Erikson's Stages with cross references from lecture/lab and NCLEX style practice questions at the end

According to Erikson's theory of emotional development, infants will develop a sense of trust when a) They can identify their mother and father b) They feel a sense of belonging, accepted as part of the family c) They can predict what is coming and needs are consistently met d) Nutritional and hygiene needs are provided on a daily basi

c) They can predict what is coming and needs are consistently met

Nurse Mary has been providing care for Tom during his hospital stay. On Tom's day of discharge, his wife brings a bouquet of flowers and a box of chocolates to his room. He presents these gifts to Nurse Mary, saying, "Thank you for taking care of me." What is a correct response by the nurse? a. "I don't accept gifts from patients." b. "Thank you so much! It is so nice to be appreciated." c. Thank you. I will share these with the rest of the staff." d. "Hospital policy forbids me to accept gifts from patients."

c. Thank you. I will share these with the rest of the staff."

maturity

Ego integrity vs. despair (65- death) refection of life

What gender-specific assessments should be emphasized with this age group?

For young adults, gender-specific assessments are breast self-exam (BSE) for women and testicular self-exam (TSE) for men.

integrity vs. despair

REFLECTION OF LIFE Looking back over one's life and accepting its meaning. Need to feel a sense of fulfillment. Success leads to a sense of wisdom, while failure results in regret, bitterness and dispair. Age: Later Adulthood (65 years and beyond) Task: Looking back over one's life and accepting its meaning Successful: Sense of integrity and fulfillment Unsuccessful: Dissatisfaction with life

The Existential Questions that one can asking at the end of each stage goes as follows:

Trust vs. Mistrust: Can I trust the world? Autonomy vs. Shame and Doubt: Is it okay to be me? Initiative vs. Guilt: Is it okay for me to do, move and act? Industry vs. Inferiority: Can I make It in the world of people and things? Identity vs. Role Confusion: Who am I? What can I be? Intimacy and solidarity bs. Isolation: Can I love? Generativity vs. Self-absorption: Can I make my life count? Ego integrity vs. Despair: Is it okay to have been me?

generativity vs. stagnation

WORK AND PARENTHOOD Fulfilling life goals that involve family, career, and society; developing concerns that embrace future generations. Feelings of success of being useful and having accomplished something, while failure results in shallow involvement in the world. Age: Middle Adulthood (25-65 years) Task: Fulfilling life goals that involve family, career, and society Successful: Ability to give and to care for others Unsuccessful: Self-Absorption and inability to grow as a person

middle adulthood

generativity vs. stagnation (25-65 years) work and parenthood

adolescence

identify vs. role confusion (12-20 years) social relationships

school age

industry vs. inferiority (6-12 years) school

early childhood/ preschool

initiative vs. guilt (3-5 years) exploration

young adulthood

intimacy vs. isolation (18-25 years) relationships

A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in? A: Trust vs. mistrust B: Initiative vs. guilt C: Autonomy vs. shame D: Intimacy vs. isolation

(A) Trust vs. Mistrust 0-18 months infancy

A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in? A: Trust vs. mistrust B: Initiative vs. guilt C: Autonomy vs. shame D: Intimacy vs. isolation

(B) Initiative vs. guilt 3-6 years old preschool

A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in? A: Trust vs. mistrust B: Initiative vs. guilt C: Autonomy vs. shame D: Intimacy vs. isolation

(D) Intimacy vs. isolation young adult hood 18-25 years

A nurse is preparing to care for a hospitalized teenage girl who is in skeletal traction. The nurse plans care knowing that the most likely primary concern of the teenager is which? A. Body image B. Obtaining adequate nutrition C. Keeping up with schoolwork D. Obtaining adequate rest and sleep

- A. Body image

A nurse, planning play activities for a hospitalized school-age child, uses Erikson's theory of psychosocial development to select an appropriate activity. The nurse should select an activity that will assist is developing which psychosocial stage? A. Initiative B. Autonomy C sense of trust D. A sense of industry

- D. A sense of industry

infancy

0-18 months

In what stages do the psychosocial developmental aspects striving for individuality, exploring one's abilities, and associative play occur? A. Toddler B. Infant C. Preschool D. Adolescent

Answer: C. Preschool Rationale: Adolescents are striving for identity, toddlers for autonomy, and infants for trust.

The nurse finds that a patient is in the integrity-versus-despair stage of Erikson's eight stages. Which patient response indicates the patient has not mastered this stage? Select all that apply. 1 The patient states she is a failure in her life. 2 The patient states she regrets her life because she did not achieve her goals. 3 The patient states she feels unable to play a role in the development of her kids. 4 The patient feels the need for an intimate relationship with another person. 5 The patient states she is preoccupied with thoughts of her appearance and body image.

1 & 2. According to Erikson, the integrity-versus-despair stage is a time when many older adults review their lives with a sense of either satisfaction or failure. They interpret their lives as meaningful or experience regret because of goals not achieved. They might see themselves as failures in their lives. In the stage of generativity versus self-absorption and stagnation, middle-aged people feel that they are unable to play a role in the development of the next generation, resulting in stagnation. The need for an intimate relationship with another person is seen in the stage of intimacy versus isolation. Identity versus role confusion is the stage where adolescents are preoccupied with thoughts of their own appearance and body image.

The nurse provides instructions to a parent about what to anticipate during her son's adolescence. Which comment by the parent indicates she understands the instructions? 1) "I know his peers will have more of an influence than I will." 2) "I'm relieved he will finally be able to make good decisions." 3) "I'm sure he will be less inclined to do things with his friends." 4) "I'm glad his growth will slow; the food bills have been huge."

1) "I know his peers will have more of an influence than I will." Rationale: Adolescents develop their own personal identity, and they do this by decreasing the attachment to their parents and developing close relationships with peers. The adolescent still lacks common sense and can have poor judgment. Adolescents have a strong need to feel part of a group. There is a growth spurt for both sexes during adolescent

A young mother of a 1-month-old infant says to the nurse, "My baby can't roll over or sit up. He can raise his head though, and he looks at me when I talk to him. Is anything wrong?" How should the nurse respond? 1) "No. Babies don't usually roll over until they are about 5 months old." 2) "Probably not. But we can do a Denver Developmental Screening Test to be certain." 3) "Probably not. If he doesn't fall over when you sit him up, he is developing normally." 4) "I don't think so, but we can have the physician examine him to be sure."

1) "No. Babies don't usually roll over until they are about 5 months old." Rationale: Development proceeds in a proximodistal pattern, beginning at the center of the body and moving outward. For example, the infant first begins to focus her eyes, then lifts her head, and later pushes up and rolls over (by about 5 months of age). There is no need to use time and money administering a Denver Developmental Screening Test (DDST); what the mother describes is certainly normal, and the nurse is qualified to make that judgment. Normally, a baby will roll over before she sits alone; it would be very unusual for a 1-month-old to do either. Also, because of proximodistal development, the infant will probably (but not always) roll over before he sits alone. The nurse does not need the physician to answer this mother's question about normal infant development.

A 10-year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team. A nurse should recognize that this child is in the process of successfully accomplishing which stage of Erikson's developmental theory? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

1. Industry versus inferiority

Liza and Chris have been married for over 50 years! They have 8 great grandchildren, 6 grandchildren and 3 children. They have lived a life full of love, trust, intimacy and caring. As they approach their last few years on earth together they feel a sense of satisfaction and peace. They have lived a life worth living and have finished the race strong. People from all around come to them for wisdom on how to live a life with such purpose. What stage/crisis are they most likely in? 1. Ego integrity versus despair 2. Ego integrity versus regret 3. Intimacy versus isolation 4. Generativity versus stagnation

1. Ego integrity versus despair What do we need to reach integrity? Complete all or the majority of each stage in a positive way. Not fear death. Live your life in such a way that when you breathe your last you have no regrets.

Dianna is in Middle School and is doing great academically and athletically. Her parents and teachers have been incredibly supportive of her and her abilities in every area. Dianna enjoys doing tasks because she knows if she applies herself she will do great - it just takes effort. Which stage/crisis is Dianna most likely in? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

1. Industry versus inferiority

Mr. and Mrs. James are so proud of the note the teacher sent home with their son Manuel. The teacher stated that "Manuel is showing such leadership abilities! He always steps up to ask if someone wants to play or choose a game the students should play on the playground. He starts all his tasks on time and always follows through. I see signs of a leader in him on a daily basis even though he is still so young." Which stage/crisis is Manuel most likely in? 1. Initiative versus guilt 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

1. Initiative versus guilt

The nurse is assessing an 8-year-old patient. According to Erikson's theory of psychosocial development, what would be the characteristics of this patient? Select all that apply. 1 The child searches for meaningful friendships. 2 The child learns to work and play with peers. 3 The child thrives on accomplishments and praise. 4 The child searches for an intimate relationship with another person. 5 The child is preoccupied with appearance and body image.

2 & 3 This 8-year-old child is in the industry-versus-inferiority stage. In this stage, the child usually learns to play and work with his or her peers. The child is encouraged by accomplishments and praise. A teenager is usually preoccupied with appearance and body image. A young adult may search for meaningful friendships and an intimate relationship with another person.

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. Which of Erikson's stages of development is this? 1 Trust versus mistrust 2 Initiative versus guilt 3 Industry versus inferiority 4 Autonomy versus sense of shame and doubt

2 Initiative versus guilt Toddlers learn that parents and society have expectations about behaviors and that they must learn to control their behavior.

Which of the following is the most prevalent major health problem for young adults? 1) Cancer 2) Obesity 3) Eating disorders 4) Cardiovascular disease

2) Obesity Rationale: Obesity has increased drastically in adults. Of course, some cancers do occur in young adults; however, cancer and cardiovascular disease become major concerns in middle adulthood. Eating disorders are a problem more typical of adolescence. They are not widespread in adults. They may occur in young adults but are not as prevalent as obesity.

A mother approaches a primary health care provider with a 5-year-old child suffering from pneumonia. The girl is continuously crying and is demanding to see her father. The girl has a short stature. She is pretending to play and not allowing the nurse to administer medication. According to Erik Erikson's theory of psychosocial development, in which stage is the child? 1. Trust versus mistrust 2 Initiative versus guilt 3 Intimacy versus isolation 4 Autonomy versus sense of shame and doubt

2. According to Erik Erikson's theory of psychosocial development, the girl is in the initiative-versus-guilt stage. In this stage, the child likes to pretend and try out new roles to escape. This stage is from 3 years to 6 years of age

The following is a journal entry from Patricia, after reading it decide which stage/crisis she is most likely in: Dear Journal, Who am I??? I can't seem to figure it out. Some days I love my parents, my friends and feel I know what I want to do in college. But, just yesterday I changed my mind AGAIN on my college application checklist. I mean - do I even WANT to go to college? Ugh - I'm so lost and confused. Of COURSE I'm going to college, but what do you study when everything and nothing at all excites you? Sincerely, The girl who is lost 1. Industry versus inferiority 2. Identity versus role confusion 3. Autonomy versus shame and doubt 4. Trust Versus mistrust

2. Identity versus role confusion

Eddie doesn't want to be alone forever - but learning how to be in a long term relationships is HARD! He knows he loves his girlfriend Erica though and is willing to do whatever it takes to make it work. He wants to build a strong relationship with her, full of openness, trust and support as they reach goals together. Who knows? Maybe one day he will even propose? What stage/crisis is Eddie most likely in? 1. Industry versus inferiority 2. Intimacy versus isolation 3. Autonomy versus shame and doubt 4. Trust Versus mistrust

2. Intimacy versus isolation

According to Erikson's Stages of Psychosocial Development what is the outcome for the school-age child to obtain during this stage? A. Competency B. Trust C. Sense of Purpose D. Love

A. Competency The school-age child is yearning to accomplish things through developed skills they will or have acquired. Accomplishments give them a sense of satisfaction and they feel content, which makes them feel like a competent person in the world they live. The goal from this stage is competency.

Which of the following would be an abnormal assessment finding for an older adult that the nurse would document and report to the primary care provider? Decreased: 1) Reaction time 2) Short-term memory 3) Intellectual ability 4) Cognitive processing speed

3) Intellectual ability Rationale: There should be no loss of intellectual ability. An elderly person can learn, although learning takes longer. Reaction time slows as we age, and it is also normal to have a decline of short-term memory, although long-term memory loss is not as common. Cognitive processing speed declines with age. This includes slower computational skills and reduced speed for problem-solving, but this does not imply that intellect is impaired.

Louisa is being potty trained! As she gets better she is gaining a sense of personal control over her environment. Her parents are so proud - even though it can be challenging when she tries to exert her independence by saying "NO!!!" for everything. Which crisis/stage is Louisa currently in? 1. Industry versus inferiority 2. Identity versus role confusion 3. Autonomy versus shame and doubt 4. Trust Versus mistrust

3. Autonomy versus shame and doubt

According to developmental norms, at what age does the greatest increase in height occur? 1) 1 to 3 years 2) 4 to 5 years 3) 6 to 11 years 4) 12 to 18 years

4) 12 to 18 years Rationale: Twelve- to 18-year-old females grow 2 to 8 inches, and males grow 4 to 12 inches. Growth is about 3 inches for children during years 1 to 3 and 4 to 5. Growth is about 2 inches during the sixth and up to the 12th year.

The nurse is planning to discuss the psychosocial challenges of middle adulthood with a community group. Which of the following should be included in the discussion? 1) There is an unavoidable decline in health in middle adulthood. 2) There are significant age-related body changes that affect health. 3) Work is more challenging because the productive years have passed. 4) Along with raising children there is often the concern of aging parents.

4) Along with raising children there is often the concern of aging parents. Rationale: Middle adults often have competing demands of raising children and caring for aging parents along with the demands of the job. There is not a noticeable decline in health, although energy levels may decline. There are some age-related changes (loss of skin turgor, muscle tone, etc.), but they are not as significant as during older adulthood, and as a rule they do not affect health. During middle adulthood, a person is usually at the peak of his career, but it is also the peak of creativity.

Lucas is the proud father of 3 boys and 1 girl. He is also a loving husband to his wife of 10 years. While Lucas enjoys working at his job, his main satisfaction comes from his ability to provide and care for his family. He spends every weekend teaching his children everything he knows about living a good life and how to solve problems and be strong and independent. He always tells his wife that he sees in his children his legacy and dreams and future. His every moment seems to be devoted for caring for his household. What stage/crisis is Lucas most likely in? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

4. Generativity versus stagnation

JoAnna was terrified to play the Trust Walk activity in Ms. Brown's class. Her panic got so high that she had to leave for the clinic. When Ms. Brown asked her if she was okay she said "Yes, I just always feel a surge of panic when in a situation where I have to rely on someone else. I've always been this way." Which crisis has JoAnn most likely completed negatively. 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Trust Versus mistrust

4. Trust Versus mistrust

Maturity

65 yr to death

A nurse, assigned to care for a hospitalized child who is 8 years old, plans care, taking into account Erik Erikson's theory of psychosocial development. According to Erikson's theory, which task represents the primary developmental task of this child? A. Mastering useful skills and tools B. Gaining independence from parent C. Developing a sense of trust in the world D. Developing a sense of control over self and body functions

A. Mastering useful skills and tools

Sam performs his assessment of Mr Calder, a 74 year old. What findings are considered normal for a pt of Mr Calder's age? (Select all that apply) A. Thin skin B. Decrease saliva production C. Decreased muscle strength D. Whitening of the eye lens E. Elevated heart rate

A. Thin skin B. Decreased saliva production C. Decreased muscle strength

A nurse caring for a 78-year-old client recently diagnosed with pneumonia will find Erikson's psychosocial development theory most helpful in determining: 1. Which needs the client will typically develop 2. Which coping mechanisms the client will likely use 3. How the client will respond to the respiratory problem 4. How the client and his family will adjust to the stressors

ANS: 3 Developmental theories are important in helping nurses assess and treat a person's response to an illness. Understanding and being able to apply the concepts of the theory will enable the nurse to determine a variety of generalized information that will assist in providing appropriate nursing care. The other options are only one area of information that is made available when applying Erikson's psychosocial development theory.

For an older adult client, an example of a common behavioral task or critical event is: 1. Selecting a mate 2. Rearing children 3. Finding a congenial social group 4. Adjusting to decreasing physical strength

ANS: 4 A common behavioral task of the older adult client is adjusting to decreasing physical strength. Selecting a mate is a developmental task commonly seen in the early adult. Rearing children is a developmental task of the middle-early adult. Finding a congenial social group is a developmental task of the middle-early adult

A nurse is preparing to discharge an 11-month-old child after a hospitalization for a viral infection. The nurse uses anticipatory guidance most effectively when: 1. Encouraging the parents to limit visitors for 14 days 2. Providing the parents with written discharge instructions 3. Arranging the follow-up pediatrician appointment for the parents 4. Informing the parents that the child may cry when taken to daycare

ANS: 4 A nurse's use of anticipatory guidance (derived from an understanding of the characteristics shown by clients in the trust versus mistrust phase of development) will help parents cope with the hospitalization of an infant and the infant's behaviors when discharged to home. The child's sense of trust may be challenged during hospitalization and may need support from parents when returning home. Encouraging the parents to limit visitors for 14 days is more educational and related to the child's physical recovery. Providing the parents with written discharge instructions is more educational and designed to reinforce the information. Arranging the follow-up pediatrician appointment for the parents is an action included in the discharge planning

In accordance with Erikson's theory, it is expected by the nurse that a middle-aged adult client will be involved in the process of: 1. Developing a sense of identity 2. Searching for meaning in life 3. Enhancing one's capability to love others 4. Expanding personal and social involvement

ANS: 4 In accordance with Erikson's theory, the middle-aged adult client is involved in the process of expanding one's personal and social involvement. Middle-aged adults should be able to see beyond their needs and accomplishments to the needs of society. Developing a sense of identity is in accordance with Erikson's identity versus role confusion (puberty) stage of development. Searching for meaning in life is in accordance with Erikson's integrity versus despair (old age) stage of development. Enhancing one's capability to love others is in accordance with Erikson's intimacy versus isolation (young adult) stage of development

A young adult is balancing the need to live and work independently with the desire to have a girlfriend for companionship and love. Which developmental stage is the young adult experiencing? a. Intimacy versus isolation b. Obedience and orientation c. Self-control and independence d. Generosity versus self-absorption

ANS: A The young adult is at the intimacy versus isolation stage of Erikson's theory of psychosocial development. The young adult is balancing the need for independence and personal growth with the desire to form intimate relationships with others. Generativity versus self-absorption is experienced during the middle adult years. Obedience and orientation is experienced during the early childhood/toddler years. Self-control and independence is also experienced during the early childhood/toddler years.

Which is a nursing intervention to assist a client to achieve Erikson's developmental task of ego integrity? A. Encourage a life review of triumphs and disappointments B. Provide opportunities for success experiences C. Focus on embracing the future D. Foster the development of creativity

ANS: A Erikson believed that between the age of 65 years and death, the goal is to review one's life and derive meaning from both positive and negative events, while achieving a positive sense of self.

Which statement describes achievement of Erikson's generativity versus stagnation developmental stage? A. "I've been a girl scout leader for troop 259 for 7 years." B. "I feel great that I could pay for my bike with my paper route money." C. "My parents are so pleased that John and I are going to be married." D. "I've had a very full life. I'm not afraid to leave this world."

ANS: A The major task of generativity versus stagnation is to achieve the life goals established for oneself while also considering the welfare of future generations.

A 10-year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team. A nurse should recognize that this child is in the process of successfully accomplishing which stage of Erikson's developmental theory? A. Industry versus inferiority B. Identity versus role confusion C. Intimacy versus isolation D. Generativity versus stagnation

ANS: A The nurse should recognize that a 10-year-old child who is successful in school both academically and socially has successfully accomplished the industry versus inferiority developmental stage of Erikson's psychosocial theory. The industry versus inferiority stage of development usually occurs between 6 to 12 years of age, at which time individuals achieve a sense of self-confidence by learning, competing, performing successfully, and receiving recognition from others.

Which concepts should a nurse identify as being included in the DSM-IV-TR definition of personality? (Select all that apply.) A. Personality is an enduring pattern of perceiving. B. Personality is influenced by relationships between the environment and self. C. Personality is developed in sporadic stages that vary from person to person. D. Personality is influenced by a wide range of social and personal contexts.E. Personality is inborn and cannot be influenced by developmental progression.

ANS: A, B, D The nurse should identify that the following concepts are included in the DSM-IV-TR definition of personality: Personality is an enduring pattern of perceiving, a wide range of social and personal contexts influences it, and it is inborn. Personality disorders are coded on Axis II of the DSM-IV-TR multiaxial diagnosis and include disorders organized into three clusters: odd and eccentric disorders (cluster A); dramatic, emotional, or erratic disorders (cluster B); and anxious or fearful disorders (cluster C).

Which are expected physical assessments finding for a middle-aged adult? (Select all that apply.) a. Difficulty hearing female voices b. Diminished breath sounds bilaterally c. Gradual loss of senses of taste and smell d. Need for reading glasses to see small print e. Decreased ability to solve practical problems

ANS: A, B, E Middle adulthood usually refers to those years between 40 and 65. Expected physical changes include a slow, progressive decrease in skin turgor, decreased abdominal strength, decreased visual acuity, and loss of accommodation of lens to focus light on near objects. The ability to solve practical problems based on experience peaks at midlife because of the ability for integrative thinking. Cranial nerves are unaffected so senses of taste and smell remain intact. Middle-aged patients often report difficulty hearing female voices as they are higher in pitch than male voices.

Which is the highest priority goal for the young adult patient with the nursing diagnosis risk for suicide related to depression and inability to make friends? a. The patient will express feelings and maintain self-control. b. The patient will not cause any sort of harm or injury to self. c. The patient will develop a therapeutic relationship with the nurse. d. The patient will verbalize less anxiety and fear around other people.

ANS: B The highest priority goal is that the patient will not cause any harm or injury to self. Expressing feelings, developing relationships, and verbalizing less anxiety are all less important than maintaining safety of the patient

A 29-year-old client living with parents has few interpersonal relationships. The client states, "I have trouble trusting people." Based on Erikson's developmental theory, which should the nurse recognize as a true statement about this client? A. The client has not progressed beyond the trust versus mistrust developmental stage. B. Developmental deficits in earlier life stages have impaired the client's adult functioning. C. The client cannot move to the next developmental stage until mastering all earlier stages. D. The client's developmental problems began in the intimacy versus isolation stage.

ANS: B Many individuals with mental health problems are still struggling to achieve tasks from a number of developmental stages. Nurses can plan care to assist these individuals to complete these tasks and move on to a higher developmental level.

The nurse is caring for an adolescent with a BMI of 22 and the nursing diagnosis imbalanced nutrition, more than body requirements related to caloric intake greater than metabolic needs. Which nursing interventions will the nurse use to help the adolescent achieve a balanced diet? (Select all that apply.) a. Use sugary treats as a reward for getting good grades in school. b. Encourage the adolescent to gradually increase physical activity. c. Recommend intake of at least 2 to 3 L of water each day. d. Remind the adolescent of how body image affects relationships. e. Encourage the adolescent to eat breakfast every day before school.

ANS: B, C, E Gradually increasing physical activity, drinking 2 to 3 L of water daily, and eating breakfast daily will help the adolescent balance the diet and manage weight. Using sugary treats as a reward will worsen the adolescent's imbalanced diet. The adolescent does not need to be reminded about how body image affects relationships

Which of the following is not a characteristic of young adults? A. Problem-solving skills are reduced and motor skills are slower. B. There is a strong need to achieve intellectually. C. Physical maturation is complete. D. Work, intimacy, and parenting are priorities.

Answer: A. Problem-solving skills are reduced and motor skills are slower. Rationale: These features are characteristic of the older adult.

The middle-aged patient is overwhelmed by the stresses of caring for aging parents as well as young children living at home. Which nursing diagnosis is most appropriate for this patient? a. Disturbed body image related to developmental changes associated with middle age b. Deficient diversional activity related to desire to enhance relaxation and contentment c. Caregiver role strain related to amount of attention and care needed by both parents and children d. Readiness for enhanced power related to desire for freedom from family responsibilities

ANS: C The patient feels overwhelmed by the care required by young children and aging parents so caregiver role strain is the appropriate diagnosis. The patient is not ready for enhanced power and does not need additional diversional activities. The patient does not demonstrate any sign of disturbed body image

The nurse interviewed a client who was uncooperative, answered questions with minimal responses, and rarely made eye contact. Which is the most complete documentation of baseline data obtained during the interview? A. "Appears uncooperative. Exhibits characteristics of depression." B. "Maintains poor eye contact throughout interview process. Unable to answer interview questions due to depression." C. "States, 'I don't need to be here.' when discussing admission status. Maintains minimal eye contact and offers little data related to triggers for admission." D. "Unwilling to respond openly during interview."

ANS: C Documentation occurs in the implementation phase of the nursing process. All charting entries to the client's legal record should be objective and based on assessed data. Implications and generalizations should be avoided.

A jilted college student is admitted to a hospital following a suicide attempt and states, "No one will ever love a loser like me." According to Erikson's theory of personality development, a nurse should recognize a deficit in which developmental stage? A. Trust versus mistrust B. Initiative versus guilt C. Intimacy versus isolation D. Ego integrity versus despair

ANS: C The nurse should recognize that the client who states, "No one will ever love a loser like me." has not adequately completed the intimacy versus isolation stage of development. The intimacy versus isolation stage is presumed to occur in young adulthood between the ages of 20 and 30 years. The major developmental task in this stage is to establish intense, lasting relationships or commitment to another person, cause, institution, or creative effort.

Which of the following might be a cause of stress for the middle-aged adult? A. Financial security B. Planned retirement C. Arrival of grandchildren D. Caring for children and aging parents

D. Caring for children and aging parents

The nurse is caring for an elderly patient who has become withdrawn and refuses to eat after being admitted to a long-term nursing facility. Which is the highest priority goal for the patient? a. The patient will participate in social activities with other residents. b. The patient will ask questions about the prescribed care and treatment. c. The patient will develop meaningful relationships with the nursing staff. d. The patient will maintain usual weight and show no signs of dehydration

ANS: D The highest priority goal for this patient is maintenance of weight and prevention of dehydration. When this goal is met, the nurse can help the patient to participate in activities with other residents, ask questions about care, and develop relationships with the staff.

In preparing to teach parents about their school-age children, the nurse should be aware of which of the following considerations? A. Increased mobility increases the risk for falls. B. Increased excursions increase the risk of accidents. C. Decreased motor skills are typical of this stage. D. The child may have difficulty adjusting to increased autonomy.

Answer: B. Increased excursions increase the risk of accidents. Rationale: School-age children are involved in increasing activities outside the home or away from the family. They have increased educational needs for accident and safety awareness. Response A refers to toddlers, response C to older adults, and response D to adolescents.

Which is the highest priority nursing diagnosis for a toddler who is at the autonomy versus doubt stage of development? a. Toileting self-care deficit related to readiness for transition from diapers b. Impaired verbal communication related to stage of cognitive development c. Readiness for enhanced sleep related to desire to sleep in a big kids' bed d. Risk for poisoning related to unawareness of environmental risks within reach

ANS: D Toddlers cannot understand the risks of their environment and want to put everything in their mouths. This presents a very significant risk of poisoning as toddlers are not aware when substances may be toxic or poisonous. Impaired verbal communication is expected for toddlers as they struggle to learn to speak clearly. Toddlers are ready to transition from a crib to a big kids' bed and to stop using diapers. Communication, toileting, and sleep are less of a priority than protection from poisoning.

A physically healthy, 35-year-old single client lives with parents who provide total financial support. According to Erikson's theory, which developmental task should a nurse assist the client to accomplish? A. Establishing the ability to control emotional reactions B. Establishing a strong sense of ethics and character structure C. Establishing and maintaining self-esteem D. Establishing a career, personal relationships, and societal connections

ANS: D The nurse should assist the client in establishing a career, personal relationships, and societal connections. According to Erikson, non-achievement in the generativity versus stagnation stage results in self-absorption, including withdrawal from others and having no capacity for giving of the self to others.

According to Erikson's developmental theory, when planning care for a 47-year-old client, which developmental task should a nurse identify as appropriate for this client? A. To develop a basic trust in others B. To achieve a sense of self-confidence and recognition from others C. To reflect back on life events to derive pleasure and meaning D. To achieve established life goals and consider the welfare of future generations

ANS: D The nurse should identify that an appropriate developmental task for a 47-year-old client would be to achieve established life goals and consider the welfare of future generations. According to Erikson, the client would be in the generativity versus stagnation stage of development.

A married, 24-year-old client works as a schoolteacher. She and her husband have just had their first child. A nurse should recognize that this client is successfully accomplishing which stage of Erikson's developmental theory? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

ANSWER 3.Intimacy versus isolation Industry versus inferiority occurs between ages 6 and 12 years old. 2 Identity versus role confusion occurs between ages 12 and 20 years old. 3 The nurse should recognize that a 24-year-old client who is married and has a child has successfully accomplished the intimacy versus isolation stage of Erikson's developmental theory. The intimacy versus isolation stage of young adulthood involves forming lasting relationships. Achievement of this task results in the capacity for mutual love and respect. 4 Generativity versus stagnation occurs between ages 25 and 65 years old.

● According to Erikson, what is the developmental stage associated with middle adulthood?

According to Erikson, the developmental stage of middle adulthood is known as generativity versus stagnation.

● According to Erikson, what is the developmental stage of the older adult?

According to Erikson, the developmental stage of older adults is known as ego integrity versus despair.

According to Erikson, what is the developmental stage of the adolescent?

According to Erikson, the developmental stage of the adolescent is known as identity versus role confusion.

According to Erikson, what is the developmental stage of the infant?

According to Erikson, the developmental stage of the infant is trust versus mistrust.

According to Erikson, what is the developmental stage of the preschooler?

According to Erikson, the developmental stage of the preschooler is initiative versus guilt.

According to Erikson, what is the developmental stage of the toddler?

According to Erikson, the developmental stage of the toddler is autonomy versus shame and doubt.

According to Erikson, what is the developmental stage of the young adult?

According to Erikson, the developmental stage of the young adult is known as intimacy versus isolation.

● What are the top two causes of death among older adults?

Among older adults, the top two causes of death are heart disease and cancer.

A nurse is providing health promotion teaching to an adolescent. Which of the following information should the nurse include in the teaching? A. "Share piercing needles only with close friends you trust." B. "Limit your caloric intake to avoid becoming overweight." C. "Tanning beds are much safer than lying in the sun." D. "Your need for sleep will increase during periods of growth."

Answer and Explanation The Correct Answer is D During periods of growth, adolescents often experience an increase in their sleep needs. This is because growth and development processes, such as bone growth and hormonal changes, require adequate rest and sleep. By addressing the increased need for sleep, the nurse can provide valuable information to help the adolescent prioritize and ensure sufficient sleep for their overall well-being. Sharing piercing needles is never recommended as it can lead to the transmission of blood-borne infections such as HIV or hepatitis. Proper sterile techniques and individual use of piercing needles should always be encouraged. It is important to promote a healthy and balanced approach to nutrition rather than focusing solely on limiting caloric intake. Encouraging healthy eating habits, regular physical activity, and a balanced diet is a more appropriate approach to weight management. Tanning beds are not safe alternatives to natural sunlight. They expose the skin to harmful ultraviolet (UV) radiation, increasing the risk of skin cancer and premature aging. It is important to educate adolescents about the risks of tanning beds and promote the use of sunscreen and protective measures when exposed to the sun.

Identify at least five appropriate topics for health teaching during middle adulthood.

Answer: Numerous answers are possible, including the following health topics for middle adulthood: ● importance of avoiding obesity ● hazards of smoking ● need to limit alcohol intake ● benefits of a balanced nutritional intake ● importance of regular exercise ● importance of stress management ● need for periodic health exams: ● gender-specific cancer screening recommendations (mammograms, PSA testing) ● need to screen for colon cancer for early detection ● immunizations ● interventions for chronic problems

A baby is having brought in for a well-child checkup. Which action of the child should the nurse identify as an indicator of positive resolution of the central task of this age? 1. The child does not cry when the parent allows the nurse to hold the child. 2. The child shows mistrust when strangers approach. 3. The child becomes willful when disciplined. 4. The child does not play with other children.

Answer: 1 Explanation: In the infancy years (birth to 18 months), the child's central task is to form trust or mistrust with people. Positive resolution would indicate a safe feeling when the parents leave the child with someone they are familiar with and can trust.

While attempting to choose a nursing diagnosis, the nurse must decide whether the client is experiencing anxiety or fear. What key point would help the nurse make this decision? 1. Anxiety is a milder form of fear. 2. Fear results in a physiological response, whereas anxiety is psychological. 3. The source of fear is identifiable, but anxiety may be vague. 4. Anxiety is generally based in reality, fear is not.

Answer: 3 Explanation: The source of fear is identifiable, but anxiety is vague.

A client is being seen in the mental health clinic for antisocial behavior. According to Erikson's stages of development, the nurse realizes that this client is experiencing which task of development? 1. Initiative versus guilt 2. Industry versus inferiority 3. Intimacy versus isolation 4. Identity versus role confusion

Answer: 4 Explanation: According to Erik Erikson, the adolescent stage is from 12 to 20 years and the central task is identity versus role confusion. Positive resolution indicates sense of self with plans to actualize one's abilities. Negative resolution indicates feelings of confusion, indecisiveness, and possible antisocial behavior.

A community health nurse is planning adult health education classes. According to Erikson's stages of development, the nurse should address which task with this age group? 1. Industry versus inferiority 2. Identity versus role confusion 3. Intimacy versus isolation 4. Generativity versus stagnation

Answer: 4 Explanation: Adulthood, age 25-65 years, is characterized by the central task of generativity versus stagnation. Positive resolution is indicated by creativity, productivity, and concern for others. Negative resolution is characterized by self-indulgence, self-concern, and lack of interests and communication.

Identify at least two important assessments to make when providing care to a preschooler.

Answers can include any of the following assessments of a preschooler: ● height, weight, and vital signs ● nutrition ● sleep patterns ● dental hygiene ● safety ● kindergarten readiness

Name two common health problems of adolescents.

Answers can include any of the following health problems of adolescents: ● physical injury ● suicide ● depression ● sexual experimentation leading to STDs and unplanned pregnancy ● experimentation with alcohol and drugs ● cigarette smoking ● obesity

According to Erik Erikson's developmental theory, which is a developmental task of the middle adult? A. Redefining self-perception and capacity for intimacy B. Providing guidance during interactions with his children C. Verbalizing readiness to assume parental responsibilities D. Making decisions concerning career, marriage, and parenthood

B. Providing guidance during interactions with his children

A nurse is developing a plan of care for an older client that will help maintain an adequate sleep pattern. Which action should the nurse include in the plan? A. Encouraging at least one daytime nap B. Discouraging the use of a night light at bedtime C. Encouraging bedtime reading or listening to music D. Discouraging social interaction, particularly at bedtime

C. Encouraging bedtime reading or listening to music

Your patient is 7-years-old. What stage of psychosocial development, according to Erikson's Theory, should this child be in? A. Autonomy vs. Shame and Doubt B. Initiative vs. Guilt C. Industry vs. Inferiority D. Identify vs. Role Confusion

C. Industry vs. Inferiority

A school-aged child has failed to hit the ball several times and now refuses to try again due to fear of failure. According to Erickson, this represents possible unsuccessful mastery of which stage of personality development? A. Trust vs Mistrust B. Autonomy vs Shame/doubt C. Initiative vs Guilt D. Industry vs Inferiority

D. Industry vs Inferiority

A nurse is caring for a 6-month-old infant. Which of the following findings should indicate to the nurse that the client is experiencing pain following a procedure? A. Increased formula consumption B. Increased crying episodes C. Decreased respiratory rate D. Decreased heart rate

Correct Answer is B Explanation Crying is a common behavioral response to pain in infants, and it serves as an important indicator of discomfort. Infants may cry more intensely, have a high-pitched cry, or exhibit inconsolable crying when they are in pain. It is important for the nurse to assess the infant's pain level and provide appropriate interventions to alleviate the discomfort.

initiative vs. guilt

EXPLORATION Becoming purposeful and directive, Experimenting with asserting control and power over environment. Success leads to sense of purpose. Children who try to exert too much power experience disapproval, resisting in a sense of guilt. Age:Preschool Childhood (3-6 years) Task: Becoming purposeful and directive Successful: Ability to initiate one's own activities; sense of purpose Unsuccessful: Sense of inadequacy or guilt

A nurse is speaking with the mother of a 6-year-old child. Which of the following statements by the mother should concern the nurse? A. "Sometimes my child acts bossy with his friends." B. "My child often cheats when we play board games C. "My child has recently lost both front top teeth." D. "The teacher says my child has to squint to see the board"Correct Answer is D

Explanation This indicates a potential vision problem in the child that needs further evaluation and intervention. Squinting to see the board suggests that the child may be experiencing difficulty with vision or visual acuity, which can impact their academic performance and overall well-being.

Trust vs. mistrust

FEEDING By caregiver providing reliable care and affection, attachment happens, which results in trust to caregiver and others. The lack of it will lead to mistrust. Age: Birth-18months Task: Attachment to the mother Successful: Trust in people; faith and hope about the environment and future Unsuccessful: General difficulties relating to people effectively; suspicion; trust- fear conflict; fear of the future.

What is the leading cause of death for this age group?

For young adults, the leading cause of death is violence.

What important physical changes occur in the school-age group?

Important physical changes in the school-age group include the following: ● Strength, physical ability, and muscle mass rapidly improve in the school-age period. ● All primary teeth are lost during this time and are replaced by secondary teeth. ● The gastrointestinal system matures and stomach capacity increases, although caloric demands are less. ● Ossification of bones continues throughout this age. ● As the immune system develops, the school-age child begins to produce antibodies and antigens. ● Toward the end of the school-age phase, girls enter a period of rapid growth, associated with the onset of puberty.

intimacy vs. isolation

RELATIONSHIPS Establishing intimate bonds of love and friendship with other people. Success leads to strong relationships, failure to loneliness and isolation. Age: Early Adulthood (18-25 years) Task: Establishing intimate bonds of love and friendship Successful: Ability to love deeply and commit oneself Unsuccessful: Emotional Isolation and Egocentricity

industry vs. inferiority

SCHOOL Developing social, physical, and school skills. Success leads to a sense of competence, failure leads to feelings of inferiority. Age: School Age (6-12 years) Task: Developing Social, Physical, and Learning Skills Successful: Competence; Ability to learn and work Unsuccessful: Sense of inferiority; difficulty learning and working

identity vs. role confusion

SOCIAL RELATIONSHIPS Making transition from childhood to adulthood , developing sense of personal identity. Success leads to an ability to stay true to yourself, while failure leads to a role of confusion and weak sense of oneself. Age: Adolescence (12-20 years) Task: Developing sense of identity Successful: Sense of personal identity Unsuccessful: Confusion about who one is; Identity submerged in relationship or group memberships

autonomy vs shame and doubt

TOILET TRAINING Gaining some basic control of self and environment and sense of independence leads to autonomy. Lack of it results in feeling shame and doubt. Age: Early Childhood (18 months-3 years) Task: Gaining some basic control over self and environment Successful: Sense of self-control and adequacy; willpower Unsuccessful: Severe feelings of self-doubt

Which of the following is not true concerning Erikson's eight stages of psychosocial development? a. A person cannot progress to the next stage until he or she has successfully resolved the prior stage b. Problems in early stages are likely to affect later stages in negative ways c. Each stage may be seen as a chapter in a generic life story of the human being living in society d. Development is a matter of the ebbing and flowing of stage-related issues over the lifespan

a. A person cannot progress to the next stage until he or she has successfully resolved the prior stage

toddlerhood

autonomy vs. shame and doubt (18mo-3 years) toilet training