Observation & Communication
What is communication?
The process of exchanging information.
What is the name of the developmental stage, according to Piaget, that occurs from birth to about 2 years old?
The Sensorimotor Stage.
What is the first psychosocial stage in Erikson’s theory, and what age group does it occur in?
Trust vs. Mistrust (Birth–1 year).
In this stage, infants learn to trust caregivers when their needs are consistently met. In healthcare, responding quickly and gently to an infant’s needs helps build trust.
What are the basic needs at the bottom of Maslow’s Hierarchy of Needs?
Physiological needs — oxygen, food, water, sleep, warmth, and elimination.
Which type of development includes changes in height, weight, motor skills, and body systems?
Physical Development
This includes growth in body size, strength, coordination, and organ function.
How can you show a patient that you are actively listening?
By :
- using non-verbal cues
- maintaining eye contact
- nodding
Which Piaget stage is characterized by egocentric thinking and difficulty understanding another person’s point of view?
The Preoperational Stage (ages 2–7).
During which stage do toddlers develop independence and a sense of control over their actions?
Autonomy vs. Shame and Doubt (1–3 years).
Toddlers want to do things on their own. In healthcare, allowing simple choices (like picking a bandage color) supports autonomy and reduces feelings of shame.
Which level of Maslow’s hierarchy focuses on protection, stability, and security?
Safety and Security needs.
A toddler begins walking independently and says simple two-word phrases like “want juice.” What areas of development are being demonstrated?
Physical development (walking)
Cognitive development (language formation and understanding)
What do the following abbreviations stand for? (Must answer both for credit)
- SOAP
- SBAR
- Subjective, Objective, Assessment, Plan
- Situation, Background, Assessment, Recommendation
A 4-year-old patient believes that the hospital gave them a shot because they were “bad.” According to Piaget’s theory, which stage are they in, and why are they thinking this way?
The Preoperational Stage.
Children in this stage engage in magical thinking and may believe illness or procedures are punishment for bad behavior. They do not yet understand logical cause and effect.
A hospitalized preschool child insists on choosing which arm gets the blood pressure cuff and becomes upset when not given options. According to Erikson, which stage is the child in, and why is offering choices important?
Initiative vs. Guilt (3–6 years).
Preschoolers want to take initiative and feel in control. Offering choices helps them feel empowered and prevents guilt or frustration during medical procedures.
A hospitalized patient refuses to participate in physical therapy because they feel lonely and unsupported by family. According to Maslow, which need may not be met?
Love and Belonging needs.
Patients need connection, support, and relationships. Without feeling supported, they may lack motivation to engage in care.
An adolescent is very concerned about peer acceptance and frequently compares themselves to others on social media. Which areas of development are most involved?
Social development (peer relationships and belonging)
Emotional development (self-esteem, self-image, and identity formation)
What is patient Autonomy?
The ethical and legal right of patients with decision-making capacity to make their own informed healthcare decisions without undue influence from providers.
How should a nurse explain a blood draw to a child in the concrete operational stage to ensure understanding based on Piaget’s theory?
The child is in the Concrete Operational Stage (ages 7–11).
The nurse should give clear, logical, and step-by-step explanations. Using simple facts, visual aids, and allowing the child to ask questions helps because children in this stage think logically about concrete (real) information.
An adolescent patient is struggling with self-image after being diagnosed with a chronic illness. According to Erikson’s theory, which psychosocial conflict are they facing, and how might this impact their healthcare experience?
Identity vs. Role Confusion (12–18 years).
Adolescents are developing their sense of identity. A chronic illness may make them feel different from peers, impacting self-esteem and treatment adherence. Healthcare providers should encourage independence, involve them in decisions, and support positive self-identity.
A patient has stable vital signs and a safe environment but expresses feelings of worthlessness after losing mobility. Which level of Maslow’s hierarchy is most affected, and how can a nurse help?
Esteem needs.
Esteem includes self-confidence, respect, and feeling valued.
An older adult is experiencing slower reaction times but has strong problem-solving skills and gives advice to younger family members. Which aspects of development are changing, and which remain strong?
Physical development: May decline (slower reflexes, decreased strength)
Cognitive development: Crystallized intelligence (knowledge and experience) often remains strong
Social/emotional development: Often improved emotional regulation and wisdom
A nurse is caring for an elderly patient who has been quiet throughout the shift. During routine vital signs, the nurse notices the patient is more withdrawn than usual, avoiding eye contact, and answering questions with short responses. The patient’s vital signs are within normal limits, but they have eaten very little of their meals and are sleeping more than usual.
QUESTION : What observations are important to recognize in this situation?
Increased withdrawal and reduced interaction
Avoiding eye contact
Short, minimal responses to questions
Decreased appetite
Increased sleeping
Change from the patient’s normal behavior
A 15-year-old patient refuses a medical procedure because they believe “nothing bad will happen” to them and that risks only apply to other people. Using Piaget’s theory, identify the developmental stage and explain how adolescent cognitive development may influence healthcare decision-making and risk perception.
Answer: The Formal Operational Stage (ages 12 and up).
Adolescents can think abstractly and understand risks, but they may experience an “imaginary audience” or “personal fable,” meaning they believe they are unique or invincible.
An older adult patient expresses regret about past life decisions and states, “I feel like my life didn’t really matter.” Using Erikson’s theory, identify the stage involved and explain how a healthcare professional can support positive psychosocial resolution during this time.
Integrity vs. Despair (65+ years).
In this stage, individuals reflect on their lives. Feeling fulfilled leads to integrity; regret leads to despair.
A patient with chronic illness has all physical and safety needs met but expresses a desire to “find purpose” and make a difference before the end of life. According to Maslow, which level is this, and why is it important in holistic healthcare?
Self-Actualization.
This is the highest level of Maslow’s hierarchy and involves reaching one’s full potential and finding meaning in life.
A hospitalized 6-year-old becomes withdrawn, refuses to eat, and regresses to bedwetting after surgery. Using knowledge of physical, cognitive, social, and emotional development, explain why this might be happening and how healthcare providers should respond.
Physical: Pain, fatigue, and stress from surgery can affect behavior.
Cognitive: At this age, children may misunderstand illness and believe they caused it.
Emotional: Fear and anxiety may cause regression (temporary return to earlier behaviors).
Social: Being away from family and normal routines increases stress.