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RN Nursing · Trauma and Stress-Related Disorders · Practice question

A 42-year-old client tells the nurse that he has been feeling anxious and overwhelmed for the past 2 weeks after receiving a poor performance evaluation at work. The client reports difficulty sleeping, irritability, and feeling tense most of the day. There is no history of trauma, loss, or prior psychiatric conditions. Vital signs and lab work are normal. The nurse identifies that the client's symptoms are most likely related to which type of stress response?

Answer & explanation

Correct: Acute stress reaction

An acute stress reaction is characterized by the development of emotional and behavioral symptoms — such as anxiety, irritability, sleep disturbance, and tension — in response to an identifiable psychosocial stressor, typically occurring within days to weeks of the stressor. In this case, the client's symptoms began two weeks ago following a specific, identifiable event — a poor performance evaluation — which fits the definition of an acute stress reaction or adjustment disorder with anxiety features. Because the symptoms are recent and directly linked to a specific stressor, chronic stress is not the best classification; chronic stress implies a prolonged, ongoing pattern without a discrete triggering event. Posttraumatic stress disorder requires exposure to a traumatic event involving threat to life or serious injury, which a work evaluation does not constitute. A maturational crisis relates to developmental life transitions such as adolescence, marriage, or retirement, not situational work stressors. The acute stress reaction concept best captures the client's short-duration, stressor-specific presentation without prior psychiatric history, making it the most appropriate identification for the nurse to document.

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