The nurse determines that a 20-month-old is in Piaget’s sensorimotor stage of cognitive development. Which actions support this assessment?

Choice A reason: Pretend play, such as stirring an empty bowl and verbalizing imaginative content, reflects symbolic thought and is more aligned with the preoperational stage, which begins around age 2. This behavior suggests emerging cognitive abilities beyond the sensorimotor stage. Choice B reason: Offering a toy to comfort a crying adult demonstrates empathy and theory of mind, which are more advanced cognitive functions. These behaviors typically emerge in the preoperational stage and beyond. Choice C reason: Insisting on routine behaviors like sitting in the same chair reflects ritualism and egocentrism, common in the preoperational stage. It does not directly reflect sensorimotor exploration or cause-effect learning. Choice D reason: Stacking blocks and clapping when they fall demonstrates cause-and-effect understanding, sensory exploration, and motor coordination—all hallmarks of the sensorimotor stage. This stage emphasizes learning through physical interaction with the environment and immediate feedback.