# A nurse is assessing a 4-year-old child during a routine pediatric visit. According to Erik Erikson's theory of psychosocial development, which behavior would best indicate that the child is successfully resolving the developmental crisis appropriate for this age group?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=541731  
> language: ko  
> subject: Growth & Development

## 문제

A nurse is assessing a 4-year-old child during a routine pediatric visit. According to Erik Erikson's theory of psychosocial development, which behavior would best indicate that the child is successfully resolving the developmental crisis appropriate for this age group?

## 보기

1. The child initiates play activities and suggests new games to play with toys in the examination room **✔ 정답**
2. The child clings to the parent and refuses to interact with the nurse or explore the environment
3. The child asks detailed questions about medical equipment and wants to understand how everything works
4. The child sits quietly and waits for instructions before engaging in any activity

**정답: 1**

## 해설

According to Erikson's Initiative vs. Guilt stage, preschoolers demonstrate initiative by starting activities and suggesting new games, as in choice 1. Other options show dependency, frustration, or passivity, which indicate unresolved guilt.

## 심화 해설

Understanding the Developmental Stage

The child in the scenario is 4 years old. According to Erik Erikson's theory of psychosocial development, this age falls within the Initiative vs. Guilt stage, which spans approximately from 3 to 6 years of age. The central conflict of this stage involves the child's growing capacity to plan and initiate new activities and the potential development of guilt when these initiatives are suppressed or fail.

Analyzing the Correct Answer

The correct behavior is that the child initiates play activities and suggests new games. This directly reflects the successful resolution of the Initiative vs. Guilt crisis. A child who is successfully navigating this stage develops a sense of purpose and the confidence to lead and create. In the clinical setting, this manifests as the child actively engaging with the environment, proposing novel ways to interact with toys, and demonstrating a desire to be the director of the play. This behavior is a hallmark of a healthy, developing sense of initiative.

Linking to the Evidence

The provided evidence strongly supports the critical role of self-directed play in healthy psychosocial development. The systematic review by Schneider et al. establishes that play is a "controlled space in which children can learn to express their problems and to regulate their emotions, thus promoting emotional and behavioral adjustment" [1]. When a child initiates a game, they are not merely playing; they are practicing emotional regulation, testing social roles, and building the executive function skills necessary to plan and execute an idea. This process is fundamental to developing a sense of initiative. By suggesting a new game, the child is demonstrating an internal belief in their own capacity to shape their environment, which is the positive outcome of this Eriksonian stage.

Why the Other Options Are Incorrect

- Option 2 (Clinging and refusing to interact): This behavior suggests a failure to resolve the earlier crisis of Trust vs. Mistrust (infancy) or Autonomy vs. Shame and Doubt (toddlerhood). A lack of exploration indicates the child does not view the environment as a safe space for learning and emotional expression, which the evidence identifies as a core function of play [1]. This is not an expected behavior for a 4-year-old successfully navigating initiative.

- Option 3 (Asking detailed questions about how things work): This behavior is more characteristic of the next stage, Industry vs. Inferiority (approximately 6 to 12 years), where the focus shifts to mastering cognitive and mechanical skills. While a 4-year-old is curious, the primary psychosocial task is not systematic understanding but rather creative and social initiation.

- Option 4 (Sitting quietly and waiting for instructions): This behavior is the direct antithesis of initiative. A child who waits passively for direction is demonstrating guilt or a lack of self-confidence in their own ideas. The play literature emphasizes that the child must be an active agent in their exploration to gain emotional and behavioral benefits, a process that emerges in close interaction with caregivers but is driven by the child's own initiations [1]. The developmental trajectory described by Bornstein positions early childhood as a "foundation and catalyst" for later functioning, where active, self-generated exploration is key to setting a positive life course .References (research sources)

- [1]Parent-Child Play and the Emergence of Externalizing and Internalizing Behavior Problems in Childhood: A Systematic Review.Meta-analysis/systematic reviewSchneider M, Falkenberg I, Berger P. (2022) · DOI: 10.3389/fpsyg.2022.822394

## 임상 시나리오

Assessing Initiative in PreschoolersClinical guide for the 3-6 year old visit
A 4-year-old is in Erikson's Initiative vs. Guilt stage. The core task is developing a sense of purpose by planning and initiating activities.

The hallmark of successful resolution is the child's spontaneous creation of play scenarios. Observe if the child suggests new games, directs the interaction, or explores toys with a clear plan.

CautionDo not mistake the school-age child's focus on rules and detailed "how-to" questions (Industry vs. Inferiority) for initiative. A child passively waiting for instructions may be signaling excessive guilt or lack of opportunity for self-directed play.

## 핵심 개념

- **Initiative vs. Guilt** — Erikson's third stage (3-6 years) where children assert power and control through directing play and other social interactions.
- **Purpose** — The ego strength or virtue developed upon successful resolution of the Initiative vs. Guilt crisis.
- **Psychosocial Development** — Erikson's theory outlining eight stages across the lifespan, each characterized by a central conflict that must be resolved for healthy personality development.

## 같은 주제 문제

- [A nurse is assessing a 4-year-old child during a routine pediatric visit. According to Eri…](https://mymerci.kr/pages/nclex_q.php?qn_id=541732)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._