During a physical examination, the nurse observes spoon-shaped nails (koilonychia). Which condition should the nurse suspect?
Chronic hypoxia
Iron deficiency anemia
Peripheral edema
Hyperthyroidism
The Correct Answer is B
Rationale:
A. While chronic hypoxia can cause changes in nail appearance, such as clubbing (rounded, bulbous fingertips with nails curving downward), it does not cause spoon-shaped nails. Therefore, chronic hypoxia is incorrect.
B. Spoon-shaped nails, or koilonychia, are a classic sign of iron deficiency anemia. In this condition, the nails become thin, concave, and may have raised ridges, resembling a spoon. This occurs due to impaired hemoglobin production and associated tissue hypoxia, which affects nail formation. Other signs of iron deficiency anemia may include pallor, fatigue, brittle hair, and glossitis (smooth, sore tongue).
C. Edema causes swelling of soft tissues in the extremities, including around the nails, but it does not produce the concave, spoon-shaped appearance characteristic of koilonychia.
D. Hyperthyroidism may cause nail thinning, brittle nails, or onycholysis (separation of the nail from the nail bed), but it does not cause spoon-shaped nails.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.8"]
Explanation
Step 1: Identify desired dose and concentration
Desired dose = 30 mg, Concentration = 40 mg/mL
Step 2: Use the formula
Volume (mL) = Desired dose ÷ Concentration
Step 3: Insert values
= 30 ÷ 40
Step 4: Calculate
= 0.75 mL
Step 5: Round to the nearest tenth
≈ 0.8 mL
Final Answer: 0.8
Correct Answer is D
Explanation
Rationale:
A. The jugular veins should not be visibly distended when the client is sitting upright. Visible jugular vein distention in this position can indicate increased central venous pressure or heart failure, which is an abnormal finding.
B. Tenderness when palpating the thyroid gland is not expected. A healthy thyroid is typically non-tender. Pain or tenderness may indicate inflammation, infection (thyroiditis), or other pathology requiring further evaluation.
C. A visibly enlarged thyroid gland is abnormal. Enlargement (goiter) may indicate thyroid dysfunction, iodine deficiency, or other endocrine disorders, and is not considered an expected finding in a healthy client.
D. Full range of motion of the neck without pain or stiffness is an expected finding. This indicates normal musculoskeletal function of the cervical spine and surrounding structures, which is consistent with a healthy assessment.
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