A nurse is providing care to a group of patients with chronic illnesses.

Who among the following patients should the nurse identify as being at the highest risk for sepsis?

The correct answer is Choice D

Choice A rationale: Moral reasoning, including distinguishing right from wrong, requires abstract cognitive processing and internalization of social norms, typically emerging during the concrete operational stage around age 7. Toddlers are in Piaget’s sensorimotor to early preoperational phase, where egocentrism dominates and behavior is guided by immediate consequences rather than ethical principles. They lack the neurological maturity and social-cognitive integration required for moral discourse, making this milestone developmentally inappropriate for the toddler age group.

Choice B rationale: Performing simple chores involves task comprehension, motor coordination, and social cooperation, which are more consistently observed in preschool-aged children (4–5 years). Toddlers may imitate adult actions but lack sustained attention, impulse control, and fine motor precision needed for chore completion. Their psychosocial development is centered on autonomy and exploration, not structured responsibility. Expecting chore cooperation at this stage exceeds normative developmental expectations and may lead to frustration or behavioral resistance.

Choice C rationale: Printing letters and numbers requires advanced fine motor control, visual-motor integration, and symbolic cognition, typically achieved between ages 5 and 6. Toddlers are still developing basic hand-eye coordination and may engage in scribbling, but they lack the neuromuscular refinement and cognitive mapping needed for structured writing. Neurodevelopmental milestones do not support this skill in the toddler phase, making it scientifically inaccurate to expect printing behavior before preschool age.

Choice D rationale: By age 3, toddlers begin to tolerate brief separations from primary caregivers due to improved object permanence, emotional regulation, and social awareness. This aligns with Erikson’s autonomy vs. shame and doubt stage, where toddlers explore independence while maintaining secure attachment. Separation anxiety peaks around 9–18 months and typically declines by age 3. The ability to separate easily for short periods reflects healthy psychosocial development and is a scientifically appropriate expectation for toddlers.

Choice A rationale

Sensation of pressure is a common symptom of urinary retention due to prostatic hypertrophy.

Choice B rationale

Dysuria, or painful urination, can occur due to the enlarged prostate pressing against the urethra.

Choice C rationale

Bladder distension is a result of the bladder becoming overly full due to inability to fully empty the bladder.

Choice D rationale

Tenderness over the symphysis pubis can occur due to the bladder being overly full and distended.