The nurse is questioning the parents of a 2-year-old child to obtain a functional history. Which topics might the nurse include? Select all that apply.

A. At 6 years, children are expected to have mastered the ability to descend stairs without needing to place both feet on each step or hold onto the railing.

B. By 3 years of age, children typically begin to walk up stairs using a reciprocal pattern, placing only one foot on each step, but may still require a railing for support when going down.

C. At 4 years, children should be able to go both up and down stairs using a reciprocal pattern and without the need for a rail.

D. By 5 years, the expectation is that children can confidently navigate stairs in a manner similar to adults, without placing both feet on each step or requiring railing support.

A. Puberty might be delayed if scrotal changes have not occurred by the age of 11 years: This statement is accurate because the lack of scrotal changes by the age of 11 years may indicate delayed puberty, prompting further evaluation by a healthcare provider.

B. Growth spurts in height occur toward the end of midpuberty: Growth spurts in height typically occur during midpuberty, rather than toward the end, as adolescents experience a rapid increase

in skeletal growth.

C. Changes in the voice signal the beginning of puberty: While changes in the voice, such as voice cracking and deepening, are indeed part of puberty, they usually occur later in puberty, not necessarily at the beginning.

D. Gynecomastia commonly occurs during late puberty: Gynecomastia, the development of breast tissue in males, typically occurs during mid-puberty and may persist into late puberty but is not exclusive to that period.