A nurse is caring for a patient diagnosed with schizophrenia. During the interaction, the nurse notices that the patient’s facial expressions are minimal and do not seem to match the emotions being expressed verbally. This is an example of:

Labile affect

Flat affect

Inappropriate affect

Blunted affect

Answer and Explanation

The Correct Answer is C

Choice A reason: Labile affect involves rapid, unpredictable emotional shifts, common in bipolar disorder. It does not describe minimal facial expressions or a mismatch between verbal and nonverbal emotions, as seen in schizophrenia. The described scenario involves incongruence, not rapid changes, making this choice incorrect.

Choice B reason: Flat affect is a near absence of emotional expression, often seen in schizophrenia, where patients show minimal facial or vocal changes. While related, it does not specifically address the mismatch between verbal emotions and minimal facial expressions described, making it less precise than inappropriate affect.

Choice C reason: Inappropriate affect, common in schizophrenia, occurs when emotional expressions do not match the context or verbal content, such as minimal facial expressions despite verbal emotional statements. This results from disrupted neural connections in the limbic system and prefrontal cortex, making it the correct choice.

Choice D reason: Blunted affect involves reduced intensity of emotional expression, often in schizophrenia, but does not emphasize a mismatch between verbal and nonverbal emotions. It describes a general dampening of affect, not the specific incongruence noted in the scenario, making this choice incorrect.

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Correct Answer is A

Explanation

Choice A reason: A legal guardian, appointed for a patient with advanced dementia, has authority to make healthcare decisions, as the patient lacks capacity due to cognitive impairment. Following the guardian’s decisions ensures legal and ethical compliance, prioritizing the patient’s best interests, making this the correct choice.

Choice B reason: Ignoring the legal guardian violates legal standards, as the guardian is appointed to act in the patient’s best interest. Nurses lack authority to override guardians, and doing so risks unethical care and legal repercussions, making this choice incorrect.

Choice C reason: Consulting a patient with advanced dementia directly disregards their lack of decision-making capacity, as cognitive impairments prevent informed choices. The legal guardian’s role supersedes patient preferences in this context, making this choice incorrect.

Choice D reason: Requiring written consent from a patient with advanced dementia is inappropriate, as they lack capacity to provide informed consent. Legal guardians provide consent for such patients, ensuring care aligns with their best interests, making this choice incorrect.

A. Disenfranchised grief B. Anticipatory grief C. Complicated grief D. Chronic grief

Correct Answer is A

Explanation

Choice A reason: Disenfranchised grief occurs when a loss is not socially acknowledged, such as in a non-traditional relationship, preventing open mourning. This leads to suppressed emotions and potential psychological distress, as the individual feels isolated in their grief, making this the correct choice for the described scenario.

Choice B reason: Anticipatory grief occurs before an expected loss, such as during a terminal illness, where individuals mourn in advance. The scenario describes grief after a death, not before, and the issue is lack of social recognition, not anticipation, making this choice incorrect.

Choice C reason: Complicated grief involves prolonged, intense grief that impairs functioning, often with unresolved emotions. While the woman’s sadness is significant, the key issue is the inability to mourn openly due to social stigma, not prolonged grief, making this choice incorrect.

Choice D reason: Chronic grief refers to persistent grief without resolution, often over years. The scenario does not indicate a prolonged duration but rather the social barrier to mourning a non-recognized relationship, aligning with disenfranchised grief, not chronic grief, making this choice incorrect.

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A nurse is caring for a patient diagnosed with schizophrenia. During the interaction, the nurse notices that the patient’s facial expressions are minimal and do not seem to match the emotions being expressed verbally. This is an example of:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an elderly patient with advanced dementia who is unable to make healthcare decisions independently. The patient’s adult child has been appointed legal guardian. What is the nurse’s best action regarding the patient’s care decisions?

Correct Answer is A

Explanation

A woman experiences deep sadness after the death of her “side-piece,” but she feels unable to openly mourn because their relationship was not recognized openly. The nurse identifies this as an example of:

Correct Answer is A

Explanation

A patient diagnosed with schizophrenia tells the nurse, “I hear voices sometimes, but they don’t bother me.” Which of the following is the most appropriate open-ended response by the nurse to further assess the patient’s experience?

The nurse is caring for a patient recently diagnosed with a terminal illness. The patient says, “There’s no way this is right. I’m going to get another opinion—this doctor doesn’t know what they’re talking about.” The nurse recognizes that the patient is in which stage of grief?

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