Caregivers of an 8-year-old client express concern about the child's growing independence and decision-making.
Which guidance should the nurse provide?
Allow your child to make all decisions without any input.
Avoid giving the child any responsibility until adolescence.
Encourage your child to make some choices in life.
Maintain strict control over decisions to prevent mistakes.
The Correct Answer is C
Choice A rationale
Permitting a school-age child to make every decision without adult guidance is developmentally inappropriate and potentially unsafe. While eight-year-old children are developing industry and a sense of competence, they still lack the cognitive maturity and life experience required to navigate complex or high-stakes situations. Total autonomy at this age can lead to anxiety or poor judgment. Parents must remain active guides while gradually increasing the child's opportunities for self-governance.
Choice B rationale
Postponing all responsibility until the adolescent years hinders the development of a healthy sense of industry, which is the primary developmental task for school-age children according to Erikson. Children need to master skills and complete tasks to build self-esteem. Denying them responsibility prevents the acquisition of necessary life skills and may result in a sense of inferiority or learned helplessness. Gradual, age-appropriate tasks are essential for building confidence and a strong work ethic.
Choice C rationale
Encouraging limited decision-making aligns with the developmental needs of an eight-year-old child. At this stage, children are transitioning from total dependence toward independence. Providing choices between two acceptable options fosters a sense of control and helps develop critical thinking skills. This approach supports the child's psychological growth while maintaining a safe environment. It allows the child to practice autonomy within boundaries, which is crucial for forming a positive self-concept and internalizing responsibility.
Choice D rationale
Maintaining rigid, strict control over every decision stifles a child's natural drive for independence and can lead to feelings of resentment or incompetence. If children are never allowed to make minor mistakes or choose for themselves, they do not learn how to evaluate consequences. Over-parenting during the school-age years may result in a child who feels inferior to peers. Balance is required to ensure the child feels supported but also capable of individual thought.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Maintaining a healthy weight is an essential health promotion strategy for preventing chronic diseases like diabetes and hypertension. However, it is not a direct intervention for preventing unintentional injuries, which are often the result of accidents or environmental hazards. While obesity can impact mobility and balance in some populations, the primary focus for young adults regarding unintentional injury involves safety behaviors. This choice addresses long-term physiological health rather than immediate safety from accidental harm.
Choice B rationale
Managing stress effectively is crucial for mental health and can prevent stress-related physical ailments. While high stress might lead to distractions that cause accidents, it is not categorized as a primary safety instruction for injury prevention. Injury prevention education typically focuses on high-risk behaviors and environmental safety. Young adults are more at risk for trauma related to motor vehicle accidents and substance use than injuries stemming directly from a lack of stress management.
Choice C rationale
Engaging in regular exercise promotes cardiovascular health and muscle strength, which contributes to overall longevity. While it can improve coordination, the most significant threats to young adults involve external factors like transportation and recreational safety. Exercise education is part of a wellness plan but does not target the leading causes of accidental death in this age group. Safety instructions must prioritize the most frequent and preventable causes of physical trauma and accidents.
Choice D rationale
Avoiding texting while driving is a vital instruction to prevent unintentional injuries, as motor vehicle accidents are a leading cause of death in young adults. Distracted driving significantly increases the risk of collisions and physical trauma. Health promotion for this demographic must emphasize behavioral choices that reduce the likelihood of accidents. By focusing on road safety, the nurse addresses the most immediate and statistically significant threat to the physical integrity of a young adult client.
Correct Answer is C
Explanation
Choice A rationale
Minimizing a child's fear by using terms like silly or dismissing the concern as impossible invalidates the preschooler's perspective. In the preoperational stage of development, children exhibit animism, believing inanimate objects have lifelike qualities and intentions. Telling the child the cuff cannot bite does not address their internal reality. This approach erodes trust and fails to reduce the autonomic nervous system's stress response, making the clinical encounter more difficult and traumatic.
Choice B rationale
Proceeding quickly and using physical restraint increases the child's physiological stress and reinforces the perception that the medical environment is a place of threat. Restraint can lead to a fight or flight response, which elevates heart rate and blood pressure, resulting in inaccurate vital sign measurements. This authoritarian approach can cause long term medical trauma and fear of healthcare providers, hindering future cooperation and the development of a therapeutic relationship with the pediatric client.
Choice C rationale
Allowing the child to practice on a caregiver utilizes therapeutic play, which is a developmentally appropriate intervention for preschoolers. This age group learns through imitation and needs to feel a sense of control over their environment to reduce anxiety. By seeing the cuff inflated on a trusted adult without harm, the child's fear of animism is mitigated through safe observation. This technique fosters cooperation and ensures the recorded blood pressure reflects a calm, resting state.
Choice D rationale
Providing a detailed scientific explanation of how the cuff works is ineffective because preschoolers are in the preoperational stage of cognitive development. They are characterized by egocentrism and literal thinking rather than abstract reasoning. They cannot process complex physiological concepts or the mechanics of pressure transducers. Over-explaining can actually increase anxiety by providing too much information that the child may misinterpret as more evidence of a potential threat or something scary and unknown.
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