Neurological Question #16


The nurse is assessing a client following a fall from two stories. The nurse immediately contacts the health provider after finding clear nasal drainage indicative of basilar skull fracture. Which of the following findings alerts the nurse to determine that the clear nasal drainage is cerebrospinal fluid?


  1. The fluid is completely dark red and bloody with pH of 6.
    • Rationale:
  2. Fluid has yellow thick clumps with pH of 8.
    • Rationale:
  3. Fluid is clear and tests negative for glucose.
    • Rationale:
  4. Fluid separates into rings and is positive for glucose.
    • Rationale:



Drainage of spinal fluid on dressing material may produce a ‘halo sign’ that appears like concentric rings and may separate into yellow or blood tinged rings. The fluid will also be positive for glucose. Nasal drainage has little glucose whereas CSF fluid from nasal area may have levels between 40 – 70 mg/dL. CSF may have some blood but usually not fully bloody, nor will it have a pH as low as 6, and it will not have thick yellow clumps. pH is usually between 7.28 – 7.32.

Learning Outcomes

Test Taking Tip

Video Rationale