A nurse is assisting with teaching a class about Kohlberg's theory of moral development. The nurse should reinforce that which of the following stages involves challenging rules that impinge on the rights of others?

Choice A reason : Prolonged stress can lead to impaired immune function. When a person is stressed, the body's stress response can suppress the immune system, making it less effective at fighting off infections. This is because stress hormones like cortisol can inhibit the production and function of white blood cells, such as lymphocytes, which are crucial for the immune response. Additionally, chronic stress can lead to inflammation and reduce the body's ability to respond to immunological challenges, increasing the risk of illness and infection.

Choice B reason : Decreased blood pressure is not typically a manifestation of prolonged stress. In fact, stress can lead to increased blood pressure due to the release of stress hormones that cause vasoconstriction and an increase in heart rate. Over time, this can contribute to hypertension and cardiovascular problems.

Choice C reason : Hypoglycemia, or low blood sugar, is not a direct manifestation of prolonged stress. However, stress can affect blood sugar levels. For individuals with diabetes, stress can make it harder to control blood sugar as stress hormones can cause blood sugar levels to rise. In non-diabetic individuals, stress typically does not cause hypoglycemia.

Choice D reason : Anemia, a condition characterized by a lack of healthy red blood cells, is not a direct result of prolonged stress. Anemia can be caused by a variety of factors, including nutritional deficiencies, chronic diseases, or genetic conditions, but it is not commonly linked to stress.

Choice A reason : Using high-pitched tones is not recommended when speaking to a client with hearing loss. High-pitched sounds can be harder to hear for many people with hearing loss, as these sounds are often the first to be affected by auditory impairment. It's better to use a lower, natural tone and speak clearly.

Choice B reason : Speaking to the client using a loud voice is not advisable. While it might seem helpful, shouting can actually distort speech sounds and make it more difficult for the client to understand. Instead, the nurse should speak in a normal, clear voice and ensure the client's hearing aids are functioning if they use them.

Choice C reason : Talking quickly can make it difficult for a client with hearing loss to understand what is being said. It is important to speak at a moderate pace, enunciating clearly and allowing the client time to process the information. Rapid speech can blend words together, making it challenging for the client to follow the conversation.

Choice D reason : Making eye contact with the client when speaking is an effective communication strategy. It helps to engage the client and allows them to use visual cues such as lip-reading and facial expressions to better understand the conversation. Additionally, it ensures that the nurse has the client's attention before speaking.