Which of the following statements by the nurse would be most appropriate to a colleague who very quietly and numbly tells the nurse that she had arrived at the scene of an automobile-pedestrian accident and unsuccessfully performed CPR on a victim three days ago? The nurse and her colleague are sitting in the break room and no one else is present.

Choice A reason: While stress can influence symptom severity, somatic symptom illness is not simply intermittent control. This explanation is incomplete and misleading.

Choice B reason: Stating there is a physical cause misinforms the family. Somatic symptom illness is psychological in origin, not undetected physical disease.

Choice C reason: Suggesting the client is fabricating symptoms is inaccurate and stigmatizing. The symptoms are real to the client, even if not physically caused.

Choice D reason: Mental distress manifests as physical symptoms in somatic symptom illness. The client is not consciously aware of the psychological origin, making this the most accurate and therapeutic explanation.

Choice A reason: Asking “Why did you perform CPR?” is inappropriate and potentially judgmental. It implies criticism of the colleague’s actions rather than offering support. This could increase guilt or shame rather than provide therapeutic communication.

Choice B reason: Sharing one’s own unresolved trauma shifts the focus away from the colleague and may burden them further. It is not therapeutic to disclose personal struggles in this context, especially when framed as “I never recovered,” which could discourage the colleague from seeking healing.

Choice C reason: Asking “Tell me what you saw” is an open-ended, therapeutic communication technique. It allows the colleague to express feelings and process the traumatic event in a safe environment. This demonstrates empathy, active listening, and support without judgment or self-disclosure.

Choice D reason: Saying “That is horrible!” validates the event but does not encourage further dialogue. It may shut down communication by focusing only on the negative rather than inviting the colleague to share their experience.