The nurse is completing an assessment for a client with uncontrolled diabetes mellitus (DM) who came to the clinic reporting frequent, painful urination. Which screening test should the nurse perform first?

Urine dipstick test.

Rapid strep test.

Nitazine pH strip.

Fingerstick glucose.

Answer and Explanation

The Correct Answer is A

A.   A urine dipstick test is a preliminary screening tool that can quickly provide information about the presence of glucose, protein, nitrites, and leukocytes in the urine. In the context of uncontrolled diabetes with symptoms of painful urination, this test is useful for identifying signs of a urinary tract infection (UTI), which is a common complication in diabetic patients.
B.   A rapid strep test is used to diagnose streptococcal infections, particularly strep throat. It is not relevant to the symptoms of frequent and painful urination and does not help in assessing diabetic complications or urinary issues.

C.   Nitrazine pH strips are primarily used to assess amniotic fluid in pregnant women to determine if labor has started. They are not used for diagnosing urinary tract infections or evaluating symptoms related to diabetes.
D.   A fingerstick glucose test measures blood glucose levels and is useful for assessing the client's current glycemic control. While monitoring blood glucose levels is important for managing diabetes, it does not directly address the issue of painful urination or the presence of a urinary tract infection.

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Correct Answer is D

Explanation

A. Cloudy discharge is more commonly associated with infections or discharge from the genital area rather than residual urinary symptoms. While urinary tract infections (UTIs) can cause cloudy urine, this is not typically associated with suprapubic tenderness or the sensation of residual pressure alone.
B. An overactive bladder is characterized by symptoms such as frequent urination, urgency, and sometimes incontinence. However, it does not typically cause suprapubic tenderness or a sensation of residual pressure after urination. The described symptoms are more consistent with bladder outlet obstruction or incomplete bladder emptying rather than an overactive bladder.

C. Black tarry stools indicate upper gastrointestinal bleeding and are unrelated to urinary symptoms. This finding would suggest a different issue entirely, such as gastrointestinal bleeding, rather than a problem with the urinary tract or bladder. This is not consistent with the client's reported symptoms of suprapubic tenderness and sensation of residual pressure after urination.
D. A weak urinary stream is a common symptom associated with bladder outlet obstruction or conditions affecting urinary flow, such as benign prostatic hyperplasia (BPH) in older men. This finding aligns with the client's reported symptoms of suprapubic tenderness and feeling of residual pressure after urination.

A. Compare the skin turgor of the client's upper and lower leg. B. Observe the specific location and appearance of the ulceration. C. Note any change in the color of the ulcer when the leg is moved. D. Measure the degree of joint range of motion in the extremity.

Correct Answer is B

Explanation

A. Skin turgor assesses skin elasticity and hydration, which is more indicative of general hydration status rather than specific types of insufficiency. While poor skin turgor might be observed in various conditions, it does not specifically differentiate between venous and arterial ulcers.
B. The location and appearance of the ulcer can provide significant clues about its etiology. Venous ulcers often appear on the lower legs, particularly around the medial malleolus (inside of the ankle), and tend to have irregular, shallow, and often wet or weepy edges.
C. Changes in color upon movement can provide insight into the type of insufficiency. For arterial ulcers, the leg may appear pale or blanched when elevated and may develop a reddish or purple color when lowered due to poor blood flow.
D. Measuring joint range of motion assesses flexibility and mobility rather than the type of ulcer. While joint mobility issues can be associated with various conditions, including those affecting the vascular system, it does not directly help in distinguishing between venous and arterial insufficiency ulcers.

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The nurse is completing an assessment for a client with uncontrolled diabetes mellitus (DM) who came to the clinic reporting frequent, painful urination. Which screening test should the nurse perform first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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