The nurse caring for a terminally ill patient sits down and lightly touches the patient’s hand. Which technique is the nurse using?

Choice A reason: Asking if the patient is reliving trauma targets a core PTSD symptom—intrusive memories or flashbacks—critical for diagnosis per DSM-5 criteria. This question helps identify PTSD’s psychological impact, guiding interventions like cognitive behavioral therapy or SSRIs. Prioritizing this ensures timely recognition of PTSD, addressing the patient’s sleep disturbances and trauma-related distress effectively.

Choice B reason: Asking when the patient wakes up provides limited insight into PTSD. While sleep timing may indicate disturbances, it doesn’t address specific PTSD symptoms like intrusive memories or hyperarousal. This question is less urgent, risking delayed identification of PTSD, which requires targeted psychological assessment to guide therapy and medication for trauma-related nightmares.

Choice C reason: Describing phobias is irrelevant to PTSD assessment, as phobias are distinct anxiety disorders. PTSD involves trauma-specific symptoms like flashbacks, not generalized fears. This question misdirects focus from trauma-related sleep issues, potentially delaying PTSD diagnosis and appropriate interventions like trauma-focused therapy, leaving the patient’s nightmares and distress unaddressed.

Choice D reason: Asking about chest pain assesses physical symptoms unrelated to PTSD’s psychological profile, which includes nightmares and intrusive thoughts. While chest pain could indicate anxiety or cardiac issues, it’s not a priority for suspected PTSD. This question risks overlooking trauma-related symptoms, delaying psychological evaluation and support critical for the patient’s mental health recovery.

Choice A reason: Depression in Kübler-Ross’s stages involves sadness and withdrawal due to loss. Marital discord suggests conflict, not introspective grief. The patient’s relational tension with her terminally ill spouse aligns with anger, not depression, which would manifest as despair or hopelessness rather than active discord.

Choice B reason: Denial involves refusing to accept the reality of death, often early in the dying process. Marital discord indicates engagement with the situation, not avoidance. The patient’s conflict suggests emotional reaction, aligning with anger, not denial, making this an incorrect stage for her behavior.

Choice C reason: Bargaining involves seeking to delay death through promises or deals, often privately. Marital discord reflects externalized emotion, not negotiation. The patient’s conflict with her spouse points to anger, not bargaining, which is less likely to manifest as relational tension, making this incorrect.

Choice D reason: Anger, per Kübler-Ross, involves frustration and resentment, often directed at loved ones, as the patient grapples with mortality. New marital discord with her terminally ill spouse suggests the patient is expressing anger, a common reaction to the unfairness of death, making this the correct stage.