Nokea
Which remark by a group participant would the nurse expect during the working stage of group therapy?
- A. "My problems are very personal and private. How do I know people in this group will not tell others what you hear?"
- B. "I have enjoyed this group. It's hard to believe that a few weeks ago I couldn't even bring myself to talk here."
- C. "One thing everyone seems to have in common is that sometimes it's hard to be honest with those you love most."
- D. "I don't think I agree with your action. It might help you, but it seems like it would upset your family."
Correct Answer: D
Rationale: In the working stage, members actively interact to help each other accomplish goals, and because trust has developed, conflict and disagreement can be expressed. Focusing on trust and confidentiality typically occur in the orientation phase as part of establishing group norms. Commonality and universality are also themes typically expressed in the orientation phase, whereas reflecting on progress is a task addressed in the termination phase.
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Nursing physical assessment of a patient with bulimia often reveals:
- A. Prominent parotid glands.
- B. Peripheral edema.
- C. Thin, brittle hair.
- D. Amenorrhea.
Correct Answer: A
Rationale: Repeated vomiting in bulimia causes parotid gland enlargement (Option A) due to salivary stimulation, per DSM-5. Edema (B), hair changes (C), and amenorrhea (D) are more typical of anorexia.
A male patient reports to the nurse, 'I'm told I have memories of childhood abuse stored in my unconscious mind. I want to work on this.' Based on this statement, what information should the nurse provide the patient?
- A. To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.
- B. How to use a defense mechanism such as suppression so that the memories will be less threatening.
- C. Psychodynamic therapy will allow the surfacing of those unconscious memories to occur in just a few sessions.
- D. Group sessions are valuable to identify underlying themes of the memories being suppressed.
Correct Answer: A
Rationale: Trauma-related memories should be addressed with the help of a trained therapist to ensure safe and effective treatment.
A medical-surgical nurse works with a patient diagnosed with a somatic symptom disorder. Care planning is facilitated by understanding that the patient will probably
- A. readily seek psychiatric counseling.
- B. be resistant to accepting psychiatric help.
- C. attend psychotherapy sessions without encouragement.
- D. be eager to discover the true reasons for physical symptoms.
Correct Answer: B
Rationale: Patients with somatic symptom disorders go from one health care provider to another trying to establish a physical cause for their symptoms. When a psychological basis is suggested and a referral for counseling offered, these patients reject both.
Clark's (1986,1988) theory of Catastrophic Misinterpretation of Bodily Sensations suggests that individuals:
- A. Are more likely to develop heart disease.
- B. Have a cognitive bias towards accepting the more threatening interpretation of their sensations.
- C. Are less able to determine when they are sickening for something.
- D. Less likely to seek treatment from medical professionals.
Correct Answer: B
Rationale: Clark’s theory (Option B) posits a cognitive bias in panic disorder where bodily sensations are catastrophically misinterpreted (e.g., palpitations as a heart attack), driving anxiety.
The client says to the nurse, 'I know I can learn to cope with my family situation. By getting help here at the clinic, I’ll be able to deal with them more effectively, and I won’t be so stressed out all the time.' This client is demonstrating a high level of
- A. hardiness.
- B. resilience.
- C. sense of belonging.
- D. self-efficacy.
Correct Answer: D
Rationale: Self-efficacy reflects belief in one’s ability to affect outcomes (D), shown here by proactive help-seeking. Hardiness (A), resilience (B), and belonging (C) don’t fit as directly.