To solve relationship puzzles like this, it helps to draw out a small family tree using placeholder names rather than just chaining titles together. Call the man M. M's father is F. F's sister, F's sibling, is M's paternal aunt, call her A. The girl in question is A's daughter, call her G. The question asks how G is related to M.
Since A is F's sister, A and F are siblings, meaning A is M's aunt (his father's sister). G is A's child, which makes G and M first cousins, because they share a set of grandparents, M's paternal grandparents are also A's parents, and therefore G's grandparents on her mother's side.
Since G is the daughter of M's father's sister, G and M share grandparents through that side and belong to the same generation, which makes them cousins.
Therefore, the correct answer is Cousin.
Family relationship terms mostly come down to two things: how many generations separate two people, and through which relative they are connected. The girl here is the daughter of the man's father's sister, so she is connected through the man's father's generation, one level above the man himself, and she herself sits in the same generation as the man. Testing each option against this generation-and-connection rule shows which term actually fits.
Since the girl and the man share the same grandparents and are separated by exactly one sibling link at the generation above them, the term that correctly fits is cousin.
Therefore, the correct answer is Cousin.