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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.
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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.
A psychiatric-mental health nurse is preparing to lead a medication group. Which of the following would be most important for the nurse to assess? Select all that apply.
- A. Cognitive abilities
- B. Medication knowledge
- C. Reading skills
- D. Writing abilities
- E. Use of a specific medication
Correct Answer: A,B,C
Rationale: For a medication group, assessing cognitive abilities (A), medication knowledge (B), and reading skills (C) is critical to ensure members can understand and engage with educational content. Writing abilities (D) are less essential, and specific medication use (E) is part of knowledge assessment.
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.
When leading a group, the nurse determines that several of the group members have assumed roles that may be interfering with the group?s function. Which roles might be involved? Select all that apply.
- A. Self-confessor
- B. Follower
- C. Dominator
- D. Elaborator
- E. Playboy
- F. Compromiser
Correct Answer: A,C,E
Rationale: Self-confessor (A), dominator (C), and playboy (E) roles can disrupt group function by focusing on personal issues, controlling discussions, or being disengaged, respectively. Follower, elaborator, and compromiser roles are typically constructive, supporting group progress.
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.