55  <br/>Kelly is an 8-year-old girl who is being evaluated by the

PMHNP because she is markedly behind her peers in school performance. During her mental status examination, she is unable to repeat three objects after five minutes, and is unable to repeat five digits forward or three digits backward. Further evaluation reveals an inability to add single digits. The PMHNP interprets this finding as:

A. Consistent with her developmental milestone expectations
B. A manifestation of profound anxiety
C. Reflective of brain damage or learning disabilities
D. Suggestive of an abnormality of thought process