A male client is attending an after-school, adolescent group session because he frequently loses his temper, argues with his teachers, and refuses to comply with classroom rules. During the group session, the adolescent repeatedly blames others regardless of the situation. To help modify the adolescent's behavior, which action should the nurse implement?

Describe the consequences of his behavior in concrete terms.

Encourage the client to verbalize his feelings of anger.

Ignore blaming behavior and praise the client's appropriate behavior.

Explain that blaming others limits his psychological growth.

Answer and Explanation

The Correct Answer is A

A) Describing the consequences of the adolescent's behavior in concrete terms is the best action. This approach helps the client understand the direct impact of his actions on himself and others. Clear and specific explanations can facilitate accountability and encourage the adolescent to reflect on how his behavior affects his relationships and environment, which is essential for behavior modification.

B) Encouraging the client to verbalize his feelings of anger may provide an outlet for his emotions, but it does not directly address the problematic behavior of blaming others. While exploring feelings is important, it should be paired with teaching responsibility and consequences for behavior.

C) Ignoring blaming behavior and praising appropriate behavior might reinforce a lack of accountability. While positive reinforcement is beneficial, it is crucial to address negative behaviors directly to facilitate change. Ignoring the blaming behavior could lead to its continuation.

D) Explaining that blaming others limits his psychological growth could be insightful, but it may not resonate with the adolescent or lead to immediate behavior change. The focus should be on concrete consequences that he can understand and relate to, which can encourage more constructive behaviors.

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Correct Answer is B

Explanation

A) Clarifying the nurse's role and clients' responsibilities is important but is typically more relevant during the initial stages of group development, specifically in the forming phase. By the working phase, roles should already be established.

B) Discussing ways to use new coping skills learned is the most appropriate approach during the working phase of group development. This phase is characterized by active engagement and collaboration among group members as they explore and practice the skills they’ve learned. It encourages growth and fosters a supportive environment for applying new strategies.

C) Helping clients identify areas of problem in their lives is an essential aspect of group therapy but is often emphasized during earlier phases when members are becoming familiar with each other and establishing trust. In the working phase, the focus shifts toward solutions and skill application.

D) Establishing rapport with group members is crucial in the forming phase of group development. By the working phase, rapport should be well established, allowing for deeper discussions and engagement in the therapeutic process. Therefore, focusing on new coping skills is more aligned with the goals of this phase.

A. Explain that these beliefs are related to her illness. B. Explain that distrust is related to feeling anxious. C. Initiate short, frequent contacts with the client. D. Offer to keep the belongings at the nurse's desk.

Correct Answer is C

Explanation

(A) Explain that these beliefs are related to her illness:While it is important to educate the client about their illness, directly challenging their delusions may increase distrust and anxiety. This approach might make the client feel misunderstood and less likely to trust the nurse.

(B) Explain that distrust is related to feeling anxious:This explanation might not be well-received by the client and could be perceived as dismissive of their concerns. It may not effectively address the client’s immediate need for trust and reassurance.

(C) Initiate short, frequent contacts with the client:This approach helps build trust through consistent and reliable interactions. It allows the nurse to establish a rapport without overwhelming the client, thereby promoting a sense of safety and trust. Regular, brief interactions can help the client feel more comfortable and secure.

(D) Offer to keep the belongings at the nurse’s desk:This action might be perceived as an attempt to take control of the client’s belongings, which could reinforce their delusions and decrease trust. It is important to respect the client’s need to keep their belongings close to them.

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Naxlex Comprehensive Predictor Exams

The nurse is leading a group on the inpatient psychiatric unit. Which approach should the nurse use during the working phase of group development?

Correct Answer is B

Explanation

The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?

Correct Answer is C

Explanation

After several days of being despondent and nonverbal, a female client with depression begins to talk and exhibit energy. Which action should the nurse implement?

A client with paranoia is admitted to the mental health unit and immediately goes to the corner of the room and sits quietly without communicating. While approaching the client, which intervention should the nurse implement first?

A client who refuses antipsychotic medications disrupts group activities, talks with nonsensical words, and wanders into client's rooms. The nurse decides that the client needs constant observation based on which of these assessment findings?

A client with somatic symptom disorder reports experiencing chest pain to the nurse. Which action should the nurse take?

A client with opioid dependence makes a statement to the nurse about desiring to lead a healthier lifestyle by making changes in the next 2 weeks. How should the nurse respond?