A child with secondary enuresis who reports of dysuria or urgency should be evaluated for what condition? (Select all that apply.)

The correct answer is Choice C: Measure abdominal girth.

Choice A rationale:

Taking vital signs, including blood pressure, is important in assessing the overall health status of a child, but it might not provide specific information about a probable intussusception. Blood pressure is not typically affected in a way that directly relates to intussusception.

Choice B rationale:

Auscultating for bowel sounds is an important assessment technique in various gastrointestinal conditions, but it may not be the most appropriate immediate action when dealing with a probable intussusception. While bowel sounds might be diminished or absent in intussusception, the priority should be on assessing other signs and symptoms.

Choice C rationale:

Measuring abdominal girth is an essential nursing action when a child with a probable intussusception has a normal, brown stool. Intussusception is the telescoping of one segment of the intestine into another, often leading to bowel obstruction. Abdominal distension or girth measurement can provide valuable information about the progression of the condition and potential obstruction.

Choice D rationale:

Notifying the practitioner is an important step, but it might not be the most immediate action required. Assessing and monitoring the child's condition should be the initial response to gather more information before notifying the practitioner.

The correct answer is choice A: Signs of stress.

Choice A rationale:

Children often express stress through physical complaints such as stomach pains, headaches, and fatigue. The 9-year-old's complaints of stomach pains, along with the description of aggressive and stubborn behavior, are indicative of stress. Stressors can include academic pressures, family issues, social challenges, or other emotional factors.

Choice B rationale:

Developmental delay refers to a situation where a child's developmental milestones are significantly delayed compared to their peers. This doesn't align with the presented symptoms of stomach pains, aggression, and stubbornness. These symptoms are more indicative of emotional or psychological distress.

Choice C rationale:

While a physical problem could potentially cause emotional stress, the scenario doesn't provide enough information to directly conclude that a physical problem is the primary trigger. Stomach pains could indeed result from emotional stress, and it's important to consider the child's overall well-being.

Choice D rationale:

Lack of adjustment to the school environment can lead to behavioral and emotional challenges, but it's not the most direct explanation for the symptoms described in the scenario. The combination of stomach pains and behavioral changes suggests a more immediate emotional trigger, which is often stress-related.