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
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
Clean drinking water is indeed crucial for preventing many diseases, especially those transmitted through the fecal-oral route or waterborne diseases such as cholera, typhoid, and hepatitis A1. However, it is not specifically targeted at diseases that are transmitted directly from person to person. Directly transmitted diseases are often spread through direct contact, such as person-to-person contact or droplet spread. Therefore, while clean drinking water is an essential aspect of public health, it is not the most effective method for preventing diseases that are transmitted directly.
Choice B rationale
Pest control is an important measure for preventing diseases transmitted by vectors, such as mosquitoes, ticks, and fleas. Diseases like malaria, dengue, Lyme disease, and plague are examples of vector-borne diseases. However, these diseases are not considered directly transmitted diseases. Direct transmission occurs when an infectious agent is transferred from a reservoir to a susceptible host by direct contact or droplet spread. Therefore, pest control, while important, is not the primary prevention method for diseases that are transmitted directly.
Choice C rationale

Isolation is one of the most effective methods for preventing the spread of directly transmitted diseases. When a person is isolated, they are separated from others to prevent the spread of communicable diseases. Isolation is used in healthcare settings to prevent the spread of infectious diseases that can be transmitted directly from person to person, such as tuberculosis, influenza, and COVID-191. Therefore, isolation is a key prevention method for diseases that are transmitted directly.
Choice D rationale
Proper sanitation, like clean drinking water, is crucial for preventing many diseases, particularly those transmitted through the fecal-oral route. Proper sanitation involves safely managing human waste and maintaining hygienic conditions through services such as garbage collection and wastewater disposal. While it is an essential aspect of public health, proper sanitation is not the most effective method for preventing diseases that are transmitted directly from person to person.