A nurse is caring for a preschooler who is terminally ill. Which of the following reactions to death should the nurse expect?

A. Perceives death as a punishment: Preschool-aged children (around 3 to 5 years old) are in the preoperational stage of cognitive development and often see death as reversible or as a consequence of bad behavior. They may believe they are being punished for something they did wrong. B. Has feelings of isolation: Feelings of isolation are more characteristic of school-age children or adolescents, who are more socially aware and may feel different from peers during illness. C. Understands that death is permanent: Understanding the permanence of death typically develops around age 7 and beyond. Preschoolers often think death is temporary or reversible, like sleep. D. Worries about physical body changes: Concerns about physical appearance and body image tend to emerge in later childhood and adolescence, not typically in preschool-aged children.