A nurse is caring for a patient who reports a recent increase in stressors.
Which of the following concepts should the nurse use to develop necessary context to both understand and deliver nursing care for this patient?

The correct answer is Choice C

Choice A rationale: A reluctance to leave the house for over a year suggests a struggle with grief and possibly depression but does not specifically indicate traumatic grief. It reflects difficulty in moving forward but lacks the intense guilt associated with traumatic grief.

Choice B rationale: Inability to cry due to a perceived need to be strong reflects emotional suppression and societal expectations. It does not directly point to traumatic grief, which often involves more severe symptoms like intense guilt and preoccupation with the deceased.

Choice C rationale: Feeling that one should have been killed instead of a friend indicates severe survivor guilt, a core component of traumatic grief. This statement reflects an intense emotional reaction and an inability to reconcile the loss, leading to profound distress and dysfunction.

Choice D rationale: Flashbacks and physical symptoms like a racing heart suggest post-traumatic stress disorder (PTSD) rather than traumatic grief. PTSD involves re-experiencing traumatic events, whereas traumatic grief focuses more on the loss and associated guilt

Choice A rationale
The adolescent’s experimentation with drugs could be a coping mechanism to deal with the trauma of the sexual assault and the subsequent posttraumatic stress disorder (PTSD).
Substance use, including drug use, is often a maladaptive coping strategy used by individuals

who have experienced trauma to numb their feelings, escape from their reality, or attempt to regain control. This must indeed be a difficult time for both the adolescent and the parent.
Choice B rationale
While experimentation is a part of normal adolescent behavior, it is not normal or healthy for an adolescent to use drugs, especially in response to a traumatic event such as a sexual assault. Drug use can lead to addiction, health problems, and further psychological distress. Therefore, it is something to be concerned about and addressed appropriately.
Choice C rationale
While it is important to understand and address the parent’s concerns, the focus should be on the adolescent’s needs. The adolescent is dealing with the aftermath of a sexual assault and a diagnosis of PTSD, and is using drugs. These are serious issues that need to be addressed with professional help. The question of which behavior to address first should be determined based on the adolescent’s immediate safety and well-being.
Choice D rationale
It is not helpful to label the adolescent’s behavior as misbehavior or to compare them to their siblings. Each child is unique and may react differently to stress and trauma. Instead of focusing on rules and comparisons, it would be more beneficial to provide support, understanding, and appropriate professional help.