Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

In the diagnosis of acute gout, which test is primarily used to exclude other disorders?

1. Joint aspiration

2. Serum uric acid creatinine

3. BUN

4. X-rays

The correct answer is: X-rays

The primary test used to exclude other disorders in the diagnosis of acute gout is joint aspiration. This procedure allows for the retrieval of synovial fluid from the affected joint, which can then be analyzed for the presence of monosodium urate crystals, confirming the diagnosis of gout. Joint aspiration also helps rule out other conditions such as pseudogout, infections, or other inflammatory arthritides by providing clear evidence through fluid analysis. While serum uric acid levels, BUN, and X-rays can provide valuable information in the context of gout diagnosis, they do not specifically exclude other disorders. Serum uric acid levels can be elevated in gout but may also be normal during an acute attack. BUN is primarily used to assess kidney function and does not provide specific information related to gout. X-rays can help identify joint damage and other conditions but are not as definitive in ruling out acute gout since they do not show the presence of crystals. Therefore, joint aspiration is the test that plays a critical role in both confirming the diagnosis of acute gout and excluding other disorders through direct analysis of the joint fluid.