A nurse has accepted a position on a pediatric unit and is learning about psychosocial development. Place Erikson's stages of psychosocial development in order from birth to adolescence. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

A. Constant need to talk about the event. While individuals with PTSD may experience intrusive thoughts or flashbacks related to the traumatic event, a constant need to talk about the event is not universally characteristic. Some individuals with PTSD may avoid discussing the traumatic event altogether due to the distress it causes them, while others may find it helpful to talk about it in therapy or support groups.

B. Increasing feelings of anger. This is the correct choice. Feelings of anger and irritability are common symptoms of PTSD. Individuals may experience heightened levels of anger as a result of feeling violated, powerless, or betrayed by the traumatic event. Anger may be directed toward the perpetrator, oneself, or others, and it can contribute to difficulties in interpersonal relationships and daily functioning.

C. Sleeping 12 hr or more each day. While sleep disturbances are common in PTSD, they typically manifest as insomnia, nightmares, or restless sleep rather than excessive sleep. Individuals with PTSD may struggle to fall asleep, experience frequent awakenings during the night, or have nightmares related to the traumatic event. Excessive sleeping is not typically associated with PTSD.

D. Increasing sense of attachment to others. Individuals with PTSD may experience difficulties in forming or maintaining relationships due to symptoms such as emotional numbing, avoidance of reminders of the trauma, and difficulties in trusting others. While some individuals may seek support from loved ones, an increasing sense of attachment to others is not typically an expected finding in PTSD.

A. "Who is lying about you and trying to poison you?": This response may come across as confrontational and may not effectively address the client's underlying fear or paranoia. It could potentially escalate the client's anxiety or reinforce their delusions by implying that the nurse believes the accusations are valid.

B. "You seem to be having very frightening thoughts.": This response acknowledges the client's experience without directly challenging or validating the content of their delusions. It conveys empathy and concern while also opening the door for further exploration of the client's feelings and experiences. By acknowledging the frightening nature of the client's thoughts, the nurse demonstrates understanding and provides an opportunity for therapeutic dialogue.

C. "You are mistaken. Nobody is lying about you or trying to poison you.": This response denies the client's reality and contradicts their experience, which can be invalidating and may cause the client to feel misunderstood or dismissed. It's important to avoid outright denial of the client's beliefs, as it can damage the therapeutic relationship and hinder effective communication.

D. "Why do you think you are being lied about and poisoned?": While this response seeks to explore the client's thoughts and feelings, it may be perceived as challenging or confrontational. It could unintentionally reinforce the client's delusions by inviting them to elaborate on their paranoid beliefs without first acknowledging the distress they are experiencing.