A nurse is caring for a patient who has returned from a bereavement support group.
Which of the following patient statements indicates that the patient is meeting the planned outcomes of treatment?

The correct answer is Choice C

Choice A rationale: A reluctance to leave the house for over a year suggests a struggle with grief and possibly depression but does not specifically indicate traumatic grief. It reflects difficulty in moving forward but lacks the intense guilt associated with traumatic grief.

Choice B rationale: Inability to cry due to a perceived need to be strong reflects emotional suppression and societal expectations. It does not directly point to traumatic grief, which often involves more severe symptoms like intense guilt and preoccupation with the deceased.

Choice C rationale: Feeling that one should have been killed instead of a friend indicates severe survivor guilt, a core component of traumatic grief. This statement reflects an intense emotional reaction and an inability to reconcile the loss, leading to profound distress and dysfunction.

Choice D rationale: Flashbacks and physical symptoms like a racing heart suggest post-traumatic stress disorder (PTSD) rather than traumatic grief. PTSD involves re-experiencing traumatic events, whereas traumatic grief focuses more on the loss and associated guilt

Choice A rationale
Agoraphobia is characterized by a fear of being in situations where escape might be difficult or embarrassing, or help might not be available in the event of panic symptoms. This does not align with the child’s symptoms of not being able to speak in class or other social situations.
Choice B rationale
Generalized anxiety disorder is characterized by excessive, uncontrollable worry about a variety of topics and is not specific to social situations. The child’s symptoms are more specific to social situations, which does not align with generalized anxiety disorder.

Choice C rationale
Selective mutism is an anxiety disorder characterized by a consistent failure to speak in specific social situations in which there is an expectation for speaking, despite speaking in other situations. This aligns with the child’s symptoms of not being able to speak during class and other social situations.
Choice D rationale
Separation anxiety disorder is characterized by excessive fear or anxiety about separation from those to whom the individual is attached. The child’s symptoms do not indicate a fear of separation, but rather a fear of speaking in social situations.