BTSC 3 August 2025
Fundamental of Nursing
Easy

Which sign is indicative of hypocalcemia when a blood pressure cuff is inflated above systolic pressure?

Appeared in: BTSC 3 August 2025

Explanation

  • Trousseau's sign is a specific indicator of latent tetany, which is caused by hypocalcemia.
  • It is elicited by inducing ischemia in the arm by inflating a blood pressure cuff to a pressure above the patient's systolic blood pressure for 2 to 5 minutes.
  • A positive sign is the development of a carpopedal spasm, characterized by flexion of the wrist and metacarpophalangeal joints, extension of the interphalangeal joints, and adduction of the thumb.
  • This response occurs due to the increased irritability of nerves when serum calcium levels are low.

Why Other Options Were Wrong

  • Option A: This sign is elicited by tapping the facial nerve in front of the ear, not by inflating a blood pressure cuff.
  • Option C: This sign is used to assess for deep vein thrombosis (DVT), not hypocalcemia. It involves checking for calf pain upon dorsiflexion of the foot.
  • Option D: This sign indicates meningeal irritation, a hallmark of meningitis. It involves pain or resistance when extending the knee while the hip is flexed.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: Knowing Clinical assessment for hypocalcemia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
  • Early recognition of hypocalcemia signs like Trousseau's is critical for nurses to prevent life-threatening complications such as seizures, laryngospasm, and cardiac arrhythmias.
  • Nurses should monitor serum calcium levels (normal range: 8.6 to 10.2 mg/dL) and be prepared to administer calcium gluconate as prescribed, especially in at-risk patients like those post-thyroidectomy.
  • What if? If the patient also shows a positive Chvostek's sign (facial twitching), it would further strengthen the suspicion of hypocalcemia, warranting immediate notification of the primary provider and preparation for intervention.
How to Approach the Question
  • First, analyze the question to identify the key clinical scenario: a specific action (inflating a blood pressure cuff above systolic pressure) is used to test for a specific condition (hypocalcemia).
  • The question asks you to name the sign associated with this procedure.
  • Review the four options provided and recall the definition and indication for each clinical sign.
  • Match the procedure described in the question with the correct definition. Trousseau's sign is specifically defined as carpal spasm induced by occluding blood flow with a BP cuff.
  • Eliminate the other options by confirming they are used for different conditions (Homan's for DVT, Kernig's for meningitis) or use a different technique (Chvostek's involves tapping the facial nerve).
Concept Tested & Keywords
  • Concept Tested: Clinical assessment for hypocalcemia
  • Stem keywords: hypocalcemia, blood pressure cuff, systolic pressure
  • Lead-in keywords: indicative
  • Negative lead-in flag: false

Question ID

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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 BTSC 3 August 2025

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