HPSSC Staff Nurse - 2021
Medical & Surgical Nursing
Easy
Tapping over the facial nerve cause twitching of the facial muscles it is known as?
Appeared in: HPSSC Staff Nurse - 2021
Explanation
- The question describes the classic method for eliciting Chvostek's sign.
- Tapping on the facial nerve (Cranial Nerve VII) just anterior to the earlobe causes a brief, involuntary twitch of the nose, lip, or other facial muscles on the same side.
- This response indicates neuromuscular irritability, which is a hallmark of hypocalcemia (low serum calcium levels).
- It can also be present in hypomagnesemia, as magnesium is important for calcium regulation.
Why Other Options Were Wrong
- Option B: Trousseau's sign is also a sign of hypocalcemia, but it is elicited by inflating a blood pressure cuff on the arm, not by tapping the facial nerve.
- Option C: Homan's sign is related to vascular assessment, not electrolyte imbalances. It involves checking for calf pain upon dorsiflexion of the foot.
- Option D: Psoas sign is an indicator of peritoneal irritation, specifically related to the psoas muscle, and is used in the assessment of appendicitis.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of clinical signs related to electrolyte imbalances as background academic context rather than a clinical decision trigger.
- A positive Chvostek's sign is a critical finding that requires prompt nursing action to prevent complications of hypocalcemia, such as laryngospasm or seizures.
- Nurses must monitor serum calcium and magnesium levels, assess the patient's airway, and initiate safety precautions for any patient at risk for or showing signs of hypocalcemia (e.g., post-thyroidectomy or parathyroidectomy patients).
- What if? If a patient has a positive Chvostek's sign and also develops carpal spasm when you take their blood pressure (a positive Trousseau's sign), it indicates a higher degree of neuromuscular irritability and a more severe level of hypocalcemia, increasing the urgency for intervention and notification of the primary provider.
How to Approach the Question
- First, read the question carefully and identify the key actions and findings described: 'tapping over the facial nerve' and 'twitching of the facial muscles'.
- This is a factual recall question that requires knowledge of specific clinical assessment signs.
- Review the definitions of each option.
- Match the description in the stem to the correct definition. Chvostek's sign is the only one that involves tapping the facial nerve to elicit a facial twitch.
- Differentiate it from Trousseau's sign, which also indicates hypocalcemia but is elicited differently (using a BP cuff).
- Rule out Homan's and Psoas signs as they relate to different conditions (DVT and appendicitis, respectively).
Concept Tested & Keywords
- Concept Tested: Identification of clinical signs related to electrolyte imbalances.
- Stem keywords: tapping, facial nerve, twitching, facial muscles
- Lead-in keywords: known as
- Negative lead-in flag: false
Question ID
QZqxgX1-rKTOrlhe4xED3F
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 30-32
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1096-1098
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 154-156
Practise the full HPSSC Staff Nurse - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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