NR-222 Health and Wellness - Set 4 - Part 3

Correct Answer: Initiative versus guilt

At four the child is starting things, not merely doing them, so repeated blocking of his plans breeds guilt rather than shame. Age is what separates this conflict from the toddler's. Option a is incorrect because trust is settled in the first year through consistent responses to hunger, distress, and discomfort. A four year old dressing himself has long since moved past that question. Option b is incorrect because the identical behavior at twenty two months would indeed be autonomy, with shame and doubt as the risk. The stem gives an age of four, which moves the answer forward one stage. Option c is incorrect because industry runs from about six to twelve and centers on real accomplishment measured against classmates. Nothing about peers, grades, or competence appears in this scene.

Correct Answer: Wait until twelve months for both, then use a cup.

Cow's milk and juice both wait until twelve months. Early cow's milk causes gut blood loss and iron deficiency, and juice after a year is limited to a small amount served in a cup with a meal. Option b is incorrect because being close to a year is not the same as reaching it. Introducing cow's milk early brings occult intestinal bleeding and a renal solute load the infant does not need. Option c is incorrect because it reverses the timing on both items. Milk is the one that must wait a few more weeks, while juice becomes acceptable in limited amounts once the first birthday arrives. Option d is incorrect because a toddler between twelve and twenty four months needs whole milk for the fat that supports brain myelination. Juice carried around all day also bathes the teeth in sugar.

Correct Answer: Ask the mother to bring the blanket in

Ritual and the security object are what make an unfamiliar place tolerable for a toddler. Bringing the blanket and reproducing the home bedtime sequence is the first and most effective step. Option a is incorrect because medication treats a problem this toddler does not have. His distress comes from lost routine and unfamiliar surroundings, and sedating him leaves that cause completely untouched. Option b is incorrect because rotating staff works against everything a hospitalized toddler needs. Consistent caregivers preserve the predictability that makes autonomy feel safe, and new faces each shift multiply the number of strangers. Option c is incorrect because another move adds one more change to a child already overwhelmed by change. Noise is not what is keeping him awake; the missing bedtime sequence and comfort object are.

Correct Answer: Tell him reaching across the tray was not safe.

A preschooler is a literal thinker who believes words about him are true, so calling him bad produces guilt. Criticize the behavior and leave the child's worth out of it entirely. Option a is incorrect because demanding an apology turns a spill into a moral failure. Initiative grows when a child can try things and make mistakes, and forced apologies teach performance rather than judgment. Option c is incorrect because a four year old genuinely lacks the impulse control this assumes. Framing an accident as deliberate misbehavior sets an expectation the child cannot meet and feeds a sense of failure. Option d is incorrect because removing the toy punishes exploration, which is the drive this stage runs on. Consistent limits and a plain statement about safety accomplish more than taking away what he reached for.

Correct Answer: Animism, giving feelings to inanimate objects

Assigning emotions and intentions to an object is animism, one of the defining features of preoperational thinking. Teddy bears get dinner plates and alarming pumps get moods for the same reason. Option b is incorrect because egocentrism means the child cannot imagine another person's point of view, like taking a toy and not understanding the tears. She is describing the pump's feelings, not overriding someone else's. Option c is incorrect because centration involves locking onto one striking feature and ignoring the rest, as when a taller glass must hold more juice. No comparison of quantity or dimension appears here. Option d is incorrect because conservation is achieved later, in the concrete operational years. It is a logical grasp that amount survives a change in shape, and a preoperational child of five fails such tasks.

Correct Answer: The doctor will put you to sleep and cut.

Preschoolers take words literally, and a child who hears put to sleep may connect it to a pet that never came back. The word cut adds fear of bodily mutilation. Option a is incorrect because that phrasing is the recommended substitute. Describing medicine that makes a child sleepy keeps the meaning accurate without borrowing language a preschooler associates with death. Option b is incorrect because it already avoids the frightening terms. Nurses are taught to replace scan and dye with a special picture, which is exactly the wording used in this option. Option d is incorrect because a small poke is the gentler alternative to shot or stick. It tells the truth about the sensation while leaving no room for images of large needles or lost blood.

Correct Answer: Sit down and invite the whole story

Reminiscence and life review are the intervention for integrity versus despair, not idle conversation. His question about whether it added up is an opening to explore meaning while there is still time. Option a is incorrect because steering him to logistics closes the very door he just opened. Care decisions still need attention, but cutting the story short to finish tasks wastes a therapeutic opportunity. Option c is incorrect because looking backward is the whole point of this stage. Telling an older adult not to dwell on the past blocks the review through which acceptance and wisdom are reached. Option d is incorrect because charting the behavior as a symptom mislabels healthy developmental work. Repeating a meaningful story is how many older adults process a life, and it is not evidence of a cognitive problem.

Correct Answer: Conservation of quantity despite appearance

Conservation is the understanding that amount stays constant when shape changes, and it arrives in concrete operations. This child centers on height alone, so a taller column reads as more medicine. Option b is incorrect because knowing hidden things still exist is settled during the first two years. This child clearly sees the cup in front of her and is judging its contents, not searching for something concealed. Option c is incorrect because hypothetical reasoning is a formal operational skill that develops around eleven or twelve. Failing it would look like trouble with algebra or debate, not a dispute about a cup. Option d is incorrect because attachment belongs to Bowlby rather than to Piaget's account of thinking. Nothing in this exchange involves a caregiver, separation, or reunion, so the concept simply does not apply.

Correct Answer: Industry versus inferiority, with conventional reasoning emerging

Classification and conservation place this child in concrete operations, roughly seven to eleven. That age band carries Erikson's industry conflict, and moral reasoning is shifting from preconventional into conventional around nine or ten. Option a is incorrect because initiative belongs to preschoolers who still fail conservation tasks. Pairing it with principled reasoning compounds the error, since almost no one reaches the postconventional level at any age. Option b is incorrect because identity work waits for adolescence and formal operational thinking. It also puts moral reasoning backward, since teenagers have generally moved into the conventional level rather than out of it. Option c is incorrect because a toddler cannot sort by two attributes or grasp that volume survives a change of container. Attaching principled moral reasoning to a two year old makes the mismatch even wider.

Correct Answer: Use diagrams and equipment he can handle

Concrete operational children reason logically about real, tangible things, so they want mechanisms they can see and touch. Diagrams, models, and handling the equipment give the cause and effect detail they need. Option a is incorrect because puppet play is aimed at preschoolers who think in symbols and fantasy. A nine year old is likely to find it babyish and will still be left without the facts he wants. Option b is incorrect because abstract and hypothetical material arrives with formal operations near eleven or twelve. Talking about distant possibilities to this child floats above what he can currently hold in mind. Option d is incorrect because withholding information breeds exactly the fear it aims to prevent. School age children ask direct questions about how the body works, and evasion tells them the truth is too terrible to say.