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:

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.

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.