The nurse inspects the client's fingernails. Which differentiating characteristics are observed in this assessment finding?

Longitudinal pigmented bands and red brown linear streaks of recent onset.

Thinned depressed nails with lateral edges tilting up to form a concave profile and proximal subungual fungal infection.

Transverse furrows and nail plate white spots that move forward with nail growth.

A nail base angle greater than 180 degrees and nail plate loosened at the distal-lateral edge, progressing proximally.

Answer and Explanation

The Correct Answer is D

A. Longitudinal pigmented bands and red-brown linear streaks of recent onset. This description is more indicative of longitudinal melanonychia, which presents as pigmented bands along the length of the nail plate. It's not typically associated with finger clubbing.

B. Thinned, depressed nails with lateral edges tilting up to form a concave profile and proximal subungual fungal infection. This description suggests koilonychia, also known as spoon nails, which are characterized by thin, depressed nails with lateral edges tilting up. The mention of a fungal infection points to a different condition. It doesn't align with finger clubbing.

C. Transverse furrows and nail plate white spots that move forward with nail growth. This description corresponds to Beau's lines and leukonychia, which are not associated with finger clubbing. Beau's lines are transverse furrows or depressions in the nail plate, while leukonychia manifests as white spots or lines.

D. A nail base angle greater than 180 degrees and nail plate loosened at the distal-lateral edge, progressing proximally. This description fits the characteristics of finger clubbing, where there's an increased nail base angle (greater than 180 degrees) and the nail plate is loosened at the distal-lateral edge, progressing proximally. This choice aligns with the assessment finding.

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Correct Answer is D

Explanation

A. Needle aspiration of the synovial space: Needle aspiration of the synovial space is a diagnostic procedure used to collect synovial fluid for analysis. It is not directly related to crepitation.

B. Knee arthroplasty surgery: Knee arthroplasty (joint replacement surgery) involves replacing damaged knee joint components with artificial ones. While it can improve joint function, it is not directly related to crepitation.

C. History of a fractured patella: A fractured patella (kneecap) can lead to altered joint mechanics and abnormal wear. This might lead to long-term issues but isn't directly associated with crepitation unless it caused secondary degenerative changes in the knee joint.

D. Degenerative disease: Degenerative joint diseases like osteoarthritis often involve changes in the cartilage, leading to rough surfaces within the joint. When these rough surfaces rub against each other during movement, crepitation can occur.

A. Ask when the adolescent was last seen in the clinic. B. Explain that the information cannot be released without the 18-year-old's permission. C. Tell the mother to have the teenager call the clinic. D. Since the serum samples were drawn last week provide the mother with the findings.

Correct Answer is B

Explanation

A: Ask when the adolescent was last seen in the clinic. This option might help confirm the identity and recent activity of the patient, but it does not address the primary issue of confidentiality and privacy regarding the adolescent's medical information. Simply asking when the adolescent was last seen does not change the legal requirement to obtain consent from the patient who is now an adult.

B: Explain that the information cannot be released without the 18-year-old's permission. This is the most appropriate response. Once an individual turn 18, they are legally an adult and their health information is protected under the Health Insurance Portability and Accountability Act (HIPAA) in the United States, or similar privacy laws in other countries. Without explicit permission from the 18-year-old patient, the nurse cannot legally release medical information to anyone else, including parents.

C: Tell the mother to have the teenager call the clinic. While this response encourages the teenager to take responsibility for their own healthcare, it does not address the immediate concern of the mother inquiring about the results. It shifts the responsibility to the adolescent but doesn't explain why the mother cannot be given the information. It's a partial solution but lacks clarity on the confidentiality issue.

D: Since the serum samples were drawn last week, provide the mother with the findings. This option is inappropriate and violates HIPAA regulations. Regardless of when the serum samples were drawn, the patient is now legally an adult and the information cannot be shared without their explicit consent. Providing the mother with the findings would be a breach of the adolescent's privacy and legal rights.

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The nurse inspects the client's fingernails. Which differentiating characteristics are observed in this assessment finding?

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Naxlex Comprehensive Predictor Exams

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

An adolescent's mother calls the primary healthcare provider's office to Inquire about the results of her daughter's serum test results that were drawn last week. Since it is the teenager's 18th birthday, how should the nurse respond to this mother's inquiry?

Correct Answer is B

Explanation

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