A nurse is educating a group of middle adults about health promotion. What statement by one of the participants indicates the need for additional education?

Trust vs. Mistrust (Birth to 1 year): In this stage, infants learn to trust or mistrust their caregivers and the world based on the consistency of care they receive.

Autonomy vs. Shame and Doubt (1 to 3 years): During this stage, toddlers learn to exercise will and to do things independently; failure to do so causes shame and doubt.

Initiative vs. Guilt (3 to 6 years): In this stage, children begin to assert control and power over their environment through directing play and other social interactions.

Industry vs. Inferiority (6 to 12 years): Here, children learn to read, write, and do things on their own. Peers and teachers become significant figures, and children strive to be competent and successful.

Identity vs. Role Confusion (12 to 18 years): Adolescents search for a sense of self and personal identity, through an intense exploration of personal values, beliefs, and goals.

A. Percussion: Percussion is typically performed before palpation. It helps to detect differences in density of abdominal contents, fluid presence, and gas patterns.

B. Auscultation: Auscultation is performed before any palpation or percussion to prevent altering bowel sounds. It is typically the second step after inspection.

C. Palpation: Palpation is used last during an abdominal assessment to prevent altering the characteristics of bowel sounds and to ensure that any tenderness or abnormal masses are identified after a thorough initial assessment. Palpation can cause changes in bowel sounds and tenderness.

D. Inspection: Inspection is always the first step in any physical examination. It allows for a visual assessment of the abdomen, looking for distension, asymmetry, and skin changes.