A nurse is preparing to interview a client and is reviewing therapeutic communication techniques. Which of the following should the nurse include in the interview to invite the client to clarify feelings?

Choice A rationale
While expressing empathy is important, this response does not demonstrate an understanding of the concept of historical trauma. Historical trauma refers to the cumulative emotional and psychological wounding of an individual or generation caused by a traumatic experience or event.

Choice B rationale
This response is not appropriate as it attempts to pinpoint the trauma to a specific time in the client’s life. The client is referring to a historical trauma that affected their ancestors and continues to impact their family.
Choice C rationale
This response is vague and does not address the client’s statement about the impact of historical trauma on their family.
Choice D rationale
This is the correct response. By stating that they understand the impact of historical trauma, the nurse acknowledges the long-term effects of traumatic events that occurred in the past and continue to affect the client’s family.

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.