The Primary Care Pediatric Nurse Practitioner Is Evaluating a 4­year­old

The primary care pediatric nurse practitioner is evaluating a 4­year­old
female child for enuresis. The parents reports that the child has never been dry at night and has recently begun having daytime incontinence, usually when at preschool. The nurse practitioner learns that the child does not appear to have an abnormal urine stream. What will the nurse practitioner do next?

A) Examine the urethral meatus and labia and obtain a dipstick clean catch urinalysis.
B) Reassure the parent that the child probably gets distracted and puts off voiding until it is urgent.
C) Refer the child to a pediatric urologist for evaluation of possible vesicoureteral reflux.
D) Suggest a bladder retraining program and use of a nighttime bedwetting alarm.