A nurse observes a patient with bipolar disorder who suddenly shifts from laughing joyfully to crying within minutes during the therapy session. This sudden and intense change in emotional expression is an example of:

Labile affect

Flat affect

Restricted affect

Blunted affect

Answer and Explanation

The Correct Answer is A

Choice A reason: Labile affect, common in bipolar disorder, involves rapid, unpredictable shifts in emotional expression, such as moving from laughter to crying. This reflects dysregulation in the limbic system and prefrontal cortex, leading to exaggerated emotional responses. The sudden mood swings described align with this condition, making it the correct choice.

Choice B reason: Flat affect describes a severe reduction or absence of emotional expression, often seen in schizophrenia or severe depression. Patients display minimal facial or vocal changes, unlike the rapid emotional shifts in the scenario. This lack of emotional variability does not match the described behavior, making this choice incorrect.

Choice C reason: Restricted affect refers to a limited range of emotional expression, less severe than flat affect, often seen in mood disorders or personality disorders. It does not involve rapid shifts between emotions, as described in the question, but rather a consistently narrowed emotional range, making this choice incorrect.

Choice D reason: Blunted affect involves a reduced intensity of emotional expression, common in schizophrenia or post-traumatic stress disorder. Patients show muted responses, not rapid shifts between intense emotions like laughter and crying. This does not align with the described bipolar disorder behavior, making this choice incorrect.

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Correct Answer is ["A","D","E"]

Explanation

Choice A reason: Slapping a patient constitutes battery, an intentional tort involving deliberate harmful or offensive contact without consent. This violates patient autonomy and ethical standards, causing physical and psychological harm. The intentional nature of the act, targeting a vulnerable confused patient, makes it a clear example of an intentional tort in nursing practice.

Choice B reason: Administering the wrong medication due to misreading a label is negligence, not an intentional tort. Negligence involves unintentional failure to meet care standards, lacking the purposeful intent required for torts like assault or battery. This error results from inattention, not deliberate harm, so it does not qualify as an intentional tort.

Choice C reason: Failing to put up side rails, leading to a patient fall, is negligence, not an intentional tort. This reflects a lapse in the standard of care, not a deliberate act to cause harm. Negligence lacks the intentionality required for torts like false imprisonment, making this choice incorrect for the question.

Choice D reason: Physically restraining a competent patient without a provider’s order is false imprisonment, an intentional tort. This deliberate act restricts patient autonomy without medical or legal justification, violating their rights. The intentional restriction of movement, especially in a competent individual, makes this a clear example of an intentional tort.

Choice E reason: Threatening to give an injection to coerce medication compliance constitutes assault, an intentional tort. The deliberate verbal threat creates fear of imminent harm, violating patient autonomy. This intentional act, aimed at manipulating the patient’s behavior, qualifies as an intentional tort in nursing practice.

A. Follow the legal guardian’s decisions regardless of what the patient wants B. Ignore the guardian and make decisions based on the nurse’s judgment C. Consult the patient directly and respect their decisions above all D. Require the patient to provide written consent for all care, even routine nursing tasks

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.

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A nurse observes a patient with bipolar disorder who suddenly shifts from laughing joyfully to crying within minutes during the therapy session. This sudden and intense change in emotional expression is an example of:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following are examples of intentional torts in nursing practice? (Select all that apply)

Correct Answer is ["A","D","E"]

Explanation

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 nurse is reviewing the medication orders for four patients. Which patient should the nurse anticipate receiving a lower dose of medication?

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:

During a psychiatric assessment, a patient frequently shifts from one topic to another and never returns to the original question asked by the nurse. This pattern of speech is best described as:

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?

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:

A nurse observes a patient with bipolar disorder who suddenly shifts from laughing joyfully to crying within minutes during the therapy session. This sudden and intense change in emotional expression is an example of:

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?

A patient becomes agitated and physically aggressive on the unit, requiring the use of restraints. Which of the following actions by the nurse is appropriate when applying and managing restraints?