NORCET 10 Prelims-2026
Child Health Nursing (Pediatrics)
Medium
3-year-old child who had been toilet trained starts bedwetting after hospitalization. Which statement best describes this condition?
Appeared in: NORCET 10 Prelims-2026
Explanation
- Hospitalization is a significant psychological stressor for a toddler, causing fear, anxiety, and a feeling of loss of control.
- Regression is a common defense mechanism in children under stress, where they revert to an earlier, safer stage of development.
- The loss of a previously mastered skill, such as toilet training, is a classic sign of regression.
- This specific situation, where a child who was dry for months begins wetting again after a stressful event, is known as secondary enuresis, for which psychological factors are a common cause.
Why Other Options Were Wrong
- Option A: This is incorrect because the question states the child 'had been toilet trained,' indicating the skill was successfully learned before the hospitalization.
- Option C: This is incorrect because the child had already achieved the developmental milestone of toilet training. Developmental delay refers to not achieving milestones at the expected age.
- Option D: While a UTI can cause enuresis, the direct link between the onset of bedwetting and a major psychological stressor (hospitalization) makes regression the most likely and 'best' description of the behavior.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric behavioral response to stress and secondary enuresis as background academic context rather than a clinical decision trigger.
- Nurses must recognize regression as a normal coping mechanism in hospitalized children to provide appropriate psychosocial support and educate parents.
- A key nursing role is to reassure parents that regression is temporary and not a failure in their parenting or the child's fault, thereby reducing family anxiety.
- Avoiding punishment and providing a supportive, comforting environment are crucial interventions to help the child regain their sense of security and previously learned skills.
How to Approach the Question
- First, identify the key elements of the clinical scenario: the patient's age (3-year-old), the core problem (bedwetting), the child's prior status (was toilet trained), and the precipitating event (hospitalization).
- Recognize that hospitalization is a major psychological stressor for a young child.
- Connect the stressor to the behavioral change. Consider how a toddler would psychologically respond to such an event.
- Evaluate the options based on principles of child development and psychology. 'Regression' is the specific term for reverting to earlier behaviors under stress.
- Rule out other options: 'Ineffective training' and 'developmental delay' are contradicted by the fact that the child was already trained. 'UTI' is a possible physical cause but less likely to be the 'best' description given the clear psychological trigger.
Concept Tested & Keywords
- Concept Tested: Pediatric behavioral response to stress and secondary enuresis.
- Stem keywords: 3-year-old, toilet trained, bedwetting, hospitalization
- Lead-in keywords: best describes
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Question ID
Q5uqOrsLjzJwH0CWTYQbd2
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1532-1534
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 12334-12336
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1098-1100
Practise the full NORCET 10 Prelims-2026
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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