Which of the following is a sign of impending death in a child?

Tachycardia, which is an increased heart rate, is often observed as a sign of impending death in children. As the body begins to shut down, the heart may attempt to compensate for diminishing organ function by pumping faster. This physiological response can indicate the body is under stress or in a state of decline.

In contrast, increased energy levels suggest that the child is responsive and can still engage with their surroundings, which is not consistent with signs of impending death. Enhanced reflexes indicate that the nervous system is still functioning well, which again contrasts with the expected decline in function as death approaches. Additionally, decreased sleeping hours would typically suggest an increase in activity or wakefulness, rather than the lethargy or unresponsiveness often seen in the final stages of life. Thus, tachycardia stands out as a pertinent indicator of the body's change as it nears death.