The nurse is assessing a 15-year-old client during a well-child visit.
Which clinical findings or behaviors would the nurse identify as expected psychosocial developments for this age group? Select all that apply.

Choice A rationale

Industry is the positive outcome of Erikson’s fourth stage of development, Industry vs. Inferiority, which typically occurs during the school-age years (ages 6 to 11). This stage focuses on the child's ability to learn new skills and complete tasks. It is not the result of infant care. In the infant stage, the focus is strictly on the acquisition of security and the reliability of the environment, not on the competence or productivity associated with later childhood.

Choice B rationale

Erikson’s first stage of psychosocial development is Trust vs. Mistrust. This stage occurs from birth to approximately 18 months. When a caregiver provides consistent, predictable, and affectionate care, the infant develops a sense of trust. However, if the care is inconsistent, cold, or fails to meet the infant's basic needs for food and comfort, the infant learns to view the world as unreliable and dangerous, resulting in the developmental outcome of mistrust.

Choice C rationale

Guilt is the negative outcome of Erikson’s third stage, Initiative vs. Guilt, which occurs during the preschool years (ages 3 to 5). During this time, children begin to assert power and control over their environment through play and social interaction. If their efforts are criticized or controlled too strictly, they may develop a sense of guilt. This is a much more complex cognitive and social stage than the foundational trust-building required during infancy.

Choice D rationale

Role confusion is the negative outcome of the fifth stage of Erikson’s theory, Identity vs. Role Confusion, which occurs during adolescence. At this stage, individuals struggle to develop a personal identity and a sense of self. It is unrelated to the infant’s struggle to find security. The psychosocial needs of an infant are focused on physical and emotional safety, whereas role confusion involves the complex integration of social roles and personal values in young adulthood. .

Choice A rationale

Adolescence is characterized by the onset of puberty and significant hormonal shifts that drive an increased interest in romantic and sexual relationships. This reflects the transition into the genital stage of psychosexual development and the exploration of intimacy. It is a normal finding for a fifteen year old to seek peer validation and explore their sexual identity as they move away from the family unit and toward more complex social interactions.

Choice B rationale

While adolescents begin to consider their future, solidifying specific long term occupational plans is generally not expected by age fifteen. According to Erikson, this age group is primarily focused on identity versus role confusion. Most fifteen year olds are still exploring various interests and lack the cognitive maturity or life experience to lock in a definitive career path. Pressuring for a solid decision at this stage would be developmentally premature and potentially stressful.

Choice C rationale

Developing a sense of industry is the primary developmental task of the school age child, typically between ages six and twelve. This stage involves mastering skills and feeling competent in one's abilities. By age fifteen, the individual has moved past industry and into the identity formation phase. Expecting a teenager to be focused on industry rather than identity indicates a misunderstanding of the chronological progression of psychosocial stages defined by developmental theorists.

Choice D rationale

A hallmark of middle adolescence is the drive for autonomy and independence from parental figures. Fifteen year olds often exhibit a push for self governance and may challenge established rules to define their own boundaries. This process is essential for healthy emotional growth and the eventual transition into adulthood. Nurses should recognize this behavior as a sign of progress in establishing a unique personal identity separate from the family structure.