
psychology, social work, nursing, or medicine.
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. - Answer-ANSWER:
C
RATIONALE: The nurse should educate the student that in psychodrama the client
plays the role of himself or herself in a life-situation scenario and is called the
protagonist. During psychodrama, the client does not observe interactions from the
audience. 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.
Which of the following observed client behaviors would lead a nurse to evaluate a
member as assuming a maintenance group 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. - Answer-ANSWER: A, B, D
RATIONALE: The nurse should identify clients who decrease conflict within the
group, offer recognition and acceptance of others, and listen attentively to group
interaction as assuming a maintenance group role. There are member roles within
each group. Maintenance roles include the compromiser, the encourager, the
follower, the gatekeeper, and the harmonizer.
Which of the following 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 rules established by the group 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 members to resolve conflicts and foster cohesiveness within the
group - Answer-ANSWER: B, C, D
RATIONALE: During the orientation phase of group development, the nurse leader
should work together with members to establish rules that will effectively 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 of group development.
A fatherless, 11-year-old African American girl lives with her grandmother after the
death of her mother. Her older stepbrother is very involved in her life. How should
the community health nurse view this family constellation, and why?
A. Abnormal; the grandmother should be concerned with issues other than
childrearing.
B. Abnormal; a two-parent household is the most advantageous arrangement for
parenting.
C. Normal; cultural variations exist in the family life cycle.
D. Normal; because of their wisdom, older adults make better parenting figures. -
Answer-ANSWER: C
,RATIONALE: The nurse should be aware that cultural differences and specific
events may lead to variety in family constellations. This is normal.
In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and
gets a tattoo. According to Bowens family systems theory, how should the
community health nurse interpret the teenagers action?
A. The teenager is attempting to differentiate self.
B. The teenager is triangulating self.
C. The teenager is cutting self off emotionally.
D. The teenager is exhibiting antisocial traits. - Answer-ANSWER: A
RATIONALE: The teenager is taking on some of the cultural values of peers and is
beginning to develop a unique identity. This process is called differentiation and is a
normal task of adolescence.
A home health nurse is visiting an Asian family. A married couple, their three
children, and the maternal grandparents all live in the home. How should the nurse
interpret the presence of the grandparents in the home?
A. The parents have diffuse boundaries and have allowed the grandparental
subsystem to be present.
B. The grandparental subsystem is not successfully managing separation from the
parental subsystem.
C. Extended family living arrangements are common in some cultures.
D. The nuclear family living arrangement is the preferred environment for
childrearing. - Answer-ANSWER: C
RATIONALE: The Asian culture highly respects the elderly. Having the grandparents
living in the home is not uncommon in this culture.
During a group session, which client statement demonstrates that the group has
progressed to the middle, or working, phase of group development?
A. Its 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. - Answer-
ANSWER: B
RATIONALE: 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 then use it constructively to foster change.
Which group leader activity should a nurse identify as being most important 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. - Answer-
ANSWER: D
RATIONALE: 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.
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 AAs 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. - Answer-ANSWER: D
RATIONALE: The student indicates an understanding of self-help groups when
stating, Members 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.
The nurse should utilize which group function to help an extremely withdrawn,
paranoid client increase feelings of security?
A. Socialization
B. Support
C. Empowerment
D. Governance - Answer-ANSWER: B
RATIONALE: The nurse should identify that the group function of support would help
an extremely withdrawn, paranoid client increase feelings of security. Support assists
group members in gaining a feeling of security from group involvement.
When planning group therapy, a nurse should identify which configuration 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 -
Answer-ANSWER: C
RATIONALE: The nurse should identify that the most optimal conditions for a
therapeutic group are when the membership is closed and the group size is between
5 and 10 members who are arranged in a circle of chairs. The focus of therapeutic
