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A group of nursing students is reviewing information about open and closed groups. The students demonstrate understanding of the information when they identify which of the following as an example of an open group?
- A. Outpatient smoking cessation group
- B. Community clinic psychoeducation group
- C. Ambulatory psychotherapy group
- D. Inpatient anger management group
Correct Answer: A
Rationale: Open groups allow new members to join ongoing sessions, common in outpatient settings like smoking cessation groups. Closed groups, typical in inpatient or structured settings like anger management or psychotherapy, have fixed membership.
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In an initial group therapy session, the nurse observes that one group member continually tries to monopolize the conversation. The nurse interprets this behavior as reflecting which of the following in the patient?
- A. Anxiety
- B. Anger
- C. Rebellion
- D. Fear
Correct Answer: A
Rationale: Monopolizing conversation in a group often reflects anxiety, as the patient may feel compelled to control the discussion to manage discomfort. Anger, rebellion, or fear may present differently, such as through hostility, defiance, or withdrawal, respectively.
A nurse is leading a group in which members are encouraged to discuss their feelings and emotions. The group session is just starting when a patient stomps into the room, slams his notebook down on a table, and sits down. His affect is one of anger and hostility. Which response by the nurse would be most appropriate?
- A. Keep the focus off the patient so his anger has time to de-escalate.
- B. Suggest the patient make a private counseling appointment to address his anger issues.
- C. Ask the patient to leave the group until he is calmer.
- D. Encourage the patient to discuss his anger with the group.
Correct Answer: A
Rationale: The patient?s angry affect suggests a need for de-escalation to ensure group safety. Keeping the focus off the patient allows time for calming without escalating tension. Asking the patient to leave or discuss anger may intensify emotions, and private counseling is not immediate.
During a group session, one of the members states, 'Let?s keep this discussion going so that everyone can participate, but let?s keep the time each person speaks to about 3 minutes.' The leader interprets this member as acting in which role?
- A. Group observer
- B. Gatekeeper
- C. Encourager
- D. Energizer
Correct Answer: B
Rationale: The gatekeeper regulates participation and time, as shown by the member?s suggestion to limit speaking time while encouraging involvement. The group observer monitors dynamics, the encourager supports contributions, and the energizer motivates action, not time management.
While participating in a group therapy session, one group member consistently asks for clarification of the topic the group is discussing. The nurse leading the group interprets this behavior as reflecting which group role?
- A. Coordinator
- B. Recorder
- C. Information seeker
- D. Standard setter
Correct Answer: C
Rationale: The information seeker role involves asking for clarification or additional information to understand the group?s discussion, as described. The coordinator organizes efforts, the recorder documents, and the standard setter establishes norms, none of which fit the behavior.
The nurse is leading a small group of hospitalized patients diagnosed with psychiatric disorders. One group member has asked for advice and often agrees with suggestions by other group members but then adds, 'Yes, but . . .' to every suggestion offered. Which response by the nurse would be most appropriate?
- A. Things would probably work out better if you joined a different group.
- B. Do you realize you say, 'Yes, but . . .' to every suggestion the group has for you?
- C. I suggest you stop and think about why you always respond to suggestions with 'Yes, but . . .'
- D. What solution do you think would work best for you?
Correct Answer: D
Rationale: The 'Yes, but . . .' response suggests resistance or difficulty accepting suggestions. Asking 'What solution do you think would work best for you?' empowers the patient to explore their own ideas, promoting engagement. Options A and B are confrontational, and C is directive, potentially shutting down communication.