What are some symptoms that may make it difficult for patients to establish trust with the nurse?

A. Anxiety and low self-esteem can interfere with the ability to trust others, making it harder for patients to form therapeutic relationships. B. Fatigue may affect energy and engagement but does not directly impair trust. C. Mistrust of the health care system reflects broader societal issues, not specific patient symptoms. D. Sadness is a common symptom in mental illness but does not inherently prevent trust-building.