A 2-year-old client, who has had multiple hospitalizations for treatment of a congenital disorder, is lying curled in bed holding a stuffed animal and will not interact with the parents. What should the nurse identify as causing this client's behavior?
1. The parents may have been abusing this child.
2. The child is probably developmentally delayed secondary to multiple hospitalizations.
3. The child is reacting as a normal 2-year-old.
4. The child could be suffering from a clinical depression.
Correct Answer: 3
Rationale 1: There is no evidence of parental abuse.
Rationale 2: There is no evidence that the client is developmentally delayed.
Rationale 3: Toddlers and preschool children often react to anxiety by either withdrawing or acting out. This child is behaving in a normal manner.
Rationale 4: There is no evidence that the client is depressed.
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