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:

Disenfranchised grief

Anticipatory grief

Complicated grief

Chronic grief

Answer and Explanation

The Correct Answer is A

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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Correct Answer is B

Explanation

Choice A reason: Asking if voices come from external sources like TV assumes a delusional origin and closes off exploration. Open-ended questions are needed to assess the nature and impact of auditory hallucinations in schizophrenia, making this choice nontherapeutic.

Choice B reason: Asking the patient to describe the voices’ content is an open-ended response that encourages detailed disclosure. This helps assess the hallucinations’ nature, frequency, and impact on behavior, aiding in risk assessment and treatment planning, making this the correct choice.

Choice C reason: Asking about harm is a closed-ended question that assumes a specific risk, potentially limiting exploration of the hallucination’s full context. While safety is critical, open-ended questions better assess the patient’s experience initially, making this choice less appropriate.

Choice D reason: Asking about the timing of voices is closed-ended and limits the depth of assessment. Understanding the content and impact of hallucinations is more critical for schizophrenia management, as timing alone does not reveal risk or severity, making this choice incorrect.

A. Inappropriate affect B. Flat affect C. Labile affect

Correct Answer is A

Explanation

Choice A reason: Inappropriate affect, where emotions like manic laughter mismatch the context of loss, is common in disorders like schizophrenia. It reflects limbic-prefrontal dysregulation, causing emotional responses to be incongruent with the situation, making this the correct choice for the described behavior.

Choice B reason: Flat affect involves minimal or no emotional expression, often in schizophrenia or depression. The patient’s manic laughter is an active, inappropriate response, not a lack of emotion, making this choice incorrect for the scenario described.

Choice C reason: Labile affect involves rapid emotional shifts, such as laughing to crying, seen in bipolar disorder. The scenario describes a single inappropriate response (manic laughter), not shifts, making this choice incorrect for the patient’s presentation.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

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:

Correct Answer is A

Explanation

An elderly patient with advanced Alzheimer’s disease is admitted to the unit. The nurse is informed that the patient has a court-appointed legal guardian. The guardian arrives and asks for information about the patient’s medications and plan of care. What is the nurse’s best response?

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 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?

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?

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 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?

What is psychomotor retardation as seen in psychiatric patients?