The nurse observes the presence of brittle, concave curves to the nails of a client on assessment. Which information should the nurse obtain from the client that may explain the appearance of the nails?
Coronary heart disease.
Iron deficiency anemia.
Diabetes mellitus.
Recent candida Infection.
The Correct Answer is B
Choice A Reason:
Coronary heart disease is incorrect. Coronary heart disease is primarily associated with cardiovascular symptoms such as chest pain, shortness of breath, and fatigue. While some nail changes may occur in individuals with coronary heart disease due to decreased oxygenation, brittle, concave nails are not a typical manifestation of this condition. Therefore, this option is less likely to explain the appearance of the nails.
Choice B Reason:
Iron deficiency anemia is correct. Iron deficiency anemia is characterized by a lack of iron in the body, leading to decreased production of hemoglobin and red blood cells. One of the classic nail findings associated with iron deficiency anemia is koilonychia, which presents as brittle, concave nails with a spoon-like appearance. This is due to structural changes in the nails caused by the deficiency of iron. Therefore, this option is the most likely explanation for the observed nail changes.
Choice C Reason:
Diabetes mellitus is incorrect. Diabetes mellitus can lead to various dermatologic manifestations, including nail changes such as thickening, discoloration, and slow nail growth. However, brittle, concave nails with a spoon-like appearance are not typically associated with diabetes mellitus. Therefore, while diabetes mellitus may affect the nails, it is less likely to explain the specific appearance observed in this case.
Choice D Reason:
Recent candida infection is incorrect. Candida infections, particularly in the nail folds (paronychia), can lead to changes in the nails such as discoloration, thickening, or separation from the nail bed. However, brittle, concave nails with a spoon-like appearance are not typical findings of candida infections. Therefore, while recent candida infection may affect the nails, it is less likely to explain the specific appearance observed in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Choice A Reason:
Jugular venous distension is correct. Jugular venous distension is a common sign of fluid overload and increased central venous pressure, which occur during exacerbations of heart failure. It indicates impaired cardiac function and elevated systemic venous pressure.
Choice B Reason:
Peripheral edema is correct. Peripheral edema, particularly in the lower extremities, is a classic manifestation of fluid retention and congestion in heart failure exacerbations. It results from increased capillary hydrostatic pressure and impaired fluid reabsorption by the kidneys.
Choice C Reason:
Dyspnea is correct. Dyspnea, or shortness of breath, is a hallmark symptom of heart failure exacerbations. It occurs due to pulmonary congestion resulting from fluid accumulation in the lungs, impairing gas exchange and leading to difficulty breathing.
Choice D Reason:
Intercostal retraction is not typically associated with exacerbations of heart failure. Intercostal retractions indicate increased work of breathing and respiratory distress, which may occur in conditions such as severe respiratory infections or asthma exacerbations, but are not specific to heart failure exacerbations.
Choice E Reason:
Headaches are not typically associated with exacerbations of heart failure. Headaches can have various causes, including tension, migraines, or sinus congestion, but they are not commonly observed as a direct manifestation of heart failure exacerbations.
Correct Answer is ["C","D","F"]
Explanation
Choice A Reason:
Macule is incorrect. A macule is a flat, discolored spot on the skin that is less than 1 centimeter in diameter. It does not contain fluid; instead, it represents a change in the color of the skin, such as a freckle or a flat mole. Macules are not filled with fluid; they are characterized by alterations in skin pigmentation without any elevation or depression.
Choice B Reason:
Papule is incorrect. A papule is a small, raised bump on the skin that is less than 1 centimeter in diameter. Papules do not contain fluid; instead, they result from localized cellular infiltration, inflammation, or proliferation in the skin layers. Examples of papules include acne lesions and insect bites.
Choice C Reason:
Wheal is correct. A wheal is a raised area of skin that is typically reddened and accompanied by itching. It contains fluid and is often associated with allergic reactions, insect bites, or hives.
Choice D Reason:
Vesicle is correct. A vesicle is a small, fluid-filled blister that appears on the skin. It contains clear fluid and can be caused by various factors such as infection, allergic reactions, or friction.
Choice E Reason:
Nodule is incorrect. A nodule is a solid, raised bump on the skin that is larger than 1 centimeter in diameter and extends into deeper layers of the skin. Similar to papules, nodules do not contain fluid; they are composed of tissue, such as fat, fibrous tissue, or tumors. Examples of nodules include lipomas and dermatofibromas.
Choice F Reason:
Pustule is correct. A pustule is a small, pus-filled blister that appears on the skin. It contains purulent fluid (pus) and is often associated with bacterial infections such as acne or folliculitis.
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