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 B
Explanation
Choice A reason: Autism spectrum disorder involves social communication deficits and restricted/repetitive behaviors, but does not typically include deceleration of head growth after normal early development.
Choice B reason: This is correct. Rett syndrome, primarily affecting females, is characterized by normal early development followed by regression, deceleration of head growth (microcephaly), loss of purposeful hand skills, and social and motor impairments. The head growth deceleration at 8 months supports Rett syndrome over ASD.
Choice C reason: Global developmental delay is a diagnosis for children under 5 with delays in multiple developmental domains but does not explain the specific pattern of regression and head growth deceleration seen here.
Choice D reason: Pervasive developmental disorder is an outdated term encompassing ASD and similar conditions; it would not capture the distinctive features of Rett syndrome in this scenario.
Correct Answer is B
Explanation
Choice A reason: Trichotillomania involves hair-pulling, but it is typically focused on the act of pulling as a tension-relieving behavior rather than an appearance-focused compulsion driven by perceived flaws.
Choice B reason: This is the correct answer. Body dysmorphic disorder involves preoccupation with perceived physical flaws, leading to repetitive behaviors (such as tweezing) to "correct" perceived imperfections. The patient’s anxiety about eyebrow asymmetry and time-consuming compulsive behavior aligns with BDD.
Choice C reason: Delusional disorder, somatic type, involves fixed false beliefs about bodily functioning or appearance, but the patient demonstrates insight that the asymmetry is “all in her head,” ruling out delusional disorder.
Choice D reason: Obsessive-compulsive disorder involves intrusive thoughts and compulsions but is not specifically focused on perceived physical flaws, which distinguishes it from BDD in this scenario.
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