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

Helping clients identify areas of problem in their lives.

Discussing ways to use new coping skills learned.

Establishing a rapport with group members.

Clarifying the nurse’s role and clients’ responsibilities.

Answer and Explanation

The Correct Answer is B

A.   Helping clients identify areas of problem in their lives is more characteristic of the orientation phase of group development, where the group establishes trust and defines the purpose and goals.
B.   Discussing ways to use new coping skills learned is appropriate during the working phase.
This phase focuses on problem-solving, decision-making, and achieving the goals identified in the orientation phase.
C. Establishing a rapport with group members is crucial during the orientation phase to build trust and create a safe environment for group members to share their experiences.
D.   Clarifying the nurse’s role and clients’ responsibilities is more relevant in the orientation phase as the group establishes structure and guidelines.

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Correct Answer is D

Explanation

A. Explain to the client that her behavior invades the rights of the nursing staff: This approach is confrontational and dismisses the client’s coping mechanism. It does not promote a therapeutic nurse-client relationship.

B. Teach the client strategies to control her obsessive-compulsive behavior: This is not the appropriate time for teaching behavioral strategies, especially when the client is experiencing stress related to an upcoming invasive procedure.

C. Ask the client to explain why she is keeping a detailed record of her nursing care: While this might offer insight, it can come across as intrusive or judgmental. It also shifts the focus away from emotional support.

D. Encourage the client to express her feelings regarding the upcoming procedure: Clients with obsessive-compulsive personality disorder often rely on control and orderliness to manage anxiety. The nurse should recognize that the client’s behavior may be a coping mechanism for procedure-related stress. Encouraging expression of feelings promotes trust and addresses the underlying anxiety.

A. The voices you are hearing are not real B. Let’s talk about the next time this happens C. You need to be calm and focus on something else D. You appear to be speaking with someone E. None F. None

Correct Answer is D

Explanation

A. Telling the client that the voices they are hearing are not real may invalidate their experience and could increase their distress or resistance to the nurse's intervention.
B. While discussing strategies for the next occurrence might be helpful, it does not address the immediate situation or acknowledge the client's current experience.
C. Asking the client to focus on something else may be perceived as dismissive and may not effectively engage them in conversation or provide support.
D. Acknowledging that the client appears to be speaking with someone validates their experience without confirming the reality of the voices. This comment encourages the client to express themselves and provides an opening for further communication, allowing the nurse to assess the situation more effectively.

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

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

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Correct Answer is D

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