A nurse is caring for a client with post-traumatic stress disorder (PTSD). The client states, "I keep having nightmares about the accident and I can't get them out of my head." This statement is an example of which symptom cluster of PTSD?

Choice B rationale:

Avoidance symptoms. This choice is accurate because the client's behavior of avoiding the site where the traumatic event occurred is characteristic of avoidance symptoms in PTSD. People with PTSD often go to great lengths to avoid reminders and triggers associated with the trauma. Now, let's address the other choices:

Choice A rationale:

Intrusion symptoms. This choice is incorrect in this context. Intrusion symptoms involve unwanted memories, nightmares, and flashbacks that intrude into a person's consciousness. Avoiding the site of the traumatic event does not align with this symptom cluster.

Choice C rationale:

Negative alterations in cognition and mood. This choice is not applicable to the client's behavior described. Negative alterations in cognition and mood involve feelings of detachment, distorted emotions, and negative beliefs about oneself or the world. Avoiding a specific location does not directly relate to this cluster.

Choice D rationale:

Alterations in arousal and reactivity. This choice is also incorrect for the given behavior. Alterations in arousal and reactivity include symptoms like irritability, hypervigilance, and difficulty concentrating. Avoidance of a particular site is not directly related to this symptom cluster.

Physical signs.

Choice A rationale:

Psychological signs involve cognitive and mental aspects of PTSD, such as flashbacks and intrusive thoughts.

Choice B rationale:

Emotional signs encompass mood-related manifestations like fear, anger, and guilt.

Choice D rationale:

Social signs refer to difficulties in interpersonal relationships and isolation. In contrast, Choice C, physical signs, include symptoms like headaches and chronic pain which are commonly associated with PTSD due to the physiological stress response triggered by the traumatic event. This response can lead to increased muscle tension and altered pain perception, resulting in these physical symptoms. Such somatic complaints are integral to the diagnosis of PTSD, and they often coexist with other psychological and emotional symptoms.