A nurse is preparing to infuse a 250-mL unit of packed RBCs over 2 hours. The drop factor of the manual IV tubing is 15 gtts/mL. The nurse should adjust the flow rate to deliver how many drops per minute?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: Babinski’s sign

Babinski’s sign is a reflex action where the big toe moves upward or toward the top surface of the foot and the other toes fan out when the sole of the foot is stimulated. This sign is used to assess neurological function, particularly in the context of central nervous system disorders. It is not related to hypocalcemia, which is the likely cause of the tingling sensation in this scenario.

Choice B reason: Chvostek’s sign

Chvostek’s sign is a clinical indicator of hypocalcemia. It is elicited by tapping the facial nerve at the angle of the jaw, which causes twitching of the facial muscles. Hypocalcemia is a common complication following thyroidectomy due to potential damage or removal of the parathyroid glands, which regulate calcium levels. The tingling sensation reported by the client is a classic symptom of hypocalcemia, making Chvostek’s sign the most relevant assessment.

Choice C reason: Brudzinski’s sign

Brudzinski’s sign is used to assess for meningitis. It involves flexing the client’s neck and observing for involuntary flexion of the hips and knees. This sign is not related to hypocalcemia or the symptoms described by the client following thyroidectomy.

Choice D reason: Kernig’s sign

Kernig’s sign is another test for meningitis. It involves flexing the client’s hip and knee, then straightening the knee. Pain and resistance to straightening the knee indicate a positive Kernig’s sign. This sign is not relevant to the assessment of hypocalcemia or the symptoms described by the client.

Choice A reason: There are no current occurrences of smallpox. Smallpox was declared eradicated in 1980 by the World Health Organization (WHO) after a successful global vaccination campaign. Therefore, the statement that there are rare, occasional occurrences of smallpox is incorrect.

Choice B reason: Smallpox lesions do not appear in various stages of healing at the same time. Unlike chickenpox, where lesions can be in different stages of healing simultaneously, smallpox lesions typically develop and progress through stages uniformly. This means that all lesions are generally at the same stage of development at any given time.

Choice C reason: The vesicles of smallpox are indeed more abundant on the face and extremities compared to the trunk. This distribution pattern is a distinguishing feature of smallpox, as opposed to chickenpox, which tends to have a more central distribution with more lesions on the trunk.

Choice D reason: Vaccination against smallpox provides lifelong immunity. The smallpox vaccine, which uses a live virus related to smallpox called vaccinia, has been shown to provide long-lasting immunity. Studies have indicated that immunity can last for decades, and even those vaccinated many years ago retain some level of protection.