Group dynamics can vary widely and at times members are capable of disrupting the group process. Which of the following participant traits may indicate a need for additional support for a new nurse facilitator? Select all that apply.

Correct Answer: B

Rationale: The correct answer is B because a quietly tearful participant expressing suicidal thoughts indicates a serious mental health concern that requires immediate attention and support. This participant may be in distress and at risk of harm, making it crucial for the new nurse facilitator to provide appropriate resources and assistance. Choice A is incorrect because paranoid delusions may not necessarily impact the group dynamics unless they lead to disruptive behavior. Choice C is incorrect as anger alone does not indicate a need for additional support unless it escalates to disruptive behavior. Choice D is also incorrect as being a calm but ineffective communicator may not necessarily indicate a need for additional support unless it hinders the group process.

Correct Answer: C

Rationale: The correct diagnosis suspected in this case is C: schizophreniform disorder. This is because the client is experiencing psychotic symptoms such as hallucinations, delusions, disorganized speech, and behavior for a period of five months. Schizophreniform disorder is characterized by similar symptoms to schizophrenia but with a duration of at least one month but less than six months. Delusional disorder (A) involves persistent delusions without other psychotic symptoms. Brief psychotic disorder (B) lasts less than one month. Schizophrenia (D) requires symptoms to be present for at least six months.

Correct Answer: C

Rationale: The correct answer is C because it demonstrates focusing by redirecting the conversation back to a specific topic or issue, encouraging the client to elaborate on their thoughts and feelings. By asking the client to recount their experience in Vietnam and their emotions after being wounded, the therapist is helping the client concentrate on a particular aspect of their story. Choices A, B, and D are incorrect: A: This statement does not exemplify focusing as it points out a discrepancy between the client's words and body language, which may lead to defensiveness and does not encourage the client to delve deeper into their thoughts or feelings. B: This statement does not involve focusing but rather reflects a literal interpretation of the client's words without guiding the conversation towards a specific topic or emotion. D: While this statement acknowledges the client's behavior, it does not guide the conversation towards a specific topic or emotion, thus not demonstrating the focusing technique.

Correct Answer: B

Rationale: The correct answer is B because reporting consistently sad, discouraged, and hopeless mood is a key indicator of a mental illness, specifically depression. This finding suggests a persistent negative emotional state that goes beyond occasional sleeplessness and anxiety (choice A), the ability to describe differences in perceptions (choice C), or difficulty in making decisions related to job changes (choice D). The persistent nature of the mood described in choice B aligns more closely with symptoms of mental illness, indicating the need for further assessment and potential intervention.

Correct Answer: D

Rationale: The correct answer is D because the patient is expressing difficulty in avoiding alcohol use, which indicates a potential substance use disorder. Referral to a partial hospitalization program is appropriate for patients struggling with substance use issues as they require intensive treatment and support. Choice A is incorrect as the patient is compliant with lithium therapy. Choice B is incorrect as psychoeducation can be provided in outpatient settings. Choice C is incorrect as the patient needs immediate inpatient care due to active suicidal ideation.