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 B

Explanation

A. A hernia may present as a bulge in the abdomen, but it is not typically pulsating. It is usually a soft, non-pulsatile mass.
B. A pulsating centrally localized abdominal distention is characteristic of an abdominal aneurysm, which occurs when the wall of the aorta weakens and bulges. The pulsation is often palpable and can be dangerous if ruptured.
C. Tympany refers to a sound produced during percussion, which is typically heard over air-filled structures like the stomach, but it doesn’t cause pulsating distention.
D. Appendicitis typically presents with localized pain in the lower right abdomen and is not associated with pulsating abdominal distention.

A. History of a fractured patella. B. Needle aspiration of the synovial space. C. Knee arthroplasty surgery. D. Degenerative disease.

Correct Answer is D

Explanation

A. A history of a fractured patella could potentially cause crepitation if there were long-term damage or improper healing. However, it is more likely that crepitation is related to degenerative changes, such as osteoarthritis.
B. Needle aspiration of the synovial space may have been performed to relieve fluid buildup or inflammation, but it would not directly explain the crepitation in the joint. Crepitation is more commonly seen in conditions that affect cartilage or joint surfaces.
C. Crepitation following knee arthroplasty is possible if there are complications, but it is more likely due to arthritis or degenerative joint disease if the patient has not undergone surgery. Arthroplasty would usually be associated with reduced crepitation.
D. Degenerative diseases, such as osteoarthritis, are the most likely cause of crepitation. As the cartilage wears away, the bone surfaces rub together, causing the characteristic crunching or grating sound when the joint is moved.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When conducting a physical examination, the nurse is assessing a client's abdomen and identifies a centrally localized distention that is pulsating. This finding should direct the nurse to consider which pathology?

Correct Answer is B

Explanation

When assessing a client's range of motion, the nurse notes crepitation with movement of the left knee. Which information in the client's history is most likely related to this finding?

Correct Answer is D

Explanation

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