PRACTICE NCLEX QUESTIONS BASED ON THEORIES OF THE GROWTH AND DEVELOPMENT ACROSS THE LIFE SPAN PART-9

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Priority concepts are development and health promotion

Psychosocial development: ERIK ERIKSON

  1. According to Erikson’s theory of the psychosocial development, each psychosocial crisis must be resolved for the child or adult to progress emotionally. Unsuccessful resolution can leave the person emotionally disabled.
    1. Describes the human life cycle as a series of 8 developmental stages from the birth to death.
    2. The result of the first stage may not permanent, but can be changed later in life, by experience.
    3. Emphasizes on the psychosocial tasks that should be accomplished throughout the life cycle.
    4. Psychosocial development occurs through a life-long series of crises affected by social and development.
    5. ERIK ERIKSON’S 8 STAGES OF PSYCHOSOCIAL DEVELOPMENT:
      1. Infancy (birth to 18 months)
      2. Early childhood (18 months- 3 yrs.)
      3. Late childhood (3-6 yrs.)
      4. School age (6-12 yrs.)
      5. Adolescence (12-20 yrs.)
      6. Early adulthood (20-35 yrs.)
      7. Middle adulthood (35-65 yrs.)
      8. Later adulthood (65 yrs. to death)

PSYCHOLOGICAL CRISIS:

AGEPSYCHOLOGICAL CRISISTASK
Infanttrust vs mistrustAttachment to the primary care giver
Early childhoodautonomy vs shame and doubtGaining some basic control over self and environment
Late childhoodinitiative vs guiltBecoming purposeful and directive
School ageIndustry vs inferiorityDeveloping social, physical, and learning skills
AdolescenceIdentity vs role confusionDeveloping sense of identity
Early adulthoodintimacy vs isolationEstablishing intimate bonds of love and friendship
Middle adulthoodgenerativity vs stagnationFulfilling life goals that involve family, career, and society
Later adulthoodintegrity vs despairLooking back over one’s life and accepting its meaning

INTERVENTIONS TO ASSIST THE CLIENT IN ACHIEVING ERIKSON’s STAGES OF DEVELOPMENT

INFANCY:

  • Hold the infant often
  • Offer comfort after painful procedures
  • Meet the infants needs for food and hygiene
  • Encourage the parents to play an active role while the infant is hospitalized

EARLY CHILDHOOD

  • Allow self -feeding opportunities
  • Encourage child to remove and put on own clothes

LATE CHILDHOOD

  • Offer medical equipment for play
  • Respect the child’s choices and expressions of feelings

SCHOOL AGE

  • Encourage the child to continue schoolwork while hospitalized
  • Encourage the child to bring pastimes to the hospital.

ADOLESCENCE

  • Take the health history and perform examinations without parents present
  • Allow adolescent a choice in the plan of care

EARLY ADULTHOOD

  • Include support from client’s partner or significant other
  • Assist with rehabilitation and contacting support services as needed before return to work

MIDDLE ADULTHOOD

  • Assist in choosing creative ways to foster social development
  • Encourage volunteer activities

LATE ADULTHOOD

  • Listen attentively to reminiscent stories about his or her life accomplishments
  • Assist with making changes to living arrangements.

COGNITIVE DEVELOPMENT: JEAN PIAGET

PIAGET’s THEORY of cognitive development defines cognitive acts as ways in which the mind organizes and adapts to its environment that is mental mapping.

SCHEMA refers to an individual’s cognitive structure or framework of thought.

ASSIMILATION: ability to incorporate new ideas, objects, and experiences into the framework of one’s thought

ACCOMMODATION: ability to change a schema to introduce new ideas, objects, or experiences

STAGES OF THE COGNITIVE DEVELOPMENT:

  1. SENSORIMOTOR STAGE: birth to 2 yrs.
  2. PREOPERATIONAL STAGE: 2 – 7 yrs.
  3. CONCRETE STAGE 7-11 yrs.
  4. FORMAL STAGE: 11 yrs. to adulthood.

MORAL DEVEOPMENT: LAWRENCE KOHLBERG

Moral development is a complicated process involving the acceptance of the values and rules of society in a way that shapes behavior. It is sequential.

LEVELS OF MORAL DEVELOPMENT:

  1. LEVEL ONE: PRECONVENTIONAL MORALITY
    1. STAGE 0: birth to 2 yrs.; Egocentric Judgement (no awareness of right or wrong)
    2. STAGE 1: 2-4 yrs.; Punishment-Obedience Orientation (view world in selfish way, no real understanding of wrong and right)
    3. STAGE 2: 4-7 yrs.; Instrumental Relativist Orientation (conforms to rules to please others)
  2. LEVEL TWO: CONVENTIONAL MORALITY
    1. STAGE 3: 7-10 yrs.: Good boy and Nice girl Orientation (being good)
    2. STAGE 4: 10-12 yrs.: Law and order orientation (focus on obeying laws, wants to be considered “good” by those whose opinions matter to him
  3. LEVEL THREE: POST CONVENTIONAL MORALITY
    1. STAGE 5: Social Contract and Legalistic Orientation
    2. STAGE 6: Universal Ethical Principles Orientation.

PSYCHOSEXUAL DEVELOPMENT: SIGMUND FREUD

COMPONENTS OF THE THEORY:

  1. LEVELS OF AWARENESS
  2. AGENCIES OF THE MIND: ID, EGO, SUPEREGO
  3. CONCEPT OF ANXIETY AND DEFENCE MECHANISM
  4. PSYCHOSEXUAL STAGES OF DEVEOPMENT

LEVELS OF AWARENESS

  • Unconscious level (no logical, governed by the Pleasure Principles)
  • Preconscious level or Subconscious level
  • Conscious level (logical, regulated by the reality principles)

AGENCIES OF THE MIND: ID, EGO, SUPEREGO

The id, ego, and superego are the three systems of personality. These psychological processes follow different operating principles. In a mature and well- adjusted personality, they work together as a team under the leadership of the ego.

The id: source of all drives, present at birth; operates according to the Pleasure Principle

The ego: follows reality principle, develops during the fourth or fifth months of life, emerges out of the id, distinguishes between things in the mind or things in the external world.

The Superego: develop during the phallic stages at 3-6 yrs. of age. It consists of the conscience and the ego ideal.

CONSCIENCE: capacity for self-evaluation and criticism, when moral codes are violated, the conscience punishes the individual by instilling guilt.

ANXIETY AND DEFENCE MECHANISM:

The ego develops defenses or defense mechanisms to fight off anxiety. It denies, falsify, or distort reality to make it less threatening. An individual cannot survive without defense mechanisms.

PSYCHOSEXUAL STAGES OF THE DEVELOPMENT:

  • Human development proceeds via series of stages from infancy to adulthood.
  • Each stage is characterized by the inborn tendency of all Individual to reduce tension and seek pleasure
  • Each stage is associated with a particular conflict that must be resolved before the child can move successfully to the next stage.

FREUD’S PSYCHOLOGICAL STAGES OF DEVELOPMENT:

ORAL STAGE Birth – 1 yrs.
The infant is concerned with self-gratification, operating on the pleasure principle and striving for immediate gratification of needs, beginning of the development of a sense of self.
ANAL STAGE 1-3 yrs.
toilet training
gains pleasure from learning to control his/her bodily needs
provision of the sense of accomplishment and independence
PHALLIC STAGE 3-6 yrs.
Child experiences pleasurable and conflicting feelings associated with the genital organs
LATENCY STAGE 6-12 yrs.
tapering off of conscious biological and sexual urges.
Task of this stage are growth of the ego functions and ability to care about and relate to others outside the home
GENITAL STAGE 12 yrs. and beyond
Emergences at adolescence with onset of puberty
Individual gains gratification from his/her own body
Develops satisfying sexual and emotional relationships with members of the opposite sex.
Individual plans life goals and gains a strong sense of personal identity

PRACTICE QUESTIONS

  1. The clinic nurse is preparing to explain the concepts of Kohlberg’s theory of moral development with a parent. The nurse should tell the parent that which factor motivates good and bad actions for the child at the preconventional level?
    1. Peer pressure
    2. Social pressure
    3. Parent’s behavior
    4. Punishment and reward
  2. The maternity nurse is providing instructions to a new mother regarding the psychosocial development of the newborn infant. Using Erikson’s psychosocial development theory, the nurse instructs the mother to take which measures?
    1. Allow the newborn infant to signal a need
    2. Anticipate all needs of the newborn infant
    3. Attend to the newborn infant immediately when crying
    4. Avoid the newborn infant during the first 10 minutes of crying.
  3. The nurse notes that a 6-year-old child does not recognize that objects exist when the objects are outside of the visual field. Based on this observation, which action should the nurse take?
    1. Report the observation to the pediatrician
    2. Move the objects in the child’s direct field of vision
    3. Teach the child how to visually scan the environment.
    4. Provide additional lighting for the child during play activities
  4. A nursing student is presenting a clinical conference to peers regarding Freud’s psychosexual stages of the development, specifically the anal stage. The student explains to the group that which characteristics relates to the anal stage?
    1. This stage is associated with toilet training
    2. This stage is characterized by the gratification of self
    3. This stage is characterized by a tapering off of conscious biological and sexual urges
    4. This stage is associated with pleasurable and conflicting feelings about the genital organs
  5. The nurse is describing Piaget’s cognitive developmental theory to pediatric nursing staff. The nurse should tell that staff that which child behavior is characteristic of the formal operations stage?
    1. The child has ability to think abstractly
    2. The child begins to understand the environment
    3. The child is able to classify, order, and sort facts
    4. The child learns to think in terms of past, present, and future.
  6. The mother of an 8-year-old child tells the clinic nurse that she is concerned about the child because the child seems to be more attentive to friends than anything else. Using Erikson’s psychosocial development theory, the nurse should make which response?
    1. You need to be concerned
    2. You need to monitor the child’s behavior closely
    3. At this age, the child is developing his own personality
    4. You need to provide more praise to the child to stop this behavior.
  7. The nurse educator is preparing to conduct a teaching session for the nursing staff regarding the theories of growth and development and plans to discuss the Kohlberg’s theory of moral development. What information should the nurse include in the session? Select All That Apply.
    1. Individuals move through all 6 stages in a sequential fashion
    2. Moral development progresses in relationship to cognitive development
    3. A person’s ability to make moral judgments develops over a period of time.
    4. The theory provides a framework for understanding how individuals determine a moral code to guide their behavior.
    5. In stage 1(punishment-obedience orientation), children are expected to reason as mature members of society.
    6. In stage 2 (instrumental-relativist orientation), the child conforms to rules to obtain rewards or have favors returned.
  8. A parent of a 3-year -old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. Using the Erikson’s psychosocial development theory, which instructions should the nurse provide to the parent? Select All That Apply.
    1. Set limits on the child’s behavior
    2. Ignore the child when this behavior occurs
    3. Allow the behavior, because this is normal at this age of period
    4. Provide a simple explanation of why the behavior is unacceptable
    5. Punish the child every time the child says “no” to change the behavior.

ANSWERS

  1. 4
  2. 1
  3. 1
  4. 1
  5. 1
  6. 3
  7. 2,3,4,6
  8. 1,4

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