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The nurse has begun group counseling sessions for several hospitalized patients in the psychiatric facility. Which of the following would be most effective for the nurse to do to promote group cohesiveness?
- A. Use team-building exercises.
- B. Encourage task completion by members.
- C. Spend time with each member individually.
- D. Be consistent with the group themes.
Correct Answer: A
Rationale: Team-building exercises foster trust and connection among members, directly promoting group cohesiveness. Task completion focuses on goals, not unity; individual time may fragment the group; and consistent themes support structure but not necessarily cohesion.
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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 group of nursing students is reviewing the factors associated with group psychotherapy through which therapeutic changes occur. The student?s demonstrate understanding when they identify which of the following as a factor? Select all that apply.
- A. Altruism
- B. Catharsis
- C. Repressed behavior
- D. Universality
- E. Hopelessness
Correct Answer: A,B,D
Rationale: Therapeutic factors in group psychotherapy, per Yalom, include altruism (A), catharsis (B), and universality (D), which promote healing through helping others, emotional release, and shared experiences. Repressed behavior and hopelessness are not therapeutic factors; hopelessness is detrimental.
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.
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.
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.