A 7-year-old girl who was formerly completely toilet trained recently began wetting the bed at night. To determine a cause for the enuresis, the nurse practitioner should ask her parents which question or make which statement?

Choice A reason: Asking about punishment may not provide insight into the underlying cause and could promote negative feelings in the child. Choice B reason: Family history can provide context, but it does not address potential environmental or psychological triggers for new-onset enuresis. Choice C reason: While some bedwetting can be normal, onset after a period of being toilet trained (secondary enuresis) warrants evaluation for stressors, medical conditions, or psychological factors. Choice D reason: This is correct. Secondary enuresis often results from stressors or major life changes, such as the arrival of a new sibling. Asking this question helps identify psychosocial triggers.