# Situation: The nurse coordinator of a hospital's bone health clinic plans an 8-session education program for 40 postmenopausal women with low bone mass. Most of the women are older adults, and several care for grandchildren at home. The program aims to reduce falls and fractures. During the third session, a woman begins to cry and says, "Since my sister broke her hip, I am afraid I will become a burden to my children." What should the nurse do?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630548  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: The nurse coordinator of a hospital's bone health clinic plans an 8-session education program for 40 postmenopausal women with low bone mass. Most of the women are older adults, and several care for grandchildren at home. The program aims to reduce falls and fractures.

During the third session, a woman begins to cry and says, "Since my sister broke her hip, I am afraid I will become a burden to my children." What should the nurse do?

## 보기

1. Acknowledge her fear and offer to talk with her privately afterward **✔ 정답**
2. Move on to the next topic so she is not embarrassed before the group
3. Invite her to tell the group about her sister's injury and treatment
4. Suggest she step outside until she feels calm, then rejoin the group

**정답: 1**

## 해설

When a participant becomes emotional about a personal problem, the nurse acknowledges the feelings and, where appropriate, links them to the topic, then offers private follow-up. Personal matters are discussed privately, not in the group.

## 심화 해설

Acknowledge, then follow up privately
During the third session, a woman begins to cry and shares a personal fear: since her sister broke her hip, she is afraid of becoming a burden to her children. The best response is to acknowledge her fear and offer to talk with her privately afterward. Recognizing the feeling shows respect and keeps her engaged, while moving the personal conversation to a private setting protects her dignity and keeps the session on track for the whole group. Where appropriate, the nurse can briefly link the concern to the topic, for example by noting that the program aims to reduce falls and fractures, which is exactly what she fears.

Group facilitation principles
A health educator leading a group balances the needs of one participant with the needs of the group. Emotions are a normal response when the topic touches on illness, loss, or dependence, and they often signal readiness to learn when handled well. The nurse uses therapeutic communication: a calm tone, a brief statement naming the feeling, and an offer of support. Personal matters, especially those involving another person's health, are discussed privately, not in front of the group.

| Response | Effect |
| --- | --- |
| Acknowledge and offer private follow-up | Respects her, protects privacy, keeps the group on track |
| Move on to the next topic | Dismisses her distress; may reduce readiness to learn |
| Invite her to tell the group about her sister | Exposes another person's health details; deepens distress |
| Suggest she step outside | Isolates her; does not address the concern |

Why the other responses are wrong
Moving on to avoid embarrassment ignores her feelings and teaches the group that concerns are not welcome. Inviting her to tell the group about her sister's injury asks her to share private health information about someone who is not present and may intensify her distress. Suggesting she step outside separates her from the group at a vulnerable moment and leaves her concern unaddressed.

Linking to the program
Her fear of hip fracture and dependence is common among older women with low bone mass. In private follow-up, the nurse can explore her concerns, reinforce what she can do to lower her fall and fracture risk, and refer her for further support if needed. Her experience may also help the nurse adjust future sessions to address fear of falling.

Exam takeaway
Key point When a group member becomes emotional about a personal issue: acknowledge the feeling, connect it to the topic if fitting, and offer private follow-up.

## 임상 시나리오

Handling Emotion in a Group SessionRespect, privacy, and group focus
When a participant becomes emotional about a personal problem, acknowledge the feeling and, if fitting, link it to the topic.

Offer to talk privately after the session. Personal matters, especially another person's health, are not discussed in the group.

Her fear of hip fracture can guide private teaching about fall and fracture prevention and support.

CautionIgnoring her, sending her out, or asking her to share details in public dismisses her feelings and breaches privacy.

## 핵심 개념

- **Group facilitation** — Guiding a group session so that all members can participate and learning goals are met.
- **Therapeutic communication** — Purposeful communication that conveys respect and helps the client express feelings.
- **Readiness to learn** — The emotional and physical state in which a learner is willing and able to learn.
- **Fear of falling** — Worry about falling that can limit activity in older adults, especially after a fall or fracture nearby.

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