A nurse is assisting with teaching a class about stress. The nurse should include that which of the following is a manifestation of prolonged stress?

Choice A reason : Irritable bowel syndrome (IBS).IBS is a gastrointestinal disorder characterized by a group of symptoms including abdominal pain and changes in the pattern of bowel movements without any evidence of underlying damage. It is not typically related to flashbacks or stress-related disorders.

Choice B reason : Posttraumatic stress disorder (PTSD).PTSD is a mental health condition triggered by a terrifying event, either experiencing it or witnessing it. Symptoms include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. The client's experience of flashbacks is a characteristic symptom of PTSD.

Choice C reason : Acute stress disorder (ASD).ASD is characterized by the development of severe anxiety, dissociation, and other symptoms that occur within one month after exposure to an extreme traumatic stressor. As the client reports flashbacks of an event from a year ago, ASD would not be the correct diagnosis due to the time frame.

Choice D reason : Episodic acute stress.Episodic acute stress refers to frequent episodes of acute stress, not necessarily related to flashbacks or a specific traumatic event. It is more about the reaction to the demands of life and is not characterized by flashbacks of a traumatic event.

Choice A reason : Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. While the causes of ADHD are not fully understood, current research does not establish childhood obesity as a direct risk factor for developing ADHD. ADHD is thought to be linked to genetic factors and certain environmental exposures during pregnancy.

Choice B reason : Hypotension, or low blood pressure, is generally not associated with childhood obesity. In fact, obesity, especially in the long term, is more commonly linked to hypertension (high blood pressure) due to increased strain on the heart and blood vessels, and not hypotension.

Choice C reason : Rheumatoid arthritis is an autoimmune condition that causes joint inflammation and damage. It is not typically considered a direct complication of childhood obesity. While obesity can contribute to joint problems due to increased mechanical stress, it is not a known cause of autoimmune conditions like rheumatoid arthritis.

Choice D reason : Diabetes mellitus, particularly type 2 diabetes, is a well-documented potential complication of childhood obesity. Obesity increases the risk of developing insulin resistance, which can lead to elevated blood sugar levels and eventually type 2 diabetes. The excess fat, particularly visceral fat, is associated with chronic inflammation and metabolic changes that contribute to the development of diabetes⁴.