A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of posttraumatic stress disorder? (Select all that apply.)

Rationale: A. Moving to a safer area is an adaptive coping response and does not indicate PTSD. This shows proactive behavior to reduce anxiety triggers. B. Feeling disconnected or detached from others is a sign of emotional numbing and depersonalization, common in clients with PTSD. C. Frequent nightmares or flashbacks about the traumatic event are hallmark symptoms of PTSD due to re-experiencing the trauma. D. Persistent anger and irritability lasting more than one month following trauma indicate difficulty with emotional regulation, a core feature of PTSD. E. Recognizing that life will not return to normal shows realistic acceptance, not a pathologic response. This demonstrates cognitive processing and adaptation, not PTSD.