A 7-year-old girl who was formerly completely toilet trained recently began wetting the bed at night. To determine a cause for the enuresis, the nurse practitioner should ask her parents which question or make which statement?
What type of punishment have you tried?
How long did each parent wet the bed?
There is no reason to make a diagnosis; bedwetting is normal up to age 10.
Has there been a major life change recently, such as a new baby?
The Correct Answer is D
Choice A reason: Asking about punishment may not provide insight into the underlying cause and could promote negative feelings in the child.
Choice B reason: Family history can provide context, but it does not address potential environmental or psychological triggers for new-onset enuresis.
Choice C reason: While some bedwetting can be normal, onset after a period of being toilet trained (secondary enuresis) warrants evaluation for stressors, medical conditions, or psychological factors.
Choice D reason: This is correct. Secondary enuresis often results from stressors or major life changes, such as the arrival of a new sibling. Asking this question helps identify psychosocial triggers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The OCI is a self-report questionnaire and useful for screening, but it is not considered the gold standard for severity assessment.
Choice B reason: The FOCI is a brief assessment tool, helpful in research or clinical settings, but lacks the comprehensive evaluation of Y-BOCS.
Choice C reason: The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the gold standard clinician-administered measure for assessing OCD symptom severity and monitoring treatment response.
Choice D reason: The NIMH Global OCD scale is less commonly used and lacks the specificity and validation of Y-BOCS for clinical severity assessment.
Correct Answer is D
Explanation
Choice A reason: Borderline personality disorder is characterized by instability in interpersonal relationships, self-image, and affect, typically emerging in adolescence or early adulthood. While emotional dysregulation is present, chronic irritability in childhood is not a strong predictor of developing borderline personality disorder.
Choice B reason: Schizophrenia involves psychosis, delusions, and hallucinations, typically emerging in late adolescence or early adulthood. Chronic irritability and temper outbursts in childhood are not predictive of schizophrenia.
Choice C reason: Bipolar I disorder is characterized by episodes of mania and depression. While irritability can appear in pediatric bipolar disorder, research shows that chronic, severe irritability with frequent temper outbursts without distinct manic episodes predicts unipolar depressive disorders rather than bipolar disorder.
Choice D reason: This is the correct answer. Chronic, severe irritability in childhood, especially when associated with temper outbursts, is strongly associated with the later development of unipolar depressive disorder in adulthood. It reflects persistent negative mood and emotional dysregulation rather than episodic mania.
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