A nurse is caring for a client who has impaired speech. Which of the following actions should the nurse take?

The correct answer is: d. Formal operational

Choice A: Concrete operational

During the concrete operational stage, which typically occurs between the ages of 7 and 11, children develop logical thinking skills. They begin to understand the concept of conservation, the idea that quantity remains the same despite changes in shape or appearance. However, their thinking is still very concrete and tied to tangible objects and real events. Abstract thinking is not yet developed at this stage.

Choice B: Sensorimotor

The sensorimotor stage spans from birth to about 2 years of age. In this stage, infants learn about the world through their senses and actions. They develop object permanence, the understanding that objects continue to exist even when they cannot be seen, heard, or touched. Abstract thinking does not occur in this stage as infants are focused on immediate sensory experiences and motor activities.

Choice C: Preoperational

The preoperational stage occurs between the ages of 2 and 7. During this stage, children begin to engage in symbolic play and learn to manipulate symbols, but they do not yet understand concrete logic. Their thinking is still egocentric, meaning they have difficulty seeing things from perspectives other than their own. Abstract thinking is not a characteristic of this stage.

Choice D: Formal operational

The formal operational stage begins around age 12 and continues into adulthood. This stage is characterized by the development of abstract thinking and hypothetical reasoning. Individuals in this stage can think about abstract concepts, consider possible outcomes and consequences of actions, and use systematic ways to solve problems. This stage marks the emergence of scientific reasoning and the ability to think about abstract ideas.

Choice A reason : Rationalization is a defense mechanism where an individual justifies behaviors or feelings with plausible but inaccurate explanations to avoid confronting the true underlying motives or facts. In this scenario, the client is rationalizing their failure to take medication by blaming their partner's forgetfulness, rather than accepting personal responsibility for their health management.

Choice B reason : Projection involves attributing one's own unacceptable thoughts, feelings, or motives to another person. If the client had accused their partner of being irresponsible with medication as a reflection of their own behavior, it would be an example of projection. However, in this case, the client is not projecting their own forgetfulness onto their partner but rather shifting the blame.

Choice C reason : Repression is an unconscious mechanism employed by the ego to keep disturbing or threatening thoughts from becoming conscious. It involves pushing uncomfortable thoughts or memories into the unconscious mind. The client's statement does not suggest they are unconsciously forgetting to take their medication; instead, they are consciously aware of their action and providing a justification for it.

Choice D reason : Regression is a return to earlier stages of development and abandoned forms of gratification belonging to them, prompted by dangers or conflicts arising at one of the later stages. A client demonstrating regression might exhibit childlike behaviors when faced with stress. The client's statement does not indicate a regression to more infantile behaviors or coping mechanisms.