A nurse is caring for a 9-year-old child who mimics shooting a gun with their hand whenever someone enters the room or tries to interact with them.

 This is an example of which manifestation of post-traumatic stress disorder? 

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.

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