A 26-month-old child displays many negative behaviors. The parent says, "My child refuses toilet training and shouts, 'No, no, no!' when given directions. What do you think is wrong?" Select the registered nurse's best reply:
Select one:

The child is striving for independence.” The behaviors described by the parent are typical for a child who is 26 months old. At this age, children are beginning to develop a sense of autonomy and independence, and they may resist direction and assert their own will. Toilet training can also be a challenging process for both children and parents, and it is not uncommon for children to resist or refuse toilet training at first.

Option a. “The child needs more control. You have been weak” is not a helpful response because it places blame on the parent and does not provide any useful information or guidance.

Option b. “Some undesirable attitudes are developing currently. A child psychologist can help you develop a remedial plan” may be an appropriate response if the child’s behaviors were significantly outside the norm for their age or if they were causing significant distress or disruption. However, based on the information provided by the parent, this does not appear to be the case.

Option d. “There may be developmental problems. Most children are toilet trained by age 2 years and a half” is not a helpful response because it may cause unnecessary worry or concern for the parent. While many children are toilet trained by age 2 and a half, there is a wide range of normal variation in when children achieve this milestone.

The ethical principle of autonomy refers to an individual's right to make decisions about their own healthcare, treatment, and life choices. As a registered nurse, it is important to respect and promote the autonomy of patients. Option b best exemplifies the implementation of the ethical principle of autonomy because it involves exploring alternative solutions with the patient and allowing them to make their own choice among those alternatives. This approach respects the patient's right to make decisions about their own care, while also ensuring that they have the information they need to make an informed decision.

Option a suggests that the nurse is imposing their own decision on the patients, which violates the principle of autonomy.

Option c may involve staying with the patient to provide support and reassurance, but it does not necessarily involve promoting the patient's autonomy.

Option d involves intervening to prevent harm to the patient, which may be necessary at times but is not necessarily an example of promoting the patient's autonomy.