A trauma survivor is requesting sleep medication because of "bad dreams." The nurse is concerned that the patient may be experiencing posttraumatic stress disorder (PTSD). Which question is a priority for the nurse to ask the patient?

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.