A nurse is caring for a child whose guardians report that the child consistently cannot speak during class and other social situations.
Which of the following anxiety disorders should the nurse identify that the child is experiencing?

Choice A rationale
Acute Stress Disorder (ASD) is a mental health condition that can occur in the immediate aftermath of a traumatic event, with symptoms starting within four weeks of the event and lasting for a minimum of three days and up to one month. This client’s statement about experiencing nightmares following a car crash two weeks ago aligns with the diagnosis of ASD.

Nightmares are a common symptom of ASD, often replaying the traumatic event, leading to disrupted sleep and increased distress.
Choice B rationale
This statement is more indicative of Post-Traumatic Stress Disorder (PTSD), a related but distinct condition from ASD. PTSD is characterized by persistent and intrusive memories of the traumatic event, which can include flashbacks, and symptoms must last for more than a month and cause significant distress or functional impairment. The chronic nature of the symptoms described by the client, including frequent flashbacks since childhood, is more consistent with PTSD than ASD.
Choice C rationale
This statement could suggest a condition known as Specific Phobia, Situational Type. This is a type of anxiety disorder characterized by an intense, persistent fear of certain situations. The individual will avoid the situation or endure it with intense fear or anxiety. In this case, the client’s inability to drive following a car crash two years ago could indicate a specific phobia related to driving.
Choice D rationale
The experience described by the client in this statement is indicative of a dissociative symptom, which can be a feature of several different mental health disorders, including but not limited to Dissociative Disorders and PTSD1. The feeling of leaving one’s body is referred to as depersonalization, a type of dissociation that can occur as a response to trauma. However, without more information, it is difficult to align this statement with a specific diag

Choice A rationale
While expressing empathy is important, this response does not demonstrate an understanding of the concept of historical trauma. Historical trauma refers to the cumulative emotional and psychological wounding of an individual or generation caused by a traumatic experience or event.

Choice B rationale
This response is not appropriate as it attempts to pinpoint the trauma to a specific time in the client’s life. The client is referring to a historical trauma that affected their ancestors and continues to impact their family.
Choice C rationale
This response is vague and does not address the client’s statement about the impact of historical trauma on their family.
Choice D rationale
This is the correct response. By stating that they understand the impact of historical trauma, the nurse acknowledges the long-term effects of traumatic events that occurred in the past and continue to affect the client’s family.