A nurse is performing a home visit on a client who has Alzheimer’s disease and their partner. The partner states, “I wish I had some time to myself and run errands, but I need to be here all the time.” Which of the following referrals should the nurse recommend to the client’s partner?

Choice A reason: Blaming others is associated with personality disorders, not PTSD. PTSD involves hyperarousal and trauma-related symptoms, not externalization of responsibility. This behavior does not align with the neurobiological changes, like amygdala hyperactivity, seen in PTSD’s trauma response.

Choice B reason: Difficulty concentrating is a hallmark of PTSD, driven by hyperarousal and intrusive thoughts. Trauma disrupts prefrontal cortex function, impairing attention and executive function, making it difficult to focus on tasks, a common symptom in PTSD’s cognitive cluster.

Choice C reason: Sleep difficulties are a core PTSD symptom, resulting from hyperarousal and amygdala dysregulation. Nightmares or hypervigilance disrupt sleep onset and maintenance, contributing to fatigue and worsening other symptoms, making this an expected finding in PTSD assessment.

Choice D reason: Persistent negative beliefs about self, like guilt or shame, are common in PTSD due to trauma-related cognitive distortions. These beliefs stem from altered self-perception and limbic system changes, contributing to the disorder’s emotional and cognitive impact, making this an expected finding.

Choice E reason: Excessive talking is not typical in PTSD but may occur in mania or anxiety disorders. PTSD clients may exhibit social withdrawal or selective mutism due to trauma-related avoidance, making this behavior inconsistent with the disorder’s psychological and neurological profile.

Choice A reason: Staying for 15 minutes post-meal is insufficient to prevent purging in anorexia nervosa, as clients may delay vomiting. Supervision for 30–60 minutes is standard to ensure nutritional retention, addressing the disorder’s characteristic behaviors driven by distorted body image and restrictive eating patterns.

Choice B reason: A daily exercise program is contraindicated in acute anorexia nervosa, as excessive activity exacerbates malnutrition and cardiac strain. Rest is prioritized to conserve energy and support weight restoration, addressing the severe caloric deficit and metabolic complications associated with the disorder’s restrictive behaviors.

Choice C reason: Discussing food during meals can increase anxiety in anorexia nervosa, as clients have intense food-related fears. Neutral conversation reduces distress, supporting nutritional intake. Food-focused talk reinforces obsessive thoughts, counteracting therapeutic goals to normalize eating behaviors and address psychological distortions.

Choice D reason: Daily weighing in acute care monitors nutritional progress in anorexia nervosa, ensuring weight restoration and guiding treatment. Consistent weights assess response to refeeding, addressing severe malnutrition risks like cardiac arrhythmias. Standardized protocols (e.g., morning post-void) ensure accuracy, making this critical for medical stabilization.