A nurse has accepted a position on a pediatric unit and is learning about psychosocial development. Place Erikson's stages of psychosocial development in order from birth to adolescence. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

A. Plan the client's schedule to allow time for rituals: This is the most appropriate action. It is essential to recognize that compulsive behaviors in OCD serve as coping mechanisms for the individual. Allowing time for rituals within the client's schedule can help reduce anxiety and provide a sense of control. Gradual exposure and response prevention techniques can be incorporated into the treatment plan over time to help the client gradually decrease reliance on rituals.

B. Isolate the client for a period of time: Isolating the client may exacerbate feelings of anxiety and distress, as well as decrease opportunities for social interaction and support, which are essential components of mental health treatment.

C. Confront the client about the senseless nature of the repetitive behaviors: Confrontation may lead to defensiveness and resistance from the client. It is important to approach the client with empathy and understanding rather than judgment. Educating the client about the nature of OCD and the role of compulsive behaviors in managing anxiety can be more helpful in fostering insight and motivation for change.

D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules: Setting strict limits may increase the client's distress and resistance. It is important to collaborate with the client in treatment planning and find a balance between supporting the client's needs and maintaining a therapeutic environment. Gradual exposure and response prevention techniques should be implemented in a supportive manner rather than through strict enforcement.

Answer: C, D, E

A. The preschooler speaks in three-word sentences.
Speaking in three-word sentences is generally considered developmentally appropriate for a preschooler. By age 3 to 4, children typically use sentences that are more complex, but this is still within a normal range for early language development.

B. The preschooler talks to himself when reading.
Talking to oneself, especially during activities like reading, can be a normal behavior for preschoolers. This self-talk can actually be a part of cognitive development, helping them to process information and reinforce learning, and does not necessarily indicate a need for speech therapy.

C. The preschooler speaks in a nasally tone.
A nasally tone may suggest a speech issue such as a cleft palate or other resonance problems. If the child consistently exhibits this speech pattern, it could indicate a need for further evaluation by a speech therapist to determine the underlying cause and appropriate interventions.

D. The preschooler stutters when speaking.
Stuttering can be a significant speech concern that may require intervention. While some children experience normal disfluencies as they learn to speak, persistent stuttering that interferes with communication is a valid reason to refer the child for speech therapy.

E. The preschooler mispronounces words.
While mispronunciation can occur during language development, consistent or unusual mispronunciations beyond what is typical for the child’s age may indicate a speech sound disorder. If the mispronunciations affect the child's ability to communicate effectively, a referral to a speech therapist would be warranted for assessment and intervention.