The nurse assesses that a client has nailbed clubbing. Which additional information is consistent with this finding?

Absent deep tendon reflexes.

Capillary refill less than 3 seconds.

3+ peripheral dependent edema.

Oxygen saturation of 85%.

Answer and Explanation

The Correct Answer is D

A.   Absent deep tendon reflexes are not typically associated with nailbed clubbing. While reflexes may be diminished in some conditions, they are not commonly related to the pathophysiology behind clubbing.
B.   A capillary refill time of less than 3 seconds is a normal finding and does not align with clubbing, which often indicates chronic hypoxia or systemic conditions such as heart or lung disease.
C.   Peripheral dependent edema refers to swelling in the lower extremities, which can be associated with circulatory problems, but it is not directly linked to nailbed clubbing. Edema is more common in conditions like heart failure or kidney disease.
D.   A low oxygen saturation of 85% is consistent with conditions that cause chronic hypoxia, such as chronic lung disease or congenital heart disease. Chronic low oxygen levels can lead to nailbed clubbing as a compensatory response to inadequate oxygenation.

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Correct Answer is A

Explanation

A. The bell of the stethoscope is best for detecting low-pitched sounds like murmurs or extra heart sounds.
B. A Doppler ultrasound is not necessary for routine auscultation of heart sounds.
C. Pulse oximetry does not provide relevant information about heart sounds.
D. Auscultating with the diaphragm is better for high-pitched sounds, so the bell is preferred for extra heart sounds.

A. Breathe in and out while all lobes of both lungs are auscultated. B. Whisper "one, two, three" in sequence during auscultation of the thorax. C. Repeat the number "99" during a systematic auscultation of the thorax. D. Repeat vocalizing the letter "E" while the thorax is auscultated.

Correct Answer is D

Explanation

A. This is not specific for egophony. While lung auscultation is part of a thorough assessment, egophony is assessed when the patient vocalizes a specific sound, not just breathing in and out.
B. This is a technique used to assess for whispered pectoriloquy, not egophony. The nurse would be looking for clarity of the whispered words, which is different from assessing for egophony.
C. This test is used to assess for bronchophony, where the nurse listens for clarity or increased volume of spoken words over the lungs. It is not related to egophony, which is a change in the sound when the client says "E."
D. This is the correct method for assessing egophony. In this test, the client is asked to say "E," and the nurse listens for any change in the sound. Normally, the "E" should sound like "E." If it sounds like "A," it indicates egophony, which can suggest a lung consolidation, such as might occur with a lung abscess.

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The nurse assesses that a client has nailbed clubbing. Which additional information is consistent with this finding?

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Naxlex Comprehensive Predictor Exams

The nurse detects a possible extra heart sound while assessing an adult client. To verify this finding, which action should the nurse take?

Correct Answer is A

Explanation

To assess for the presence of egophony, which instruction should the nurse give the client who has a lung abscess?

Correct Answer is D

Explanation

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