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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.
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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 preparing to lead an older adult group. Which of the following would the nurse need to keep in mind when leading this group?
- A. Focusing the group to promote learning of new information
- B. Keeping the pace of the group meetings slow
- C. Discouraging the use of life review strategies
- D. Teaching entirely new methods for coping
Correct Answer: B
Rationale: Older adult groups benefit from a slower pace to accommodate potential cognitive or sensory changes, ensuring effective participation. Learning new information or coping methods may be challenging, and life review strategies are often therapeutic, not discouraged.
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.
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 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.