A nurse is caring for an adolescent with an anxiety disorder.
Which of the following statements by the adolescent indicates a protective factor in the form of a positive childhood experience?

Choice A rationale
Quality education does not typically include coverage for medical expenses. Education and healthcare are generally considered separate entities, with different funding and administration.
Choice B rationale
Individuals who attain a quality education are indeed more likely to secure a job that pays a living wage. Education often provides the skills and knowledge necessary for higher-paying

jobs, which can lead to improved health outcomes through increased access to healthcare, healthier lifestyles, and better living conditions.
Choice C rationale
While technology and virtual healthcare services are increasingly being integrated into various aspects of society, quality education does not inherently provide increased access to virtual visits with primary care physicians.
Choice D rationale
The requirement to purchase healthy lunches at school is not a characteristic of quality education. While nutrition is important for overall health and academic performance, it is not a defining factor of the quality of education.

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