A nurse is providing care for a client who has recently returned from active combat and lost a close friend during combat.
Which statement by the client indicates that they are experiencing traumatic grief?

“It has been more than a year, and I still don’t want to leave the house.”.

“I can’t cry when I talk about my friend because I’m supposed to be strong.”.

“I should have been the one who was killed instead of my friend.”.

“When I have flashbacks, it feels like my heart is going to beat through my chest.”.

Answer and Explanation

The Correct Answer is C

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

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Correct Answer is C

Explanation

Choice A rationale
Having the child carefully repeat the events of the trauma is not always the best strategy. Repeatedly recounting traumatic events can potentially retraumatize the child.
Choice B rationale
Assessing the child without their caregiver present can be beneficial in some cases, especially if there is a suspicion of abuse by the caregiver. However, in the context of school violence, it might be more beneficial to have a trusted adult present to provide comfort and support.
Choice C rationale
Having toys or drawing materials available for the child is a good strategy. Play and art can be therapeutic for children and can provide a non-threatening way for them to express their feelings and experiences.
Choice D rationale

Focusing solely on the physical domain of health may not provide a comprehensive understanding of the child’s experience. While physical health is important, understanding the child’s emotional and psychological responses to the violence is also crucial.

A. “I was in a car crash two weeks ago and I have nightmares when I sleep.”. B. “I was physically abused as a child and have frequent flashbacks since then.”. C. “I was in a terrible car crash two years ago and I have been unable to drive since then.”. D. “My parents fought a lot when I was a child.

Correct Answer is A

Explanation

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

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A nurse is providing care for a client who has recently returned from active combat and lost a close friend during combat. Which statement by the client indicates that they are experiencing traumatic grief?

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A nurse is providing care for a client who has recently returned from active combat and lost a close friend during combat.
Which statement by the client indicates that they are experiencing traumatic grief?