An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?

Hypercalcemia

Hypomagnesemia

Hyponatremia

Hypernatremia

Answer and Explanation

The Correct Answer is C

A. Hypercalcemia: Hypercalcemia may cause confusion but is less likely associated with dehydration.

B. Hypomagnesemia: This can cause neuromuscular symptoms but is less commonly linked to confusion in dehydration.

C. Hyponatremia: Low sodium levels disrupt brain cell function, leading to confusion and neurological symptoms, which are common in dehydrated older adults.

D. Hypernatremia: While dehydration may cause hypernatremia, it is less likely to present with confusion in this context compared to hyponatremia.

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Correct Answer is B

Explanation

A. Cullen's sign: Cullen's sign is a bluish discoloration around the umbilicus, indicating possible internal bleeding or a ruptured ectopic pregnancy. It is unrelated to hypocalcemia.

B. Chvostek's sign: Chvostek's sign is a spasm or twitching of the facial muscles when the facial nerve is tapped, which is a classic sign of hypocalcemia due to low calcium levels affecting neuromuscular function.

C. Brudzinski's sign: Brudzinski's sign involves involuntary flexion of the knees and hips when the neck is flexed, indicative of meningitis. It is unrelated to hypocalcemia.

D. Kernig's sign: Kernig's sign involves resistance to leg extension when the hip is flexed and is indicative of meningitis. It is not associated with hypocalcemia.

A. Tap the face just below and in front of the ear. B. Inflate a blood pressure cuff around the upper arm for 4 minutes. C. Apply pressure over the ulnar and radial arteries. D. Forcefully dorsiflex the ankle when the knee is in an extended position.

Correct Answer is A

Explanation

A. Tap the face just below and in front of the ear: This is the correct technique for eliciting Chvostek’s sign, which involves tapping over the facial nerve. A positive sign (twitching of facial muscles) indicates hypocalcemia.

B. Inflate a blood pressure cuff around the upper arm for 4 minutes: This describes Trousseau’s sign, another test for hypocalcemia, where carpopedal spasm occurs due to ischemia.

C. Apply pressure over the ulnar and radial arteries: This describes Allen’s test, used to assess arterial blood flow, not calcium levels.

D. Forcefully dorsiflex the ankle when the knee is in an extended position: This describes Homan’s sign, which is used to assess for deep vein thrombosis (DVT), not hypocalcemia.

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An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has hypocalcemia. For which of the following signs should the nurse monitor?

Correct Answer is B

Explanation

The nurse is using Chvostek sign to assess for hypocalcemia. Which statement correctly describes this test?

Correct Answer is A

Explanation

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