The preliminary management of a 6-year-old diagnosed with nocturnal enuresis (bedwetting) focused on behavioral modifications and positive reinforcement. Follow-up evaluation determines no significant improvement. The nurse practitioner should change the plan to include:
bowel cleansing.
urine analysis.
a bedwetting alarm.
a referral to a pediatric urologist.
The Correct Answer is C
Rationale:
A. Bowel cleansing may be considered if constipation is contributing, but it is not the standard next step when behavioral strategies alone fail.
B. Urinalysis is useful for ruling out underlying urinary tract infections or diabetes but is typically performed earlier in the evaluation process.
C. A bedwetting alarm is a first-line second-step intervention after behavioral modifications have not produced improvement. It conditions the child to wake in response to bladder fullness and has demonstrated efficacy in reducing nocturnal enuresis.
D. Referral to a pediatric urologist is generally reserved for refractory cases, underlying anatomic abnormalities, or complicated presentations, not as the immediate next step after failed behavioral therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Pericardial effusion is the accumulation of fluid in the pericardial sac surrounding the heart, not in the pleural cavity.
B. Parapneumonic pleural effusion is fluid that accumulates in the pleural space secondary to pneumonia; it is usually serous, purulent, or bloody but not specifically lymphatic.
C. Pleural empyema is pus in the pleural space, typically resulting from infection, not lymphatic fluid.
D. Chylothorax is the accumulation of lymphatic fluid (chyle) in the pleural cavity, usually due to trauma, obstruction, or congenital malformation of the thoracic duct. It is characterized by a milky appearance and high triglyceride content.
Correct Answer is C
Explanation
Rationale:
A. Poisoning is a common unintentional injury in preschool-aged children and a significant cause of morbidity and mortality.
B. Drowning is a leading cause of death in this age group and considered an unintentional injury.
C. Physical abuse is not classified as an unintentional injury; it is intentional and a form of child maltreatment.
D. Motor vehicle crashes, including pedestrian and passenger injuries, are among the leading causes of death in preschool-aged children.
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