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 D

Explanation

Choice A reason: Repetitive, purposeless movements like hand-wringing are stereotypic behaviors often observed in anxiety disorders or obsessive-compulsive disorder. These actions stem from heightened psychological distress or neurological compulsions, not the slowed motor and emotional responses characteristic of psychomotor retardation. This condition, primarily linked to depression, involves reduced activity due to altered dopaminergic and serotonergic activity, making this choice incorrect.

Choice B reason: Sudden, jerky muscle spasms are typically extrapyramidal symptoms, such as tardive dyskinesia, caused by antipsychotic medications affecting dopamine pathways in the basal ganglia. These involuntary movements are abrupt and distinct from the generalized slowing of physical and emotional responses in psychomotor retardation, which is a hallmark of depression, rendering this choice incorrect.

Choice C reason: Rapid, involuntary movements are associated with anxiety or hyperkinetic disorders, reflecting increased autonomic arousal and motor activity. These contrast with psychomotor retardation, where patients exhibit slowed movements and emotional expression due to decreased neural activity in mood-regulating brain regions, such as the prefrontal cortex, making this choice incorrect for defining psychomotor retardation.

Choice D reason: Psychomotor retardation, common in major depressive disorder, involves slowed physical movements, speech, and emotional responses due to disruptions in dopaminergic and serotonergic neurotransmission. This leads to lethargy, delayed cognitive processing, and reduced expressiveness, accurately describing the condition and making this the correct choice for the clinical presentation described in the question.

A. Our staff is excellent, and you are in good hands. B. I think you should calm down and look at the positive side. C. Are you feeling that no one understands? D. I find that hard to believe.

Correct Answer is C

Explanation

Choice A reason: Praising the staff dismisses the patient’s feelings, a nontherapeutic response. It fails to explore the patient’s sense of isolation, potentially worsening distrust, as it does not engage the emotional distress expressed, making this choice incorrect.

Choice B reason: Telling the patient to calm down and focus on positives minimizes their feelings, a nontherapeutic approach. It ignores the underlying emotional distress, potentially inhibiting therapeutic communication and trust, making this choice incorrect for the scenario.

Choice C reason: Reflecting the patient’s feeling of being misunderstood is therapeutic, as it validates their emotions and invites further exploration. This open-ended response engages the patient’s limbic system, fostering trust and emotional processing, making this the correct choice.

Choice D reason: Expressing disbelief invalidates the patient’s experience, a nontherapeutic response. It risks alienating the patient, hindering therapeutic alliance by dismissing their emotional distress rather than exploring it, 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

What is psychomotor retardation as seen in psychiatric patients?

Correct Answer is D

Explanation

A client on a psychiatric unit states, “It’s a waste of time being here. I can’t talk to you or anyone.” Which is the correct nursing response?

Correct Answer is C

Explanation

A patient recently diagnosed with type 2 diabetes tells the nurse, “This is all my fault. If I had taken better care of myself, I wouldn’t be in this situation.” Which response by the nurse is the most therapeutic?

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?

A patient is brought to the psychiatric unit by family members after expressing suicidal thoughts but refuses voluntary admission. The healthcare team proceeds with involuntary commitment. Which of the following statements best describes involuntary commitment?

A patient with depression tells the nurse, “Sometimes I think people would be better off without me being alive.” Which closed-ended question should the nurse ask next to assess the patient’s safety?

During a mental health assessment, a patient laughs manically while describing a recent loss of a loved one. The nurse recognizes this emotional expression as:

A patient missed a treatment option. Later, the patient appears withdrawn and avoids eye contact when discussing calling loved ones. Which is the best nursing action?

The nurse uses a variety of therapeutic communication skills when working with patients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication?