A nurse is caring for a client at an outpatient clinic.

Select the 2 diagnostic tests the nurse should anticipate the provider to prescribe.

Cerebrospinal fluid electrophoresis

Paracentesis

Bone marrow biopsy

MRI of brain

X-ray of abdomen

Answer and Explanation

Correct Answer : A,D

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.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Bone is exposed within the wound: Exposure of bone indicates a stage IV pressure injury, which involves full-thickness tissue loss with exposed muscle, tendon, or bone. This is more severe than stage III.

B. The skin is reddened and intact: Reddened, intact skin corresponds to a stage I pressure injury, which involves non-blanchable erythema without skin breakdown.

C. Subcutaneous fat is visible: Stage III pressure injuries involve full-thickness skin loss, where subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed. This finding is consistent with stage III classification.

D. Slough and eschar is present: While slough and eschar may be present in stage III or IV injuries, the presence alone is not sufficient to determine stage. The key characteristic for stage III is full-thickness tissue loss with visible subcutaneous fat without exposed deeper structures.

A. Administer calcium gluconate for urine output less than 50 mL/hr. B. Check deep tendon reflexes every 8 hr C. Administer one dose of betamethasone now and repeat in 24 hr. D. Limit IV intake to no more than 200 mL/hr.

Correct Answer is C

Explanation

A. Administer calcium gluconate for urine output less than 50 mL/hr: Calcium gluconate is given to treat magnesium sulfate toxicity, which is indicated by absent deep tendon reflexes, respiratory depression, or high serum magnesium levels. Low urine output requires monitoring but does not automatically warrant calcium gluconate administration.

B. Check deep tendon reflexes every 8 hr: Deep tendon reflexes should be assessed frequently during magnesium sulfate therapy, usually every 1–2 hours, to detect early signs of toxicity. Checking only every 8 hours is insufficient for safe monitoring.

C. Administer one dose of betamethasone now and repeat in 24 hr: Betamethasone is given to accelerate fetal lung maturity in preterm gestation, which is critical at 31 weeks. Administering the two-dose course as prescribed helps reduce neonatal respiratory complications, making this a priority intervention alongside magnesium sulfate therapy.

D. Limit IV intake to no more than 200 mL/hr: Monitoring and limiting IV fluids helps prevent fluid overload and pulmonary edema in preeclamptic clients, but ensuring fetal lung maturity with betamethasone takes priority at this gestational age in case of an early delivery.

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A nurse is caring for a client at an outpatient clinic. Select the 2 diagnostic tests the nurse should anticipate the provider to prescribe.

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A nurse is caring for a client at an outpatient clinic.

Select the 2 diagnostic tests the nurse should anticipate the provider to prescribe.