Question

The nurse interprets a positive Homans sign as

• A. . Stroke
• B. . Pulmonary embolism
• C. . Deep venous thrombosis
• D. . Pneumothorax

Hint:

Associate specific clinical signs with the conditions they are meant to detect. Homans sign = DVT (though not definitive). Always be aware of the sensitivity and specificity of clinical tests.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
The question asks for the medical condition indicated by a positive Homans sign.

Step 3: Detailed Explanation:
* Homans Sign: This is a physical examination finding that was historically used to assess for deep venous thrombosis (DVT). It involves forcibly dorsiflexing the foot (pulling the toes upwards towards the shin) while the patient's knee is extended. Pain in the calf or popliteal region (behind the knee) with this maneuver is considered a positive Homans sign.
* DVT: DVT is a condition where a blood clot (thrombus) forms in a deep vein, usually in the leg.
* Clinical Relevance: While the Homans sign is classically associated with DVT, its diagnostic value is limited, and it is not a highly sensitive or specific test. Modern diagnostic approaches for DVT rely more on imaging studies (like ultrasound). However, in a theoretical context, it is associated with DVT.
* Other conditions:
- Stroke: Neurological event, diagnosed with brain imaging.
- Pulmonary embolism: Blood clot in the lungs, often a complication of DVT, but Homans sign directly points to DVT in the leg.
- Pneumothorax: Collapsed lung, diagnosed with chest imaging.
Therefore, a positive Homans sign is interpreted as an indicator of deep venous thrombosis.

Step 4: Final Answer:
A positive Homans sign is interpreted as Deep venous thrombosis.

Answer 2

The Homans sign is checked by pulling the foot upward while the knee is kept straight, and understanding why this particular movement causes pain helps connect it to the right condition.

1. Stroke: This is a brain event affecting movement, speech, or sensation, and is diagnosed through neurological exam and brain imaging, not by stretching the calf muscle.
2. Pulmonary embolism: This happens when a clot travels to the lungs and is suspected from symptoms like sudden breathlessness and chest pain, not from a calf stretching test.
3. Deep venous thrombosis: Pulling the foot upward stretches the calf muscles around the deep veins of the leg. If a clot is sitting in one of these veins, this stretch presses on the clot and the inflamed vein wall, producing pain, which is the classic positive Homans sign.
4. Pneumothorax: This is a collapsed lung, identified by breathing difficulty and confirmed with a chest X-ray, and has no connection to a leg or calf examination.

Since the test's forced dorsiflexion specifically stretches the calf around the deep leg veins, a positive result is linked to a clot sitting in those veins.

Therefore, the correct answer is Deep venous thrombosis.