Deck 12: Elimination Disorders

Question 1

Nocturnal enuresis is more common in males than in females.

Answer 1

True

Question 2

Individuals who are diagnosed with a diurnal only type of enuresis are:

A)Passing urine in the waking hours
B)Passing urine only during nighttime sleep
C)Passing urine in both waking hours and during nighttime sleep
D)None of the above patterns

Answer 2

A

Question 3

Paul Dieringer was completely potty trained by age 4. Shortly thereafter, his baby sister was born and Paul was enrolled in preschool. His mother seemed to have less time for him and it was about that time that Paul started passing feces into inappropriate places; that is, his mother would find "evidence" in his clothing or on the floor in the back of his closet. Paul would most likely receive a diagnosis of:

A)Encopresis, primary type
B)Encopresis, secondary type
C)Enuresis, diurnal
D)None of the above

Answer 3

B

Question 4

Johnny is a bright and well behaved 4-year old. Unfortunately he has one disgusting behavior that he is unable to control. Johnny has a problem going to the bathroom. His mother finds Johnny's feces in places other than the toilet, for example in his underwear. Johnny's feces seep out everywhere leaving a smelly mess. This has been going on for the past 3 months. His diagnosis would be:

A)Echolalia
B)Encopresis
C)Enuresis
D)Echopraxia

Question 5

The chronological age for the diagnosis of enuresis is:

A)Five years of age
B)Five years of age or the equivalent developmental level
C)Six to 12 years of age
D)Thirteen to eighteen years of age
True/False:

Question 6

Mrs. Sweeney begins by telling the social worker that she is, "Going through a rough divorce." Mrs. Sweeney adds that she feels guilty that lately she not as available to her son, Jimmy, as she should be. She continues, "Anyway, I felt like I needed some time to myself so I encouraged my Jimmy to go on an overnight camping trip. What could happen, I thought? Let me give you a little background. You see, Jimmy wets his bed every night." According to Mrs. Sweeney, this has been going on for at least the past 3 months and started right around the time the couple decided to go their separate ways. When the other kids found out about Jimmy's wetting they started making fun of him. Mrs. Sweeney continues, "He hasn't been the same since." She subsequently took her son to the doctor urologist) who did some sleep tests over 3 nights and found out that Jimmy is completely asleep when he wets and does not wake up. "Worse yet," adds Mrs. Sweeney, "Jimmy may probably be like this for the rest of his life." What is the most likely diagnosis for Jimmy Sweeney?

A)Enuresis
B)Encopresis
C)Separation anxiety disorder
D)Other specified elimination disorder

Question 7

Of the following, which is not characteristic of individuals with other specified elimination disorder?

A)Causes significant distress or impairment in important areas of life
B)Does not fully meet criteria for any of the elimination disorders
C)Meets criteria for any of the elimination disorders
D)The practitioner may choose to communicate the reason that the client's presentation does not meet criteria for any of the elimination disorders

Question 8

All of the following can be seen with the elimination disorders except:

A)Minimal age requirements of the diagnosis
B)The disorders are based on developmental age and not solely on chronological age
C)The disorders may be voluntary or involuntary
D)The co-occurrence between enuresis and encopresis is not seen

Question 9

When considering the diagnosis of enuresis, the child must have reached an age at which continence is expected or, at a minimum, a chronological age of 5 years.

Question 10

The diurnal-only subtype of enuresis occurs in the absence of enuresis during the day and may be referred to simply as nocturnal incontinence.

Question 11

Elimination disorder is associated with:

A)Enuresis
B)Encopresis
C)Co-occurrence of enuresis and encopresis
D)Other unspecified disorders

Question 12

To assign the encopresis specifier "with constipation and overflow incontinence" the following is required:

A)A comorbid DSM-5 disorder of enuresis
B)Evidence of constipation on physical examination or by history
C)No evidence of constipation on physical exam or by history
D)Urinary tract infections

Question 13

All of the following statements about enuresis are true except:

A)Chronological age of onset is at least 5 years or the equivalent developmental level
B)Voiding of urine patterns can be involuntary or intentional
C)The individual voids his or her urine into bed or clothes
D)Individuals with enuresis will also show repeated passage of feces into inappropriate places

Question 14

Lax toilet training and psychosocial stress may increase the child's risk for developing enuresis.

Question 15

Which of the following statements accurately describes the diagnosis of encopresis?

A)The specifier of with constipation and overflow incontinence refers to an often involuntary behavior
B)The specifier of with constipation and overflow incontinence refers to well-formed stool
C)A physical exam is not required to assign the specifier of without constipation and overflow incontinence
D)The specifier of without constipation and overflow incontinence applies only when there is an irregular pattern of constipation

Question 16

Each of the following is considered to be an elimination disorder except:

A)Enuresis
B)Encopresis
C)Nocturnal urinary discharge
D)Other specified elimination disorder

Question 17

The defining feature of enuresis is repeated and intentional voiding of urine during the day into the bed or clothes.

Question 18

To qualify for the diagnosis of enuresis, the voiding of urine must occur at least twice a week for one month, at a minimum.

Question 19

The nocturnal-only subtype of enuresis, sometimes called monosymptomatic enuresis, is the most common subtype and involves incontinence only during nighttime sleep.

Question 20

For the child with diurnal enuresis, sometimes he or she may not use the toilet because they are busy on the playground and "forget" the urge to void.

Question 21

Use the following terms to answer:

A child should not be diagnosed with _______________ until his or her chronological age is at least 5 years or the developmental equivalent.

Question 22

Use the following terms to answer:

A diagnostic criterion for _______________ requires that an individual be of an age in which consistent continence can be reasonably expected.

Question 23

While the general public may think of nighttime incontinence as a central aspect of enuresis, it can be seen in the daytime, or both nighttime and daytime.

Question 24

Use the following terms to answer:

The prevalence of ____________ declines with older age.

Question 25

Use the following terms to answer:

The _______________ disorders all involve a child's inappropriate elimination of urine or feces.

Question 26

Use the following terms to answer:

A child should not be diagnosed with _______________ until his or her chronological age is at least 4 years or the developmental equivalent.

Question 27

Use the following terms to answer:

When considering a diagnosis for the _____________ disorders, one considers chronological age or the equivalent developmental level.

Question 28

Match each term with the appropriate definition:
$\begin{array}{|l|l|}\hline\text { Term: } & \text { Definition: } \\\hline \text { a) Enuresis } &\_\_\_ \begin{array}{c}\text { Characterizes the repeated passage of feces into } \\\text { inappropriate places }\end{array} \\\hline \text { b) Noctumal only } &\_\_\_ \text { Subtype of enuresis indicating passage of urine } \\&\text { during w aking hours }\\\hline \text { c) Diurnal only }&\_\_\_\begin{array}{ll}\text { Feces in this subtype are characteristically }\\\text { poorly formed, and leakage can be infrequent to }\\\text { continuous happening mostly during the day }\end{array}\\\hline\text { d) Noctumal and diurnal }&\_\_\_\begin{array}{ll}\text { This diagnosis is not considered if the child has }\\\text { a urinary tract infection }\end{array}\\\hline \text { e) Encopresis }&\_\_\_\begin{array}{ll}\text { Subtype of enuresis indicating passage of urine }\\\text { only during nighttime sleep }\end{array}\\\hline \begin{array}{l}\text { f) Constipation } \\\text { overflow } \\\text { incontinence }\end{array}&\_\_\_ \begin{array}{l}\text { Feces in this subtype are likely to be of normal }\\\text { form and consistency with intermittent soiling } \end{array}\\\hline \text { g) Without constipation } &\_\_\_ \text { Subtype of enuresis indicating passage of urine } \\\text { and overflow } & \text { during nighttime and the waking hours }\\&\text { incontinence }\\\hline \text { h) Unspecified } &\_\_\_ \text { A diagnosis used when the practitioner may } \\\text { elimination disorder } & \text { choose not to specify the reason diagnostic criteria are }\\&\text { not met for a specific elimination disorder }\\\hline \end{array}$
$\quad$

Question 29

Use the following terms to answer:

A _______________ pattern of enuresis is more common in males while the ____________ pattern of incontinence is more common in females.