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

A 50-year-old patient admitted for an acute exacerbation of hyperparathyroidism

A 7-year-old child admitted for severe burns

A 24-year-old admitted for chronic alcohol abuse

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

Answer and Explanation

The Correct Answer is C

Rationale:
A. Hyperparathyroidism typically causes hypercalcemia, which would not result in a positive Chvostek’s sign.
B. Severe burns can cause fluid and electrolyte imbalances, including hypocalcemia, but it's less specific than option C.
C. Chronic alcohol abuse can lead to hypocalcemia and hypomagnesemia, which are known causes of a positive Chvostek’s sign, a clinical sign of neuromuscular irritability due to low calcium levels.
D. Osteoporosis may be related to chronic calcium deficiency, but it does not directly cause the acute hypocalcemia needed to produce a positive Chvostek’s sign.

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Correct Answer is A

Explanation

Rationale:

A. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

B. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

C. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

D. pH 7.41: Normal range is 7.35–7.45. PaCO₂ 45 mm Hg: Normal range is 35–45 mm Hg. HCO₃⁻ 26 mEq/L: Normal range is 22–26 mEq/L. PaO₂ 84 mm Hg: Normal range is 80–100 mm Hg. SaO₂ 97%: Normal range is 95–100%. All values are within normal limits, indicating a balanced acid-base and oxygenation status.

A. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.002 B. A 4-year-old preschooler who has status asthmaticus and a pulse oximetry of 95% C. A 1-year-old infant who has roseola and a temperature of 39°C (102.2°F) D. A 10-year-old child who has sickle cell anemia and a pain rating of 6 on a 0 to 10 scale.

Correct Answer is A

Explanation

Rationale:
A. Diabetes insipidus can lead to profound dehydration due to excessive fluid loss. A urine specific gravity of 1.002 indicates very dilute urine, supporting the concern. This child is at immediate risk for hypovolemic shock, so the nurse should assess them first.
B. A pulse oximetry of 95% is within acceptable range for a child with asthma, suggesting no acute distress at this time.
C. Roseola with a fever of 39°C is expected; while monitoring is needed, it's not the highest priority.
D. Pain of 6/10 in sickle cell anemia is concerning and requires attention, but it is not as emergent as potential fluid imbalance in diabetes insipidus.

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

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Naxlex Comprehensive Predictor Exams

Interpret the ABG: pH 7.41, PaCO2 45mmHg. HCO3 26, PaO2 84 mmHg. SaO2 97%

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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