A parent is discussing the sleep needs of a preschooler with the nurse. Which information will the nurse share with the parent?

Choice A reason: Expressive aphasia impairs speech production due to brain injury, but patients can often use nonverbal methods like gestures or facial expressions. Including a goal for nonverbal communication is realistic, promoting effective interaction while speech therapy progresses. This aligns with the patient’s current abilities and supports functional communication.

Choice B reason: Recovering full speech vocabulary in one day is unrealistic for expressive aphasia, which requires prolonged speech therapy due to neurological damage. This goal sets false expectations, ignoring the chronic nature of traumatic brain injury recovery, and is not appropriate for the care plan.

Choice C reason: Carrying a pen and pad may help some patients, but expressive aphasia does not guarantee writing ability, as written language can also be impaired. This goal is less broadly applicable than nonverbal communication, which leverages intact motor and emotional expression, making it a less suitable choice.

Choice D reason: Thickening drinks prevents aspiration in dysphagia, not aphasia. Expressive aphasia affects speech, not swallowing. This goal is irrelevant to the patient’s condition, as there is no indication of swallowing difficulty, making it an incorrect focus for the care plan.

Choice A reason: Acute stress disorder occurs within one month of trauma, with symptoms like nightmares and dissociation. However, symptoms persisting beyond one month, as in this case, indicate PTSD. The patient’s presentation aligns with chronic trauma effects, making PTSD the more likely diagnosis over acute stress disorder.

Choice B reason: General adaptation syndrome describes the body’s physiological response to stress (alarm, resistance, exhaustion). It is not a psychiatric diagnosis and does not account for trauma-specific symptoms like nightmares or emotional numbing. This is unrelated to the patient’s psychological response, making it incorrect.

Choice C reason: PTSD is characterized by persistent symptoms beyond one month post-trauma, including nightmares, intrusive memories, avoidance, and emotional numbing, matching the patient’s presentation. Sexual assault is a common trigger, and the nurse would expect this diagnosis documented due to the chronicity and specificity of symptoms.

Choice D reason: Alarm reaction is the initial phase of general adaptation syndrome, involving acute stress response like fight-or-flight. It is not a diagnosis and does not explain chronic psychological symptoms like recurrent memories or emotional detachment, making it irrelevant to the patient’s trauma-related condition.