# Situation: A 9-year-old boy in grade 4 is admitted to the pediatric ward for a planned operation on his left leg, to be followed by several days of bed rest. He worries about missing school and his basketball games. While recording his fluid intake, the nurse pours his juice from a short, wide cup into a tall, narrow bottle. The boy says, "It's the same amount, because if you pour it back, it will fill the cup just like before." He correctly judges that the amount has not changed. The REASON he gives shows MAINLY which mental operation?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629517  
> language: ko  
> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: A 9-year-old boy in grade 4 is admitted to the pediatric ward for a planned operation on his left leg, to be followed by several days of bed rest. He worries about missing school and his basketball games.

While recording his fluid intake, the nurse pours his juice from a short, wide cup into a tall, narrow bottle. The boy says, "It's the same amount, because if you pour it back, it will fill the cup just like before." He correctly judges that the amount has not changed. The REASON he gives shows MAINLY which mental operation?

## 보기

1. Reversibility **✔ 정답**
2. Conservation
3. Classification
4. Decentering

**정답: 1**

## 해설

His judgment that the amount stays the same is conservation, but the reason he gives is reversibility: he mentally undoes the pouring and returns the juice to its starting state. Decentering would show as reasoning that the bottle is taller but also narrower. Both are concrete operational abilities, and the question asks which one his justification uses.

## 심화 해설

Clinical Context

A school-age child is hospitalized for leg surgery and will need prolonged bed rest. During routine intake measurement, the nurse transfers juice between containers of different shapes. The child states that the amount remains unchanged and explains this by saying it would refill the original cup if poured back. The question asks which mental operation his reasoning primarily demonstrates.

Core Concept

Piaget placed children around 7–11 years in the concrete operational stage. In this stage, thinking becomes logical but remains tied to tangible objects and direct experience. Two hallmark abilities emerge: conservation and reversibility. They are closely related, but they describe different aspects of the same cognitive achievement.

Conservation is the understanding that a physical quantity—such as liquid volume, mass, or number—does not change when its appearance or arrangement changes. The child in this scenario correctly judges that the amount of juice is the same after it is poured into a taller, narrower bottle. That judgment itself is conservation.

Reversibility is the mental operation that allows the child to undo an action in thought and return to the starting point. The child explains his judgment by saying that if the juice were poured back into the original cup, it would fill it just as before. The reason he gives is reversibility: he mentally reverses the pouring action and verifies that the original state is restored. This is the specific operation the question asks about.

Differentiating the Options

| Mental operation | What it means | How it would appear in this scenario |
| --- | --- | --- |
| Reversibility | Mentally undoing an action to return to the original state | “If you pour it back, it will fill the cup just like before” |
| Conservation | Knowing the amount stays the same despite a change in appearance | “It’s the same amount” |
| Classification | Grouping objects by shared properties | Sorting cups and bottles by shape or size |
| Decentering | Considering more than one dimension at the same time | “The bottle is taller, but it is also narrower” |

Watch out! The child’s statement contains both conservation and reversibility. The question does not ask what he understands; it asks what mental operation his *reason* uses. The phrase “if you pour it back” is the clue that points to reversibility, not conservation.

Key point! Conservation is the *outcome*—the correct judgment that quantity is unchanged. Reversibility is the *mechanism*—the mental undoing that supports that judgment. In test items, always check whether the question is asking for the ability demonstrated or the justification given.

Developmental and Clinical Relevance

Piaget’s framework remains a useful reference for understanding how hospitalized children interpret procedures and explanations. A child in the concrete operational stage can follow logical sequences when they are tied to visible, concrete steps. For a 9-year-old facing surgery and bed rest, the nurse can use this capacity by explaining what will happen in a step-by-step, reversible way—for example, describing how the leg will be positioned, how the dressing will be changed, and how each step can be undone or followed by the next. This supports the child’s emerging ability to mentally manipulate actions and reduces anxiety related to unfamiliar routines.

The study by Marwaha and colleagues examined Piagetian principles in younger children, primarily in the 4–7 year range, which corresponds to the preoperational and early concrete operational transition. Their work reinforces that cognitive abilities such as conservation and reversibility emerge along a developmental continuum and are not uniformly present in all children of the same chronological age . In clinical practice, nurses should assess each child’s reasoning level individually rather than assuming ability based on age alone. A school-age child who can explain reversibility is demonstrating concrete operational thought, but a child of the same age who cannot yet do so may still be functioning at an earlier cognitive level and will need more concrete, step-by-step preparation.

Test-Taking Strategy

When a question describes a child’s correct conservation judgment and then asks about the *reason* given, look for the specific wording of the explanation. If the child says the action can be undone or reversed, the answer is reversibility. If the child compares two dimensions, such as height and width, the answer is decentering. If the child simply states that the amount is unchanged without explaining how, the answer is conservation. In this item, the phrase “if you pour it back” directly signals reversibility as the mental operation being tested.

## 임상 시나리오

Piaget: Reversibility vs ConservationSchool-age cognitive assessment at the bedside
In the concrete operational stage (7–11 years), a child who says the amount is unchanged demonstrates conservation. When the child explains by mentally pouring the juice back, the reasoning is reversibility.

Ask the child to explain the answer. A justification based on undoing the action indicates reversibility; a justification based on height and width together indicates decentering.

CautionDo not label the reason as conservation. Conservation is the correct judgment, but the question asks which mental operation the child's explanation uses.

## 핵심 개념

- **Reversibility** — Mental ability to undo an action in thought and return to the starting state, a concrete operational skill.
- **Conservation** — Understanding that quantity remains unchanged despite changes in appearance or arrangement.
- **Concrete operational stage** — Piaget's stage from about 7 to 11 years when logical thinking about tangible objects develops.
- **Decentering** — Ability to consider multiple aspects of a situation simultaneously, such as height and width.

## 같은 주제 문제

- [Situation: A 20-month-old boy is admitted to the pediatric ward of a district hospital for…](https://mymerci.kr/pages/nclex_q.php?qn_id=629416)
- [Situation: A 20-month-old boy is admitted to the pediatric ward of a district hospital for…](https://mymerci.kr/pages/nclex_q.php?qn_id=629417)
- [Situation: A 20-month-old boy is admitted to the pediatric ward of a district hospital for…](https://mymerci.kr/pages/nclex_q.php?qn_id=629418)
- [Situation: A 20-month-old boy is admitted to the pediatric ward of a district hospital for…](https://mymerci.kr/pages/nclex_q.php?qn_id=629419)
- [Situation: In the treatment room of a district hospital, the nurse prepares a 4-year-old g…](https://mymerci.kr/pages/nclex_q.php?qn_id=629420)
- [Situation: In the treatment room of a district hospital, the nurse prepares a 4-year-old g…](https://mymerci.kr/pages/nclex_q.php?qn_id=629421)
- [Situation: In the treatment room of a district hospital, the nurse prepares a 4-year-old g…](https://mymerci.kr/pages/nclex_q.php?qn_id=629422)
- [Situation: The nurse at a Rural Health Unit (RHU) holds a class for parents of young child…](https://mymerci.kr/pages/nclex_q.php?qn_id=629423)

---

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

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