A nurse is monitoring a client who was admitted for hypocalcemia. Which of the following findings should the nurse expect?
Positive Chvostek's sign
Hypotension
Confusion
Positive Babinski reflex
The Correct Answer is A
A. Positive Chvostek's sign. Hypocalcemia increases neuromuscular excitability, leading to involuntary twitching of facial muscles when the facial nerve is tapped. This sign is a well-known indicator of calcium deficiency and reflects heightened nerve sensitivity.
B. Hypotension. While severe hypocalcemia can affect cardiovascular function, hypotension is not a primary or consistent finding. More commonly, calcium imbalances affect muscle contractions rather than directly causing low blood pressure.
C. Confusion. Hypocalcemia can cause neurological symptoms, but confusion is more common in severe or prolonged cases. Early manifestations are usually neuromuscular, such as tetany or muscle cramps, rather than cognitive impairment.
D. Positive Babinski reflex. This reflex is associated with upper motor neuron dysfunction and neurological disorders rather than electrolyte imbalances like hypocalcemia. Calcium deficiency primarily affects peripheral nerves and muscle excitability.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Same-sex activity is less risky during pregnancy than male-female intercourse." Sexual activity of any kind can pose potential risks, such as vaginal irritation, pressure on the abdomen, or infection transmission if proper hygiene is not maintained. While pregnancy risks associated with semen exposure do not apply in a same-sex relationship, safety considerations remain important.
B. "There are some modifications that can increase the safety of sexual activity during your pregnancy." Sexual activity is generally safe during pregnancy, but adjustments may be necessary to ensure comfort and reduce potential risks. As the pregnancy progresses, certain positions may need to be changed to avoid pressure on the abdomen. If complications such as placenta previa or a history of preterm labor are present, additional precautions may be recommended.
C. "Most people find that pregnancy significantly decreases their desire for sexual activity." Sexual desire during pregnancy varies among individuals. Some may experience a decrease due to hormonal changes, nausea, or fatigue, while others may have an increased desire for sexual activity.
D. "Since you are monogamous there are no risks related to sexual activity during your pregnancy." A monogamous relationship reduces the risk of sexually transmitted infections but does not eliminate other potential concerns. Vaginal irritation, complications related to certain pregnancy conditions, or discomfort due to physical changes can still occur, making it important to discuss any concerns with a healthcare provider.
Correct Answer is B
Explanation
A. Decrease daily fluid intake. Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension, particularly after the first dose. Decreasing fluid intake could exacerbate hypotension and increase the risk of syncope. Clients should maintain adequate hydration unless otherwise instructed by their provider.
B. Rise slowly from a sitting position to a standing position. Enalapril can cause orthostatic hypotension, especially when starting therapy. Clients should be advised to change positions slowly to reduce dizziness and syncope risk. Lying down if dizziness occurs can help restore blood pressure and prevent falls.
C. Withhold the medication if pulse rate is less than 60/min. Enalapril primarily affects blood pressure rather than heart rate. Unlike beta-blockers or some calcium channel blockers, it does not significantly lower the heart rate. The decision to hold enalapril should be based on blood pressure readings rather than pulse rate.
D. Increase dietary potassium. ACE inhibitors reduce potassium excretion, increasing the risk of hyperkalemia. Clients should be cautious with potassium-rich foods and supplements to avoid dangerous elevations in potassium levels, which can lead to cardiac complications.
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