Tapping over the facial nerve cause twitching of the facial muscles it is known as?

HPSSC Staff Nurse - 2021

Medical & Surgical Nursing

Easy

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.

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.

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

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