A nurse is performing an assessment on the fingers and toes of a patient.
What finding is consistent with clubbing?

Decreased angle between the cuticles and the nails.

Upward curving of the nails.

Blue nails.

Angle of nails > 160 degrees.

Answer and Explanation

The Correct Answer is D

Choice A rationale

A decreased angle between the cuticles and the nails is not indicative of clubbing. In fact, it is often associated with healthy nails. Clubbing is recognized by changes that increase the angle between the nail bed and the cuticle.

Choice B rationale

An upward curving of the nails, known as koilonychia or spoon nails, is not characteristic of clubbing but is often associated with iron-deficiency anemia. Hence, this answer is incorrect for clubbing.

Choice C rationale

Blue nails indicate cyanosis, which is related to a lack of oxygen in the blood. This is distinct from clubbing, which is more about the shape and angle of the nails rather than their color.

Choice D rationale

Clubbing is recognized by an increase in the angle between the nail bed and the cuticle, often greater than 160 degrees. This is a hallmark feature and the correct indicator of clubbing.

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Correct Answer is C

Explanation

Choice A rationale

The optic nerve (CN II) is responsible for vision, transmitting visual information from the retina to the brain. Dysfunction of the optic nerve would result in visual disturbances, such as loss of vision or changes in visual acuity, rather than difficulty with tongue movement. This nerve does not control motor functions of the tongue.

Choice B rationale

The abducens nerve (CN VI) controls the lateral rectus muscle of the eye, which is responsible for moving the eye outward, away from the nose. Dysfunction of the abducens nerve would result in issues with eye movement, such as double vision or inability to move the eye laterally, not tongue movement. It does not play a role in tongue motor control.

Choice C rationale

The hypoglossal nerve (CN XII) controls the muscles of the tongue, enabling movements necessary for speech, swallowing, and mastication. Dysfunction of this nerve would result in difficulty protruding the tongue and reduced strength during resistance testing. Symptoms can include atrophy of the tongue muscles, fasciculations, and deviation of the tongue to one side when extended.

Choice D rationale

The vestibulocochlear nerve (CN VIII) is responsible for hearing and balance, transmitting sound and equilibrium information from the inner ear to the brain. Dysfunction of the vestibulocochlear nerve would lead to symptoms such as hearing loss, tinnitus, or balance disorders like vertigo. It does not affect the motor control of the tongue.

A. The nurse will understand the unaffected ear will show lateralization to the Weber's test. B. Place the activated tuning fork to the mid skull and ask if the patient can hear it louder in either ear. C. Place the activated tuning fork to the patient's mastoid bone first then place over air. D. Place the activated tuning fork to the client's ear over the mastoid bone then activate it again over the air.

Correct Answer is B

Explanation

Choice A rationale

Lateralization to the unaffected ear in Weber's test actually indicates sensorineural hearing loss in the affected ear. This choice is incorrect as it doesn’t describe the correct procedure for the test.

Choice B rationale

The Weber's test involves placing an activated tuning fork in the midline of the skull and asking the patient if the sound is heard more loudly in either ear. This helps determine if there is lateralization, which is key in diagnosing the type of hearing loss. Thus, this is the correct procedure for the test.

Choice C rationale

Placing the tuning fork on the mastoid bone and then over air is actually part of the Rinne test, not the Weber test. This choice is, therefore, incorrect for the Weber test.

Choice D rationale

Similar to Choice C, this process describes the Rinne test, which compares air conduction and bone conduction of sound. This is not the correct method for performing Weber’s test.

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A nurse is performing an assessment on the fingers and toes of a patient.What finding is consistent with clubbing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

On assessment of the client's tongue, the client is unable to protrude the tongue and has poor strength on testing against resistance.This would indicate dysfunction of which cranial nerve?

Correct Answer is C

Explanation

The nurse plans to assess the client's hearing.What action should the nurse take when performing the Weber's test?

Correct Answer is B

Explanation

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On assessment of the client's tongue, the client is unable to protrude the tongue and has poor strength on testing against resistance.This would indicate dysfunction of which cranial nerve?

A nurse is performing an assessment on the fingers and toes of a patient.
What finding is consistent with clubbing?