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A nurse is deciding about the size of the group. The nurse determines that a large group would be best based on which of the following?
- A. Transference and countertransference issues will be moderate to minimal.
- B. Group cohesiveness will be strong with greater interpersonal experiences.
- C. The number of potential interactions and relationships is limited.
- D. The group is effective for dealing with a specific issue.
Correct Answer: A
Rationale: Large groups (10?20 members) reduce intense transference and countertransference due to diluted focus, making them suitable for certain settings. Cohesiveness is stronger in smaller groups, interactions increase with size, and specific issues are better addressed in smaller, focused groups.
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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.
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.
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.
A group of nursing students is reviewing information about the different types of group. The students demonstrate understanding of the information when they identify which of the following as a characteristic of a self-help group that differentiates it from a supportive therapy group?
- A. The group is led by a professional.
- B. The group is led by a consumer.
- C. There is no identified leader.
- D. The group is focused on a specific problem.
Correct Answer: B
Rationale: Self-help groups are typically led by consumers (peers with shared experiences), unlike supportive therapy groups, which are led by professionals. Both may focus on specific problems, and no identified leader is less common in structured settings.
A patient has been placed in an anger management group because he has trouble controlling his angry outbursts. The nurse interprets this type group as an example of which of the following?
- A. Psychotherapy
- B. Self-help
- C. Psychoeducation
- D. Supportive therapy
Correct Answer: C
Rationale: Anger management groups focus on teaching skills and strategies to manage emotions, characteristic of psychoeducation. Psychotherapy involves deeper psychological exploration, self-help groups are peer-led, and supportive therapy emphasizes emotional support, not skill-building.