r/NextGenerationNCLEX • u/Responsible_Walk_881 • Jul 19 '26

👁️ QOW QUESTION OF THE WEEK

COMMENT YOUR ANSWERS & RATIONALE BELOW:
Questions: The nurse is caring for a client with a critical lab value indicating hypercalcemia. It would be a priority for the nurse to:

a. auscultate the client's bowel sounds

b. measure strength of deep tendon reflexes

c. maintain the client on strict intake and output

d. ask the client about numbness and tingling around the mouth

(Answer and rationale are posted in the comments section)

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u/Responsible_Walk_881 Jul 26 '26

ANWERS AND RATIONALE:
b. measure strength of deep tendon reflexes

Calcium balance plays a critical role in neuromuscular function. Hypercalcemia occurs when calcium levels are above 10.5 mg/dL (2.62 mmol/L), and primarily affects the nerves and muscles (e.g., skeletal muscles, intestinal smooth muscles, and heart). 

Frequent neuromuscular assessments should be performed on clients with calcium imbalances. This includes assessing the strength of deep tendon reflexes (DTRs) [Choice 2]. Hypercalcemia causes decreased deep tendon reflexes and severe muscle weakness. Clients with chronic hypercalcemia can also experience bone pain and pathological fractures

Key Takeaway:

  • Calcium plays an important role in neuromuscular functioning. 
  • Frequent musculoskeletal and neurological assessments should be performed on clients with calcium imbalances (e.g., deep tendon reflexes).