A nurse is providing care to 13-year-old who has an atrial septal defect (ASD). Their caregivers raise concerns regarding mood changes, reporting the child seems more anxious and worried than usual over the past year. Considering the diagnosis of ASD, which of the following responses is appropriate for the nurse to make?

A. "Worrying is normal for this age group.": Some worry is developmentally common, but new or worsening anxiety, especially over a year, merits assessment rather than being dismissed as simply normal. B. "All children with ASD have mood disorders.": There is an increased risk of mood and anxiety disorders in children with congenital heart disease, but not every child will develop a mood disorder. C. "Children with ASD are at greater risk for experiencing anxiety.": Children with atrial septal defect and other congenital heart conditions have a higher risk for anxiety and mood problems; caregivers should monitor and seek evaluation if concerns arise. D. "Children may become anxious when they have to be in a health care setting.": Health-care–setting anxiety can occur in many children, but this statement does not address the condition-specific increased risk for anxiety associated with congenital heart disease.