A nurse is assessing a client for potential PTSD symptoms. Which statement by the client indicates they are experiencing intrusion symptoms?

Choice A rationale:

Intrusion symptoms. This choice is accurate because the client's statement about recurring nightmares and intrusive thoughts related to the accident aligns with the intrusion symptoms of post-traumatic stress disorder (PTSD). Intrusion symptoms involve distressing memories, nightmares, and flashbacks that "intrude" into the person's consciousness. Now, let's address the other choices:

Choice B rationale:

Avoidance symptoms. This choice is incorrect for this scenario. Avoidance symptoms in PTSD involve efforts to avoid reminders, thoughts, or situations associated with the traumatic event. The client's statement does not specifically reflect avoidance behaviors.

Choice C rationale:

Negative alterations in cognition and mood. This choice is also incorrect in this context. Negative alterations in cognition and mood include feelings of detachment, negative beliefs, and distorted emotions. The client's statement does not directly relate to these alterations.

Choice D rationale:

Alterations in arousal and reactivity. This choice is incorrect for the given statement. Alterations in arousal and reactivity involve symptoms like irritability, hypervigilance, and exaggerated startle response. The client's description of recurring nightmares and intrusive thoughts does not align with this symptom cluster.

Choice A rationale:

Intrusive memories are characterized by the sudden and distressing re-experiencing of the traumatic event. These memories can be in the form of flashbacks or nightmares and are not directly related to the client's reported inability to remember aspects of the event and feeling detached.

Choice B rationale:

Negative mood, while common in PTSD, pertains to feelings of sadness, anger, or guilt. It is not the primary symptom described in this scenario, where the client is struggling with memory gaps and detachment.

Choice C rationale:

The nurse is observing dissociation in this client. Dissociation involves feeling disconnected from oneself or the environment, often as a defense mechanism in response to trauma. This can manifest as depersonalization (feeling detached from one's own body) or derealization (feeling detached from one's surroundings).

Choice D rationale:

Avoidance refers to the avoidance of reminders or situations associated with the traumatic event. While it can be a symptom of PTSD, it doesn't fully capture the reported memory issues and detachment observed in this client.

Choice E rationale:

Arousal symptoms involve heightened physiological responses such as hypervigilance, irritability, and exaggerated startle responses. These symptoms are not the primary focus of the scenario, which is centered around memory gaps and detachment.