For a 7-year-old presenting with nocturnal enuresis, which assessment is essential?

• A. Check dietary intake
• B. Assess bullying, assess emotional state of child
• C. Sleep study
• D. Ignore wetting

Answer: (B)

Assessing the child’s emotional well-being and potential bullying is essential. Stress, anxiety, or peer problems can contribute to bedwetting or make it worse, so identifying these factors helps tailor support from family, school, and possibly a mental health professional. This psychosocial assessment often reveals modifiable contributors that address the issue without needing medical interventions first. Sleep studies are not routinely required unless there are red flags like snoring or daytime sleepiness, and dietary intake isn’t the primary factor to confirm at the initial visit. Ignoring the wetting would miss a key signal of underlying distress that may be driving the behavior.