A nurse is teaching a client with major depressive disorder about their new prescription for bupropion. Which of the following instructions should the nurse include?

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: The honeymoon stage, where abusers show remorse, typically shortens over time as the cycle of violence accelerates. This statement is incorrect, as prolonged abuse often leads to shorter reconciliation periods, with increased frequency and severity of abusive episodes.

Choice B reason: Survivors often experience guilt due to psychological manipulation by abusers, who may blame them for the abuse. This internalized guilt, rooted in emotional trauma, affects self-esteem and decision-making, making it a key indicator of understanding the psychological impact of intimate partner abuse.

Choice C reason: Abusers typically have low self-esteem, using control and violence to compensate for insecurity. High self-esteem is not characteristic, as abusers often exhibit traits of narcissism or insecurity, contradicting this statement and indicating a misunderstanding of abuser psychology.

Choice D reason: Continued abuse often erodes victims’ confidence, leading to learned helplessness rather than increased determination for independence. Psychological trauma and fear reduce autonomy, making this statement incorrect, as victims may feel trapped rather than empowered to leave.