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 C

Explanation

Choice A reason: Herbal supplements may interact with medications, potentially requiring dose adjustments, but this is not a standard reason for lower doses. Drug metabolism varies, and interactions depend on specific herbs, making this choice less likely than renal impairment for dose reduction.

Choice B reason: A young female post-appendectomy typically has normal organ function, requiring standard medication doses. No physiological factors like impaired renal or hepatic function suggest a need for lower doses, making this choice incorrect for dose adjustment.

Choice C reason: Decreased renal function, common in elderly patients, reduces drug clearance, increasing the risk of toxicity. Lower doses are often required to prevent accumulation, as the kidneys’ glomerular filtration rate declines with age, making this the correct choice.

Choice D reason: Seasonal allergies do not typically affect medication metabolism or clearance, so standard doses are appropriate. Unlike renal impairment, allergies do not alter pharmacokinetics, making this choice incorrect for anticipating a lower medication dose.

A. This must be incredibly hard for you. B. Tell me more about what you’re feeling right now. C. You’ll feel better soon, just give it time. D. I’m here for you; let’s talk about what you’re going through.

Correct Answer is C

Explanation

Choice A reason: Expressing empathy, such as acknowledging the difficulty of the loss, fosters a therapeutic connection. It validates the patient’s emotions, encouraging open expression of grief, which is essential for processing loss and aligns with therapeutic communication principles, making this choice therapeutic.

Choice B reason: Asking the patient to elaborate on their feelings is a therapeutic open-ended question. It promotes exploration of emotions, facilitating grief processing by engaging the patient’s prefrontal cortex in reflecting on their experience, making this a therapeutic response and incorrect for the question.

Choice C reason: Saying “You’ll feel better soon” minimizes the patient’s grief, dismissing their current emotional state. This nontherapeutic response can inhibit emotional expression, as it implies a timeline for grief recovery, potentially disrupting the patient’s natural mourning process, making this the correct choice.

Choice D reason: Offering support and encouraging discussion is therapeutic, as it builds trust and validates the patient’s experience. This response engages the patient in processing grief, supporting emotional regulation through empathetic communication, making it a therapeutic response and incorrect for the question.

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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

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

Correct Answer is C

Explanation

A patient recently lost her spouse and says, “I don’t know how I’m going to live without him.” Which of the following responses by the nurse is nontherapeutic?

Correct Answer is C

Explanation

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:

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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?

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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: