A client is admitted with post-traumatic stress disorder following a fire in his home in which family members died. Which of the following should the nurse recognize as an adaptive defense mechanism?

Choice A reason: Postponing needed surgery is a maladaptive defense mechanism, likely denial or avoidance, as it delays essential care. In PTSD, trauma-related hyperarousal from amygdala hyperactivity may drive avoidance, but this action risks health deterioration, making it non-adaptive compared to coping strategies that address symptoms directly. Choice B reason: Reading a book during hand tremors triggered by loud noise is an adaptive defense mechanism, likely distraction or self-soothing. In PTSD, this helps manage hyperarousal from overactive amygdala responses to trauma cues, allowing the client to regain control without avoiding necessary activities, promoting emotional regulation. Choice C reason: Focusing on daily routines when asked about the fire suggests avoidance, a maladaptive defense in PTSD. This behavior, driven by amygdala-mediated fear responses, prevents processing trauma, potentially worsening symptoms like intrusive thoughts, making it less adaptive than engaging in active coping strategies. Choice D reason: Developing stomach pains when seeing fire on television indicates somatization, a maladaptive defense in PTSD. This psychosomatic response reflects unprocessed trauma, as the amygdala triggers physical symptoms under stress, hindering emotional recovery and making it less adaptive than coping mechanisms like distraction or grounding.