A 20-month-old child is a client on the pediatric unit of a hospital. The nurse notices that this child is lagging in stage 6 of Piaget's phases of cognitive development. Which activity would indicate that this child is struggling at this stage?
1. The child wants the same toy to sleep with during naptime and bedtime.
2. The child merely watches as the other children pretend-play.
3. The child cries when the parents leave the unit.
4. The child does not cooperate with some of the treatments.
Correct Answer: 2
Rationale 1: Ritual is important for the child of the tertiary circular reaction, age 12 to 18 months.
Rationale 2: In this stage of development, inventions of new means, children interpret the environment by mental image. They use make-believe and pretend-play. A child who is unable to do this would not be demonstrating the behavior that is significant at this stage.
Rationale 3: Crying when parents leave the unit and not cooperating with certain medical treatments is normal behavior for children of various ages, especially when hospitalized, and would not indicate lags in development.
Rationale 4: Not cooperating with certain medical treatments is normal behavior for children of various ages, especially when hospitalized, and would not indicate lags in development.
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