A school-aged client was recently diagnosed with type 1 diabetes mellitus. Which symptom did the client's parents most likely report?

Gained 10 lb (4.5 kg) within one month.

Drinks more fluids than previously.

Voids only one or two times per day.

Refuses to eat favorite meals at home.

Answer and Explanation

The Correct Answer is B

A.   Gained 10 lb (4.5 kg) within one month. Weight gain is not typically associated with the onset of type 1 diabetes. In fact, weight loss is more common due to the body's inability to use glucose properly.
B.   Drinks more fluids than previously. Increased thirst (polydipsia) is a classic symptom of type 1 diabetes due to high blood sugar levels causing dehydration.
C.   Voids only one or two times per day. Increased urination (polyuria) is a common symptom of type 1 diabetes as the body attempts to excrete excess glucose, so decreased urination is unlikely.
D.   Refuses to eat favorite meals at home. While changes in appetite can occur, it is not a primary symptom of type 1 diabetes. Increased hunger (polyphagia) is more typical.

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Correct Answer is B

Explanation

A. Initiating teaching for client care after discharge is incorrect. Teaching, especially initial or comprehensive education, is within the scope of practice of a registered nurse (RN), not a practical nurse (PN).
B. Using bladder ultrasound to detect urinary retention is correct. This is a task within the scope of practice for a PN, as it involves data collection and does not require independent clinical judgment.
C. Completing comprehensive assessments is incorrect. Comprehensive assessments require critical thinking and are the responsibility of the RN. PNs may collect data but do not perform initial comprehensive assessments.
D. Beginning initial sterile wound care for surgical clients is incorrect. The RN should perform the first sterile dressing change postoperatively to assess the wound properly. The PN may perform subsequent dressing changes per facility policy.

A. For the next 24 hours, notify the nurse when the bladder is full, and the nurse will collect catheterized specimens. B. Urinate immediately into a urinal, and the lab will collect the specimen every 6 hours for the next 24 hours. C. Urinate at a specified time, discard this urine, and collect all subsequent urine during the next 24 hours. D. Cleanse and meatus, discard the first portion of voiding, and collect the rest in a sterile bottle.

Correct Answer is C

Explanation

A. This instruction is incorrect because it suggests collecting catheterized specimens, which is not necessary for a creatinine clearance test. Catheterization may increase the risk of contamination and is not typically performed for this test.
B. This instruction is incorrect because it does not involve the collection of a complete 24-hour urine specimen. Collecting specimens every 6 hours would not provide an accurate measurement of creatinine clearance over a 24-hour period.
C. This instruction is correct. For a 24-hour urine collection, the client should urinate at a specified time to start the collection period, discard this urine, and then collect all subsequent urine produced over the next 24 hours. This ensures that the entire 24-hour period is captured for analysis.
D. This instruction is incorrect because it does not involve the collection of all urine produced over a 24-hour period. Additionally, discarding the first portion of voiding is not necessary for a creatinine clearance test and may lead to inaccurate results.

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A school-aged client was recently diagnosed with type 1 diabetes mellitus. Which symptom did the client's parents most likely report?

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