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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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While leading a small group, the nurse sets up the ground rules at the beginning of the group?s first meeting. One of the rules established is that the group will always start at the specified time rather than waiting to start until after everyone has arrived. This rule reflects which of the following?
- A. Group norms
- B. Group cohesion
- C. Group think
- D. Group process
Correct Answer: A
Rationale: Group norms are shared rules or expectations, such as starting on time, that guide group behavior. Group cohesion refers to unity, group think is uncritical conformity, and group process involves interaction dynamics, not specific rules.
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.
A nurse is leading a group on an adolescent psychiatric unit. A new member in the group is from out of state; his accent and his way of dressing set him apart from the other patients; and it is obvious that the group, for the most part, dislikes this patient. During the group session, the nurse has the members draw the emotion they are feeling and then has them present their drawings and explain them to the group. Which of the following would be the most effective way to address the group?s dislike for the new member?
- A. Skip him when it is his turn to present his drawing.
- B. Let the patient talk last so the others will not have time to make fun of him.
- C. Compliment the patient when he presents his drawing.
- D. Demand that each member of the group tell the patient why they dislike him.
Correct Answer: C
Rationale: Complimenting the patient?s drawing fosters inclusion and validates his contribution, countering the group?s dislike without confrontation. Skipping him or delaying his turn risks further isolation, and demanding explanations may escalate hostility, disrupting group dynamics.
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.