A nurse is working with a client who has an anxiety disorder and is in the orientation phase of the therapeutic relationship.
Which of the following statements should the nurse make during this phase?

Choice A rationale: Sticking the tongue out assesses cranial nerve XII (hypoglossal nerve). This action is used to evaluate tongue movement and is not related to cranial nerve XI (accessory nerve) function.

Choice B rationale: Frowning symmetrically assesses cranial nerve VII (facial nerve). This action is used to evaluate facial muscle strength and is not related to cranial nerve XI (accessory nerve) function.

Choice C rationale: Identifying a sour taste assesses cranial nerve IX (glossopharyngeal nerve). This action is related to taste sensation on the posterior third of the tongue and is not specific to cranial nerve XI (accessory nerve) function.

Choice D rationale: Correct. Shrugging the shoulders assesses cranial nerve XI (accessory nerve). This nerve controls the sternocleidomastoid and trapezius muscles, which are responsible for shoulder movements. Testing the strength of these muscles helps assess the integrity of cranial nerve XI.

Choice A rationale:

Managing conflict within the group is an important skill, but it is more appropriate for the working phase of group therapy. During the orientation phase, the focus is on establishing trust, setting group norms, and creating a safe environment. Conflict resolution skills become more relevant as the group progresses.

Choice B rationale:

Encouraging the use of problem-solving skills is essential in group therapy, but it is a skill that is developed during the working phase. During the orientation phase, the nurse focuses on building rapport, creating a comfortable atmosphere, and explaining the purpose and goals of the group.

Choice C rationale:

Maintaining the group's focus on identified issues is a crucial aspect of the orientation phase. The nurse should guide the discussion to ensure that participants understand the purpose of the group and stay on topic. This helps in establishing clear goals and expectations for the group sessions.

Choice D rationale:

Establishing a rapport with group members is a primary goal of the orientation phase. Building trust and a therapeutic relationship with the adolescents creates a supportive environment where they feel comfortable sharing their experiences and emotions. A strong rapport enhances the effectiveness of the support group.