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?

A. This response is a straightforward denial. It reflects a direct and possibly automatic answer that the client does not use recreational drugs. However, this type of response might be influenced by the phrasing of the question, which could lead the client to respond in a way that aligns with what they perceive as socially acceptable or expected.
B. This response indicates that the client acknowledges past use of a recreational drug (marijuana) but minimizes its frequency and significance. The response suggests that the phrasing of the question might have led the client to clarify their past behavior, showing an attempt to be honest while downplaying the extent of use.

C. This response suggests that the client is seeking clarification on what the term "recreational drugs" includes. The question might have been vague or broad, prompting the client to ask for a definition or to specify which substances are considered recreational drugs. This response indicates that the client might be unsure about whether their drug use falls into the category of recreational drugs.
D. This response implies that the client does use recreational drugs but does so infrequently or sporadically. It suggests a level of acknowledgment of occasional use without providing specifics. This type of answer might reflect that the client is uncomfortable with a direct yes/no response and opts for a more ambiguous acknowledgment.

A. Inequality in muscle contraction is not related to the monofilament test, which assesses sensation rather than muscle strength or contraction. This finding would be more relevant to a neurological or musculoskeletal assessment rather than a sensory test.
B. An intention tremor is a type of tremor that occurs when a person is trying to make a precise movement, often associated with conditions affecting the cerebellum. This is not related to the monofilament test, which measures sensory perception and not motor function or tremors.

C. Slowed capillary refill is a sign of poor peripheral circulation and is assessed by pressing on the nail bed or skin and observing how long it takes for color to return. While it is important for assessing blood flow, it is not directly related to the monofilament test, which evaluates sensory function.
D. Loss of peripheral sensation is a direct and relevant finding for an abnormal response on the monofilament test. The monofilament test is designed to detect loss of sensation in the feet, which can be an indicator of diabetic neuropathy. An abnormal result, such as the inability to feel the monofilament or diminished sensation in certain areas, would indicate that the client is experiencing peripheral neuropathy.