A nurse is caring for a client who is having difficulty sleeping and is pacing the floor. The client's head down, and he is wringing his hands. Which of the following actions should the nurse take?

A) "My child was born with a birth defect due to an exposure I had overseas."

This statement does not directly relate to the core symptoms of PTSD. While exposure to trauma can have a variety of consequences, including potential exposure-related health issues, this statement does not necessarily indicate the re-experiencing, avoidance, or hyperarousal symptoms characteristic of PTSD.

B) "I check any room I enter because the enemy is still after me and could be hiding anywhere."

This statement is more indicative of hyperarousal and hypervigilance, which are common symptoms of PTSD. However, it does not explicitly involve re-experiencing the traumatic event through nightmares or intrusive memories, as described in the correct answer.

C) "In my dreams, all I can see are the wounded reaching out and trying to grab me."

Explanation:

The statement "In my dreams, all I can see are the wounded reaching out and trying to grab me" indicates symptoms commonly associated with posttraumatic stress disorder (PTSD). This statement reflects the re-experiencing symptom cluster of PTSD, where individuals may have distressing and intrusive memories, nightmares, or flashbacks related to the traumatic event they experienced. The imagery of wounded individuals trying to grab the person suggests a strong emotional impact and ongoing distress related to the traumatic experience.

D) "I killed four enemy soldiers with my bare hands and saved my entire battalion."

While this statement might reflect exposure to a traumatic event and could contribute to symptoms of PTSD, it is presented in a way that seems more like a narrative of heroic actions rather than a symptom of distress or re-experiencing.

A. Joining a group discussion about a local election: While group discussions can be productive, a person in the manic phase of bipolar disorder may have difficulty focusing and may become overly talkative or agitated. Engaging in a group discussion about a local election may exacerbate their symptoms and lead to increased energy and agitation.

B. Watching a video with a group in the day room: Watching a video in a group setting may not be suitable for a person in the manic phase, as they might find it hard to sit still and concentrate. The fast-paced and changing nature of videos may contribute to increased restlessness and agitation.

C. Participating in a basketball game in the gym: Engaging in physical activities like basketball can be too stimulating for someone in the manic phase. Their heightened energy levels may cause them to become overly competitive, agitated, or impulsive, potentially leading to risky behavior or increased symptoms.

D. Walking with the nurse in the courtyard: Taking a walk in a calm and soothing environment, such as a courtyard, can help a person in the manic phase expend excess energy in a controlled manner. Walking provides physical activity without overstimulating or overwhelming the individual, making it a more appropriate choice to address boredom while managing their symptoms.