A 5-year-old boy dreams that he is riding in a car that starts flying, then turns into a monster. At the end of the dream, he dies. The boy tells his mom, "I became a ghost like Grandpa." Which of the following would be an appropriate statement by the NP to the mother?

Choice A reason: While monitoring for anxiety is important, a single dream in a child of this age is generally developmentally appropriate and not indicative of psychopathology. Immediate evaluation is not required. Choice B reason: This is correct. Children around age 5 often incorporate recent events, especially deaths, into their dreams as they attempt to process and understand concepts of mortality. This is a normal developmental response. Choice C reason: Early signs of schizophrenia are rare at age 5, and this child’s behavior is not consistent with early psychotic symptoms. Choice D reason: Family psychiatric history may provide context but is not relevant for interpreting a typical childhood dream about death.