In which patient will the nurse expect to see a positive Chvostek sign?

A 24-year-old adult admitted for chronic alcohol abuse

A 75-year-old patient admitted for a broken hip related to osteoporosis

A 50-year-old patient admitted for acute hyperparathyroidism

A 7-year-old child admitted for severe burns

Answer and Explanation

The Correct Answer is C

Choice A reason: Chronic alcohol abuse may cause hypomagnesemia, which can mimic hypocalcemia symptoms, but a positive Chvostek sign is specific to low calcium. Alcoholism alone is less likely to cause this sign without concurrent hypocalcemia, making this choice incorrect.

Choice B reason: Osteoporosis in a 75-year-old involves bone density loss but does not typically cause hypocalcemia or a positive Chvostek sign. Calcium levels are usually normal unless other conditions exist, making this choice incorrect for the expected finding.

Choice C reason: Acute hyperparathyroidism can lead to hypocalcemia after parathyroidectomy or in secondary complications, causing a positive Chvostek sign (facial twitching when tapping the facial nerve). Low calcium triggers this neuromuscular response, making this the correct choice.

Choice D reason: Severe burns cause fluid shifts and potential electrolyte imbalances, but hypocalcemia is not a primary feature. A positive Chvostek sign is less likely without specific calcium depletion, making this choice incorrect for the expected finding.

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Correct Answer is A

Explanation

Choice A reason: Decreased skin elasticity is an expected finding in an 84-year-old, as aging reduces collagen and elastin, causing thinner, less resilient skin. This physiological change increases wrinkling and fragility, making it a common and anticipated sign in elderly patients.

Choice B reason: Increased muscle strength is not expected in an 84-year-old, as aging leads to sarcopenia, reducing muscle mass and strength. This causes weakness and mobility issues, making this an incorrect finding for an elderly patient’s typical presentation.

Choice C reason: Enhanced night vision is not typical in aging; older adults often experience reduced night vision due to retinal changes and slower pupil adaptation. This makes night vision an incorrect expected finding for an 84-year-old patient.

Choice D reason: Improved short-term memory is not expected, as aging often impairs short-term memory due to neuronal loss and slower cognitive processing. Memory decline is common in the elderly, making this an incorrect finding for an 84-year-old.

A. pH 7.35, PaCO2 40 mm Hg, HCO3- 25 mEq/L B. pH 7.4, PaCO2 35 mm Hg, HCO3- 35 mEq/L C. pH 7.3, PaCO2 36 mm Hg, HCO3- 19 mEq/L D. pH 7.45, PaCO2 45 mm Hg, HCO3- 30 mEq/L

Correct Answer is C

Explanation

Choice A reason: pH 7.35, PaCO2 40 mm Hg, HCO3- 25 mEq/L are normal values, indicating no acidosis. Metabolic acidosis involves low pH and low bicarbonate, which this does not show, making it incorrect.

Choice B reason: pH 7.4 is normal, and HCO3- 35 mEq/L suggests metabolic alkalosis, not acidosis. Renal failure and diabetes typically cause acidosis due to acid accumulation, making this inconsistent with metabolic acidosis.

Choice C reason: pH 7.3 (low) and HCO3- 19 mEq/L (low) with normal PaCO2 indicate metabolic acidosis, common in renal failure due to impaired acid excretion and diabetic ketoacidosis, making this the correct choice.

Choice D reason: pH 7.45 and HCO3- 30 mEq/L suggest metabolic alkalosis, not acidosis. Elevated bicarbonate is opposite to the low levels expected in metabolic acidosis, making this incorrect for the patient’s condition.

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In which patient will the nurse expect to see a positive Chvostek sign?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for an 84-year-old patient. Which finding would be expected?

Correct Answer is A

Explanation

The nurse is caring for a diabetic patient in renal failure. Which laboratory findings are consistent with metabolic acidosis?

Correct Answer is C

Explanation

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