Positive chvostek is a sign of

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-3rd)

Explanation

A positive Chvostek's sign is a key clinical finding for hypocalcemia.
It involves twitching of the facial muscles (perioral levator and zygomaticus muscles) after tapping the facial nerve just anterior to the ear.
This response occurs because low serum calcium levels increase neuromuscular irritability, leading to involuntary muscle spasms (tetany).
Along with Trousseau's sign, it is a classic indicator of latent tetany associated with hypocalcemia.

Option B: Hypercalcemia (high calcium) decreases neuromuscular excitability.
Option C: Hypokalemia (low potassium) primarily causes generalized muscle weakness, fatigue, and cardiac ECG changes (like U waves).
Option D: Hyperkalemia (high potassium) leads to muscle weakness, abdominal cramps, and significant cardiac arrhythmias (like peaked T waves).

Visual 1: Diagram: Illustration demonstrating the correct location to tap the facial nerve to elicit Chvostek's sign.
Visual 2: Diagram: Illustration showing the characteristic carpopedal spasm seen in a positive Trousseau's sign.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of electrolyte imbalances, specifically hypocalcemia as background academic context rather than a clinical decision trigger.
Recognizing Chvostek's and Trousseau's signs is a critical nursing skill for the early detection of hypocalcemia.
Prompt identification allows for timely intervention with calcium supplementation, preventing more severe complications such as laryngeal spasms, seizures, and cardiac arrhythmias.
What if? If a postoperative thyroidectomy patient develops numbness and tingling around the mouth, the nurse should immediately assess for Chvostek's and Trousseau's signs, as inadvertent removal of or damage to the parathyroid glands is a common cause of acute hypocalcemia.

How to Approach the Question

Identify the key term in the question: 'Chvostek's sign'.
Recall the definition and clinical significance of this specific physical assessment finding.
Associate Chvostek's sign with increased neuromuscular excitability.
Connect increased neuromuscular excitability (tetany) with its primary electrolyte cause, which is hypocalcemia.
Evaluate the given options and eliminate those associated with different electrolyte imbalances or opposite effects (e.g., hypercalcemia, which causes decreased excitability).

Concept Tested & Keywords

Concept Tested: Clinical signs of electrolyte imbalances, specifically hypocalcemia.
Stem keywords: Positive chvostek, sign
Lead-in keywords: is a sign of

Qlchfguo-q64JRVLEIQS29

Practise the full RRB Nsg. Superintendent-20 July 2019 (Shift-3rd)

Attempt every question from this paper in a timed mock, then review the full solution for each one.