A client is requesting information from a nurse about a nitrazine test. Which of the following statements should the nurse make?

"The test will determine if there is leaking amniotic fluid."

"Your bladder should be full prior to me performing this test."

"I will be taking a blood sample to test for changes in your hormones levels."

"If this test is positive you will be required to have a non-stress test."

Answer and Explanation

The Correct Answer is A

A. "The test will determine if there is leaking amniotic fluid.": The nitrazine test is used to detect the presence of amniotic fluid in the vagina by measuring pH. A positive result indicates a more alkaline pH, suggesting rupture of membranes. This explanation accurately describes the purpose of the test to the client.

B. "Your bladder should be full prior to me performing this test.": A full bladder is not required for a nitrazine test. In fact, urine can interfere with results because it is acidic and may cause a false-negative reading, so the bladder should not influence the test outcome.

C. "I will be taking a blood sample to test for changes in your hormone levels.": The nitrazine test does not involve blood samples and is unrelated to hormone levels. It is performed using vaginal fluid to detect amniotic fluid, so this statement is inaccurate.

D. "If this test is positive you will be required to have a non-stress test.": A positive nitrazine test indicates ruptured membranes, which may require further assessment, but it does not automatically mandate a non-stress test. Additional evaluation and clinical judgment guide next steps rather than an automatic NST.

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Correct Answer is ["A","D"]

Explanation

Rationale:

A. Cerebrospinal fluid electrophoresis: CSF electrophoresis is used to detect oligoclonal bands, which are indicative of multiple sclerosis (MS). The client’s presentation—fatigue, intermittent muscle weakness, tremors, double vision, and gait disturbances—suggests a demyelinating disorder, making this test appropriate.

B. Paracentesis: Paracentesis is used to evaluate ascites, which is not indicated in this client. There are no signs of abdominal fluid accumulation or liver disease that would warrant this procedure.

C. Bone marrow biopsy: Bone marrow biopsy is used for hematologic disorders such as anemia, leukemia, or other blood dyscrasias. The client’s symptoms do not indicate a primary bone marrow pathology.

D. MRI of brain: MRI is the diagnostic imaging of choice for detecting lesions in the central nervous system consistent with multiple sclerosis. It helps visualize demyelination and correlate it with clinical symptoms.

E. X-ray of abdomen: Abdominal X-ray is not indicated, as the client does not present with abdominal pain, obstruction, or gastrointestinal issues requiring imaging.

A. Encourage the client to drink 3000 mL of fluid daily. B. Review the need for the indwelling urinary catheter daily. C. Empty the drainage bag when it is half-full. D. Use soap and water to provide perineal care. E. Place the drainage bag on the bed when transporting the client. F. Change the indwelling urinary catheter tubing every 3 days.

Correct Answer is ["B","C","D"]

Explanation

Rationale:

A. Encourage the client to drink 3000 mL of fluid daily: This is contraindicated because the client has heart failure with signs of fluid volume excess (crackles and 3+ pitting edema). Increasing fluid intake could worsen fluid overload.

B. Review the need for the indwelling urinary catheter daily: Daily assessment of catheter necessity allows for timely removal when it is no longer needed, which significantly decreases the risk of catheter-associated urinary tract infections (CAUTIs).

C. Empty the drainage bag when it is half-full: Keeping the drainage bag from becoming overfilled prevents urine backflow into the bladder, which can introduce bacteria and increase infection risk. Regular emptying is a key preventive measure.

D. Use soap and water to provide perineal care: Proper perineal hygiene with mild soap and water helps remove bacteria and maintain skin integrity, reducing the risk of urinary tract infection, especially in incontinent clients.

E. Place the drainage bag on the bed when transporting the client: The drainage bag should always remain below the level of the bladder and off the bed to prevent backflow of urine, which can introduce bacteria and increase infection risk.

F. Change the indwelling urinary catheter tubing every 3 days: Routine scheduled tubing changes are not recommended, as unnecessary manipulation of the system can increase infection risk. Tubing should only be changed when clinically indicated (e.g., contamination, obstruction).

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