A school nurse is providing care to a child in the nurse's office. Exhibits Complete the following sentence by using the lists of options. The child is likely experiencing dropdown as evidenced by the child's dropdown and dropdown

Rationale: This child’s presentation is most consistent with bullying because the change is recent, tied to peer interactions, and includes the classic triad of psychosocial, somatic, and academic consequences. Six months ago the child was quiet but excelled academically and had normal screenings and growth; over the past months the teacher reports social withdrawal (playing alone, avoiding group work), and grades have declined, a clear change in academic performance that correlates with the timing of peer problems. Parents report frequent headaches, stomachaches, sleep disturbance, loss of appetite, weight loss (50th to 5th percentile) and loss of interest in activities; these are common psychosomatic symptoms of chronic stress and anxiety from bullying rather than primary medical disease. The child also expresses low self-esteem due to classmates’ comments and refuses to discuss peers, which supports an interpersonal (peer-related) cause.