Certified Pediatric Nurse (CPN)

In evaluating a child for encopresis, which symptom is most likely to be reported?

1. Adjusted well to Kindergarten

2. Fatty stools that float

3. Soft formed stools 2-3 times daily

4. Liquid stool staining underwear

The correct answer is: Liquid stool staining underwear

Liquid stool staining underwear is most likely to be reported in a child with encopresis because this condition involves the involuntary passage of stool, often associated with fecal impaction. As a child becomes constipated, the large intestine absorbs excess water from the stool, leading to hard, dry stools that can cause discomfort. When liquid stool leaks around these impacted feces, it can lead to soiling of the underwear, which is a common presentation in encopresis. In contrast, other options present variations of stool characteristics and behaviors that are less commonly associated with encopresis. For instance, adjusted well to kindergarten does not pertain to physical symptoms but rather emotional and social adaptation, while fatty stools that float usually indicate malabsorption issues rather than encopresis. Soft, formed stools 2-3 times daily indicates a normal stool pattern and is not indicative of the difficulties associated with encopresis. Hence, the presentation of liquid stool staining the underwear directly correlates with how encopresis typically manifests in children.