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

A. Puberty might be delayed if scrotal changes have not occurred by the age of 11 years:
Scrotal changes, such as thinning, reddening, and enlargement, are among the first signs of puberty in boys. If these changes have not started by age 11, it may indicate delayed puberty, warranting further assessment.

B. Changes in the voice signal the beginning of puberty: Voice changes usually occur later in puberty, after the onset of testicular and scrotal development. They are a secondary sexual characteristic, not an initial sign.

C. Growth spurts in height occur toward the end of midpuberty: Growth spurts typically happen during early to midpuberty, not toward the end. Height velocity peaks around Tanner stages 3 to 4, before puberty concludes.

D. Gynecomastia commonly occurs during late puberty: Gynecomastia tends to occur during early to midpuberty due to hormonal fluctuations and usually resolves spontaneously. It is less common to develop or persist into late puberty.

A. "This is a typical reaction for a child who is sick.” While illness may heighten distress, the behavior described—crying when the parent leaves—is more related to developmental stage than to acute illness, and should not be solely attributed to sickness.

B. "This is a response to an overstimulating environment." Overstimulation can cause fussiness or irritability, but separation anxiety, not overstimulation, best explains the infant’s reaction to the parent leaving.

C. "This is a normal, expected reaction for a child of this age." Separation anxiety typically emerges around 6–8 months of age as infants begin to understand object permanence. The child’s distress upon separation is a developmentally appropriate behavior.

D. "This is a common reaction to an overexposure to caregivers." Overexposure does not lead to distress when a caregiver leaves. Rather, strong attachment bonds cause infants to become upset when their primary caregiver is not present.