A nurse is caring for a client who has impaired speech. Which of the following actions should the nurse take?

The correct answer is: d. Formal operational

Choice A: Concrete operational

During the concrete operational stage, which typically occurs between the ages of 7 and 11, children develop logical thinking skills. They begin to understand the concept of conservation, the idea that quantity remains the same despite changes in shape or appearance. However, their thinking is still very concrete and tied to tangible objects and real events. Abstract thinking is not yet developed at this stage.

Choice B: Sensorimotor

The sensorimotor stage spans from birth to about 2 years of age. In this stage, infants learn about the world through their senses and actions. They develop object permanence, the understanding that objects continue to exist even when they cannot be seen, heard, or touched. Abstract thinking does not occur in this stage as infants are focused on immediate sensory experiences and motor activities.

Choice C: Preoperational

The preoperational stage occurs between the ages of 2 and 7. During this stage, children begin to engage in symbolic play and learn to manipulate symbols, but they do not yet understand concrete logic. Their thinking is still egocentric, meaning they have difficulty seeing things from perspectives other than their own. Abstract thinking is not a characteristic of this stage.

Choice D: Formal operational

The formal operational stage begins around age 12 and continues into adulthood. This stage is characterized by the development of abstract thinking and hypothetical reasoning. Individuals in this stage can think about abstract concepts, consider possible outcomes and consequences of actions, and use systematic ways to solve problems. This stage marks the emergence of scientific reasoning and the ability to think about abstract ideas.

Choice A reason : Prolonged grief, also known as complicated grief, is characterized by an intense longing and preoccupation with thoughts or memories of a loved one, which persists long after the loss has occurred. It can significantly impair important areas of functioning and is defined by the DSM-5-TR as grief that stays with you long-term. The client's inability to accept the loss after three years suggests that they may be experiencing prolonged grief, which may require the guidance of a mental health professional for resolution.

Choice B reason : Uncomplicated grief, also known as normal grief, involves a range of feelings, including sadness, anger, and longing, that gradually start to improve over time. The person experiencing uncomplicated grief will begin to accept the loss and resume normal activities. Since the client is still unable to accept the loss after three years, this would not be classified as uncomplicated grief.

Choice C reason : Disenfranchised grief occurs when an individual's grief is not acknowledged or validated by society, often because the relationship to the deceased is not recognized, such as in the case of a pet or a distant relative. This type of grief is not typically associated with the duration of the grief but rather with the social context in which the grieving occurs.

Choice D reason : Anticipatory grief occurs before the actual loss, often in situations where a loved one is terminally ill. It involves grieving the impending loss and can include some of the same emotions as post-loss grief. Since the client's partner has already died, this would not be considered anticipatory grief.