Erikson's Stages Summary with cross references and NCLEX questions

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Trust vs. mistrust

FEEDING

By caregiver providing reliable care and affection, attachment happens, which results in trust to caregiver and others. The lack of it will lead to mistrust.

autonomy vs shame and doubt

TOILET TRAINING

Gaining some basic control of self and environment and sense of independence leads o autonomy. Lack of it results in feeling shame and doubt.

initiative vs. guilt

EXPLORATION

Becoming purposeful and directive, Experimenting with asserting control and power over environment. Success leads to sense of purpose. Children who try to exert too much power experience disapproval, resisting in a sense of guilt.

industry vs. inferiority

SCHOOL

Developing social, physical, and school skills.
Success leads to a sense of competence, failure leads to feelings of inferiority.

identify vs. role confusion

SOCIAL RELATIONSHIPS

Making transition from childhood to adulthood , developing sense of personal identity. Success leads to an ability to stay true to yourself, whine failure leads to a role of confusion and weak sense of oneself.

intimacy vs. isolation

RELATIONSHIPS

Establishing intimate bonds of love and friendship with other people. Success leads to strong relationships, failure to loneliness and isolation.

generativity vs. self-absorption

WORK AND PARENTHOOD

Fulfilling life goals that involve family, career, and society; developing concerns that embrace future generations. Feelings of success of being useful and having accomplished something, while failure results in shallow involvement in the world.

integrity vs. despair

REFLECTION OF LIFE

Looking back over one's life and accepting its meaning. Need to feel a sense of fulfillment. Success leads to a sense of wisdom, while failure results in regret, bitterness and dispair.

infancy

0-18 months

early childhood

2-3 yr

preschool

3-5 yr

school age

6-11 yr

adolescence

12-18 yr

young adulthood

19-40 yr

middle adulthood

40-65yr

Maturity

65 yr to death

infancy

trust vs. mistrust

(birth to 18 months)

feeding

early childhood

autonomy vs. shame and doubt

(2-3 years)

toilet training

preschool

initiative vs. guilt

(3-5 years)

exploration

school age

industry vs. inferiority

(6-11 years)

school

adolescence

identify vs. role confusion

(12-18 years)

social relationships

young adulthood

intimacy vs. isolation

(19-40 years)

relationships

middle adulthood

generativity vs. stagnation

(40-65 years)

work and parenthood

maturity

Ego integrity vs. despair

(65- death)

refection of life

A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?

A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation

(A) Trust vs. Mistrust

0-18 months

infancy

A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?

A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation

(B) Initiative vs. guilt

3-6 years old

preschool

A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in?

A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation

(D) Intimacy vs. isolation

young adult hood

19-40 years

According to Erikson, what is the developmental stage of the infant?

According to Erikson, the developmental stage of the infant is trust versus mistrust.

According to Erikson, what is the developmental stage of the toddler?

According to Erikson, the developmental stage of the toddler is autonomy versus shame and doubt.

According to Erikson, what is the developmental stage of the preschooler?

According to Erikson, the developmental stage of the preschooler is initiative versus guilt.

Identify at least two important assessments to make when providing care to a preschooler.

Answers can include any of the following assessments of a preschooler:
● height, weight, and vital signs
● nutrition
● sleep patterns
● dental hygiene
● safety
● kindergarten readiness

What important physical changes occur in the school-age group?

Important physical changes in the school-age group include the following:
● Strength, physical ability, and muscle mass rapidly improve in the school-age period.
● All primary teeth are lost during this time and are replaced by secondary teeth.
● The gastrointestinal system matures and stomach capacity increases, although caloric demands are less.
● Ossification of bones continues throughout this age.
● As the immune system develops, the school-age child begins to produce antibodies and antigens.
● Toward the end of the school-age phase, girls enter a period of rapid growth, associated with the onset of puberty.

According to Erikson, what is the developmental stage of the adolescent?

According to Erikson, the developmental stage of the adolescent is known as identity versus role confusion.

Name two common health problems of adolescents.

Answers can include any of the following health problems of adolescents:
● physical injury
● suicide
● depression
● sexual experimentation leading to STDs and unplanned pregnancy
● experimentation with alcohol and drugs
● cigarette smoking
● obesity

According to Erikson, what is the developmental stage of the young adult?

According to Erikson, the developmental stage of the young adult is known as intimacy versus isolation.

What is the leading cause of death for this age group?

For young adults, the leading cause of death is violence.

What gender-specific assessments should be emphasized with this age group?

For young adults, gender-specific assessments are breast self-exam (BSE) for women and testicular self-exam (TSE) for men.

● According to Erikson, what is the developmental stage associated with middle adulthood?

According to Erikson, the developmental stage of middle adulthood is known as generativity versus stagnation.

Identify at least five appropriate topics for health teaching during middle adulthood.

Answer:
Numerous answers are possible, including the following health topics for middle adulthood:
● importance of avoiding obesity
● hazards of smoking
● need to limit alcohol intake
● benefits of a balanced nutritional intake
● importance of regular exercise
● importance of stress management
● need for periodic health exams:
● gender-specific cancer screening recommendations (mammograms, PSA testing)
● need to screen for colon cancer for early detection
● immunizations
● interventions for chronic problems

Name two age-related changes seen in older adults.

A multitude of answers are possible. For a complete listing, go to Table 9-8, Age-Related Changes and Areas for Assessment, in the Expanded Discussion of Chapter 9 on this Electronic Study Guide.

● According to Erikson, what is the developmental stage of the older adult?

According to Erikson, the developmental stage of older adults is known as ego integrity versus despair.

● What are the top two causes of death among older adults?

Among older adults, the top two causes of death are heart disease and cancer.

Description of Theory
Theorists
1. Studied cognitive development based on the assumption that human nature is rational.
2. Theorized that psychosexual development occurs through the lifespan. Phases include oral through genital and development of the personality structures of id, ego and superego.
3. Humanist who organized human needs into a hierarchical framework.
4. Theorized that development encompasses eight stages, birth through death, involves developmental goals.

A. Freud
B. Piaget
C. Rogers
D. Erikson
E. Maslow
F. Roy

Answer:
1. B
2. A
3. E
4. D

In preparing to teach parents about their school-age children, the nurse should be aware of which of the following considerations?
A. Increased mobility increases the risk for falls.
B. Increased excursions increase the risk of accidents.
C. Decreased motor skills are typical of this stage.
D. The child may have difficulty adjusting to increased autonomy.

Answer:
B. Increased excursions increase the risk of accidents.

Rationale:
School-age children are involved in increasing activities outside the home or away from the family. They have increased educational needs for accident and safety awareness. Response A refers to toddlers, response C to older adults, and response D to adolescents.

Which of the following is not a characteristic of young adults?
A. Problem-solving skills are reduced and motor skills are slower.
B. There is a strong need to achieve intellectually.
C. Physical maturation is complete.
D. Work, intimacy, and parenting are priorities.

Answer:
A. Problem-solving skills are reduced and motor skills are slower.

Rationale:
These features are characteristic of the older adult.

In what stages do the psychosocial developmental aspects striving for individuality, exploring one's abilities, and associative play occur?
A. Toddler
B. Infant
C. Preschool
D. Adolescent

Answer:
C. Preschool

Rationale:
Adolescents are striving for identity, toddlers for autonomy, and infants for trust.

Which of the following would be an abnormal assessment finding for an older adult that the nurse would document and report to the primary care provider? Decreased:

1) Reaction time
2) Short-term memory
3) Intellectual ability
4) Cognitive processing speed

3) Intellectual ability

Rationale:
There should be no loss of intellectual ability. An elderly person can learn, although learning takes longer. Reaction time slows as we age, and it is also normal to have a decline of short-term memory, although long-term memory loss is not as common. Cognitive processing speed declines with age. This includes slower computational skills and reduced speed for problem-solving, but this does not imply that intellect is impaired.

The nurse provides instructions to a parent about what to anticipate during her son's adolescence. Which comment by the parent indicates she understands the instructions?

1) "I know his peers will have more of an influence than I will."
2) "I'm relieved he will finally be able to make good decisions."
3) "I'm sure he will be less inclined to do things with his friends."
4) "I'm glad his growth will slow; the food bills have been huge."

1) "I know his peers will have more of an influence than I will."

Rationale:
Adolescents develop their own personal identity, and they do this by decreasing the attachment to their parents and developing close relationships with peers. The adolescent still lacks common sense and can have poor judgment. Adolescents have a strong need to feel part of a group. There is a growth spurt for both sexes during adolescent

Which of the following is the most prevalent major health problem for young adults?

1) Cancer
2) Obesity
3) Eating disorders
4) Cardiovascular disease

2) Obesity

Rationale:
Obesity has increased drastically in adults. Of course, some cancers do occur in young adults; however, cancer and cardiovascular disease become major concerns in middle adulthood. Eating disorders are a problem more typical of adolescence. They are not widespread in adults. They may occur in young adults but are not as prevalent as obesity.

According to developmental norms, at what age does the greatest increase in height occur?

1) 1 to 3 years
2) 4 to 5 years
3) 6 to 11 years
4) 12 to 18 years

4) 12 to 18 years

Rationale:
Twelve- to 18-year-old females grow 2 to 8 inches, and males grow 4 to 12 inches. Growth is about 3 inches for children during years 1 to 3 and 4 to 5. Growth is about 2 inches during the sixth and up to the 12th year.

The nurse is planning to discuss the psychosocial challenges of middle adulthood with a community group. Which of the following should be included in the discussion?

1) There is an unavoidable decline in health in middle adulthood.
2) There are significant age-related body changes that affect health.
3) Work is more challenging because the productive years have passed.
4) Along with raising children there is often the concern of aging parents.

4) Along with raising children there is often the concern of aging parents.

Rationale:
Middle adults often have competing demands of raising children and caring for aging parents along with the demands of the job. There is not a noticeable decline in health, although energy levels may decline. There are some age-related changes (loss of skin turgor, muscle tone, etc.), but they are not as significant as during older adulthood, and as a rule they do not affect health. During middle adulthood, a person is usually at the peak of his career, but it is also the peak of creativity.

A young mother of a 1-month-old infant says to the nurse, "My baby can't roll over or sit up. He can raise his head though, and he looks at me when I talk to him. Is anything wrong?" How should the nurse respond?

1) "No. Babies don't usually roll over until they are about 5 months old."
2) "Probably not. But we can do a Denver Developmental Screening Test to be certain."
3) "Probably not. If he doesn't fall over when you sit him up, he is developing normally."
4) "I don't think so, but we can have the physician examine him to be sure."

1) "No. Babies don't usually roll over until they are about 5 months old."

Rationale:
Development proceeds in a proximodistal pattern, beginning at the center of the body and moving outward. For example, the infant first begins to focus her eyes, then lifts her head, and later pushes up and rolls over (by about 5 months of age). There is no need to use time and money administering a Denver Developmental Screening Test (DDST); what the mother describes is certainly normal, and the nurse is qualified to make that judgment. Normally, a baby will roll over before she sits alone; it would be very unusual for a 1-month-old to do either. Also, because of proximodistal development, the infant will probably (but not always) roll over before he sits alone. The nurse does not need the physician to answer this mother's question about normal infant development.

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