During a follow-up visit, a patient reports worsening symptoms of PTSD after experiencing sexual violence. What steps should the nurse take next? (Select all that apply)

Choice A reason: Encouraging detailed discussion of feelings may be harmful initially, as it risks re-traumatization. Sexual violence triggers intense stress responses, increasing amygdala activity and cortisol levels. Scientifically, forcing trauma processing before establishing safety can exacerbate anxiety and PTSD symptoms, delaying recovery by overwhelming the client’s emotional regulation capacity.

Choice B reason: Weekly therapy is beneficial for long-term trauma processing but not an immediate priority. Sexual violence survivors need acute stabilization first, addressing safety and coping. Scientifically, therapy requires emotional readiness, as premature exploration may heighten stress responses, increasing risk of PTSD or dissociation without immediate safety measures.

Choice C reason: Support groups provide peer connection but aren’t the immediate priority post-disclosure. Survivors need safety and coping strategies first to manage acute anxiety. Scientifically, group settings may overwhelm clients early in recovery, as social exposure can trigger stress responses, delaying stabilization of trauma-related neurobiological changes like hyperarousal.

Choice D reason: A safety plan with coping strategies and resources addresses immediate needs post-sexual violence. It reduces anxiety through practical tools like breathing exercises, calming the amygdala and lowering cortisol. Scientifically, ensuring safety mitigates trauma’s neurobiological impact, stabilizing emotional regulation and preventing further harm, making it the most urgent intervention.

Choice A rationale: Encouraging participation in cognitive stimulation activities, such as puzzles, reading, or social engagement, helps maintain current cognitive function and delays further decline. These activities promote neuroplasticity and can improve the quality of life for patients with neurocognitive disorders.

Choice B rationale: Educating the family is a critical nursing intervention. Major neurocognitive disorders are progressive, and families often experience significant caregiver strain. Providing information on what to expect and teaching effective coping strategies ensures a more supportive environment for the patient.

Choice C rationale: Memory aids like written lists, calendars, and electronic alarms serve as external compensations for internal memory deficits. These tools help the patient maintain some level of independence in their daily activities and reduce the anxiety associated with forgetting tasks or appointments.

Choice D rationale: A highly structured and predictable routine is essential for patients with neurocognitive impairment. Consistency in the daily schedule reduces the cognitive load required to navigate the day, which minimizes confusion, agitation, and the "sundowning" effect often seen in these patients.