The PMHNP is evaluating a 7-year-old boy who is brought in by his grandmother. The child has epicanthal skin folds, a short nose, a small head circumference, and a smooth, indistinct philtrum. What is the most likely diagnosis?

Choice A reason: Rett syndrome primarily affects girls and involves regression of motor and language skills after a period of normal development, not facial dysmorphisms like epicanthal folds and smooth philtrum. Choice B reason: Increased intracranial pressure can cause macrocephaly or other neurologic signs but does not explain characteristic facial features. Choice C reason: Fetal alcohol syndrome is associated with specific facial dysmorphisms such as epicanthal folds, smooth philtrum, short nose, and microcephaly, making this the most consistent diagnosis. Choice D reason: Global developmental delay describes overall delayed development but does not account for the characteristic facial features observed.