Poems use rhyme to create a singsong quality
only if they are sonnets as a refrain only if they are couplets

Hello. This question is incomplete. The full question is:

"How does the difference between the character's spoken words and internal thoughts affect the story?

I smiled. "I'm doing great! How are you?" This smile is breaking my face; tears will flood me; I'm going to collapse like a bridge in an earthquake.

A. It creates dramatic tension.  B. It introduces a new character.  C. It ties up the loose ends.  D. It changes the point of view."

A. It creates dramatic tension.

Explanation:

In the excerpt shown in the question above, the character states that he is smiling, which means that he is happy and excited. However, when we have access to his thoughts, we see that the character is highly sad and melancholy, so he says that he can collapse at any moment of so much sadness.

Based on that, we can see that what the character shows and what he feels is totally different and that difference creates a strong dramatic tension.