NSG526 Exam 4 V1 | NSG 526 Clinical
Modalities Adv. Psych | Wilkes University
1. In Bowenian family therapy, the concept of ‘differentiation of self’ refers to an individual’s
ability to:
A. Distinguish between their own intellectual processes and emotional feelings.
B. Merge their emotional identity with that of their spouse for stability.
C. Completely cut off contact with the family of origin to achieve independence.
D. Triangulate a third person to reduce anxiety in a dyadic relationship.
Answer: A
Rationale: Differentiation of self is a core concept in Bowenian therapy that describes the
ability to maintain one’s own identity while staying emotionally connected to the family.
High differentiation allows a person to think clearly and not be overwhelmed by the
family’s emotional reactivity. This process involves the capacity to distinguish between
subjective feelings and objective thoughts.
2. According to Salvador Minuchin, ‘enmeshment’ within a family system is characterized by:
A. Diffuse boundaries that result in over-involvement in each other’s lives.
B. Rigid boundaries where members are emotionally isolated from one another.
C. Clear boundaries that allow for both autonomy and connection.
D. A lack of hierarchy where children hold more power than parents.
,Answer: A
Rationale: Enmeshment occurs when boundaries are diffuse, leading to family members
being overly reactive and involved in each other’s personal affairs. This often results in a
loss of individual autonomy as the family functions as a single emotional unit. Structural
family therapy aims to clarify these boundaries to promote healthy individual
development.
3. A group leader notices that members are beginning to challenge the rules and compete for
status. Which stage of group development is this?
A. Forming
B. Performing
C. Norming
D. Storming
Answer: D
Rationale: The storming stage is characterized by conflict, competition for leadership, and
the questioning of the group’s purpose or rules. It is a necessary phase where members test
boundaries and express their individuality before reaching a consensus. The leader must
remain neutral and facilitate communication to move the group into the norming phase.
4. Which of Yalom’s curative factors involves the realization that one is not alone in their
suffering or problems?
A. Altruism
, B. Universality
C. Catharsis
D. Imparting information
Answer: B
Rationale: Universality is the recognition that other people share similar experiences,
thoughts, and feelings. This realization helps reduce the sense of isolation and stigma often
felt by psychiatric patients. It is one of the most powerful initial factors in group therapy
that fosters a sense of belonging.
5. The ethical principle of ‘veracity’ in psychiatric nursing requires the practitioner to:
A. Act in the best interest of the patient at all times.
B. Ensure that the patient is always told the truth about their care.
C. Respect the patient’s right to make their own decisions.
D. Distribute resources fairly among all patients in the community.
Answer: B
Rationale: Veracity refers to the obligation to be honest and truthful with patients
regarding their diagnosis, treatment, and prognosis. This principle builds trust in the
provider-patient relationship and is essential for informed consent. Without veracity, the
therapeutic alliance is compromised and legal issues regarding autonomy may arise.
Modalities Adv. Psych | Wilkes University
1. In Bowenian family therapy, the concept of ‘differentiation of self’ refers to an individual’s
ability to:
A. Distinguish between their own intellectual processes and emotional feelings.
B. Merge their emotional identity with that of their spouse for stability.
C. Completely cut off contact with the family of origin to achieve independence.
D. Triangulate a third person to reduce anxiety in a dyadic relationship.
Answer: A
Rationale: Differentiation of self is a core concept in Bowenian therapy that describes the
ability to maintain one’s own identity while staying emotionally connected to the family.
High differentiation allows a person to think clearly and not be overwhelmed by the
family’s emotional reactivity. This process involves the capacity to distinguish between
subjective feelings and objective thoughts.
2. According to Salvador Minuchin, ‘enmeshment’ within a family system is characterized by:
A. Diffuse boundaries that result in over-involvement in each other’s lives.
B. Rigid boundaries where members are emotionally isolated from one another.
C. Clear boundaries that allow for both autonomy and connection.
D. A lack of hierarchy where children hold more power than parents.
,Answer: A
Rationale: Enmeshment occurs when boundaries are diffuse, leading to family members
being overly reactive and involved in each other’s personal affairs. This often results in a
loss of individual autonomy as the family functions as a single emotional unit. Structural
family therapy aims to clarify these boundaries to promote healthy individual
development.
3. A group leader notices that members are beginning to challenge the rules and compete for
status. Which stage of group development is this?
A. Forming
B. Performing
C. Norming
D. Storming
Answer: D
Rationale: The storming stage is characterized by conflict, competition for leadership, and
the questioning of the group’s purpose or rules. It is a necessary phase where members test
boundaries and express their individuality before reaching a consensus. The leader must
remain neutral and facilitate communication to move the group into the norming phase.
4. Which of Yalom’s curative factors involves the realization that one is not alone in their
suffering or problems?
A. Altruism
, B. Universality
C. Catharsis
D. Imparting information
Answer: B
Rationale: Universality is the recognition that other people share similar experiences,
thoughts, and feelings. This realization helps reduce the sense of isolation and stigma often
felt by psychiatric patients. It is one of the most powerful initial factors in group therapy
that fosters a sense of belonging.
5. The ethical principle of ‘veracity’ in psychiatric nursing requires the practitioner to:
A. Act in the best interest of the patient at all times.
B. Ensure that the patient is always told the truth about their care.
C. Respect the patient’s right to make their own decisions.
D. Distribute resources fairly among all patients in the community.
Answer: B
Rationale: Veracity refers to the obligation to be honest and truthful with patients
regarding their diagnosis, treatment, and prognosis. This principle builds trust in the
provider-patient relationship and is essential for informed consent. Without veracity, the
therapeutic alliance is compromised and legal issues regarding autonomy may arise.
