Final Answer:
The nurse should include as the first manifestation of sexual maturation by Testicular enlargement. So, the correct option is C. Testicular enlargement.
Step-by-step explanation:
Testicular enlargement marks the onset of puberty in males, typically occurring between ages 9 and 14. This physiological change, known as gonadarche, is the first visible sign of sexual maturation in boys. The testes begin to grow in size due to increased production of testosterone, initiating the cascade of puberty-related changes.
During puberty, hormonal fluctuations trigger a sequence of events, leading to various physical changes. Testicular enlargement precedes other visible signs, such as pubic hair growth, voice changes, and facial hair growth. As the testes enlarge, testosterone secretion increases, contributing to secondary sexual characteristics like the growth of pubic hair and eventual development of facial hair.
Understanding the chronological sequence of pubertal changes is crucial for educators and healthcare professionals. While other changes like voice deepening and the growth of facial hair occur later in puberty, the initial manifestation of sexual maturation in boys is testicular enlargement. Teaching this sequence helps individuals identify and comprehend the natural progression of male puberty, aiding in early recognition of any potential developmental concerns.
So, the correct option is C. Testicular enlargement.