The nurse is caring for a patient in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder?
1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation
2. The addition of a 10% potassium hydroxide solution to the vaginal secretions
3. A vaginal pH of less than 4.5
4. A Gram stain positive for the fungus
2
Rationale 1: The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation is a test that confirms a diagnosis of vulvovaginal candidiasis.
Rationale 2: Adding a 10% potassium hydroxide solution to the vaginal secretion of a patient with bacterial vaginosis, called a "whiff" test, produces a fishy smell.
Rationale 3: The vaginal pH is usually greater than 4.5 if there is bacterial vaginosis.
Rationale 4: A Gram stain test is positive with vulvovaginal candidiasis.
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