A nurse is caring for a patient with post-traumatic stress disorder who is considering prolonged exposure therapy.
The patient asks, “How does this therapy work?” Which of the following responses accurately describes this type of therapy?

Choice A rationale
Agoraphobia is characterized by a fear of being in situations where escape might be difficult or embarrassing, or help might not be available in the event of panic symptoms. This does not align with the child’s symptoms of not being able to speak in class or other social situations.
Choice B rationale
Generalized anxiety disorder is characterized by excessive, uncontrollable worry about a variety of topics and is not specific to social situations. The child’s symptoms are more specific to social situations, which does not align with generalized anxiety disorder.

Choice C rationale
Selective mutism is an anxiety disorder characterized by a consistent failure to speak in specific social situations in which there is an expectation for speaking, despite speaking in other situations. This aligns with the child’s symptoms of not being able to speak during class and other social situations.
Choice D rationale
Separation anxiety disorder is characterized by excessive fear or anxiety about separation from those to whom the individual is attached. The child’s symptoms do not indicate a fear of separation, but rather a fear of speaking in social situations.

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.