A client tells the nurse that he has bugs in his brain and asks the nurse if the nurse can see them. Which response by the nurse is most therapeutic?

Choice A reason: Questioning death’s reason reflects normal grief, involving amygdala-driven emotional processing and cortisol surges. It does not indicate complicated bereavement, which involves prolonged, impairing despair, disrupting serotonin-mediated emotional recovery after a year.

Choice B reason: Stating life has no meaning a year after loss suggests complicated bereavement, with persistent serotonin deficits and amygdala-driven despair. This indicates unresolved grief, impairing prefrontal cortex-mediated coping and emotional integration, characteristic of prolonged, dysfunctional mourning.

Choice C reason: Questioning God’s role is a normal grief response, reflecting amygdala-driven existential distress. It does not indicate complicated bereavement, which requires persistent functional impairment and serotonin dysregulation beyond the expected grief timeline of one year.

Choice D reason: Self-focused questioning is part of normal grief, driven by amygdala-anxiety and cortisol. It does not signify complicated bereavement, which involves prolonged, debilitating despair and serotonin deficits, impairing recovery and functioning beyond a year.

Choice A reason: Divorce represents distress, not eustress, as it triggers negative emotional responses via heightened cortisol and amygdala activity, disrupting serotonin and dopamine balance. This chronic stress impairs prefrontal cortex function, leading to emotional dysregulation, unlike eustress, which promotes positive motivation and growth.

Choice B reason: Job loss threat is distress, activating the HPA axis to release cortisol, increasing amygdala-driven anxiety. This disrupts serotonin signaling, impairing mood regulation, and does not foster positive motivation or growth, unlike eustress, which involves beneficial stress enhancing performance without overwhelming neural systems.

Choice C reason: Financial strain is distress, elevating cortisol via HPA axis activation, increasing amygdala activity, and reducing prefrontal control, leading to anxiety. Unlike eustress, which promotes motivation through manageable challenges, this scenario causes negative emotional responses, disrupting serotonin and dopamine balance, impairing coping mechanisms.

Choice D reason: Learning new skills for a promotion is eustress, activating moderate HPA axis responses and dopamine release in the reward system, enhancing motivation and prefrontal cortex function. This positive stress promotes neuroplasticity, improving cognitive adaptability and emotional resilience, unlike distress, which overwhelms neural regulatory systems.