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?

A) Abduct each hip while the client is supine:
While assessing hip abduction can provide information about hip joint mobility, it may not be the most appropriate initial assessment for hip dysfunction. This action primarily evaluates the range of motion but may not specifically target dysfunction in the hip region.

B) Flex the hip and knee while standing:
Flexing the hip and knee while the client is standing can help assess hip function, particularly in weight-bearing positions. This action can reveal limitations in hip mobility and detect dysfunction such as pain or weakness during movement.

C) Observe balance while the client stands:
Observing balance while the client stands is important for assessing overall lower extremity function, including the hips. However, it may not specifically target dysfunction in the hip region and may provide more general information about mobility and stability.

D) Inspect gluteal folds for symmetry:
Inspecting gluteal folds for symmetry can help identify asymmetry or abnormalities in the hip region, but it may not provide direct information about hip dysfunction. This action is more focused on assessing external appearance rather than functional movement or mobility.

Answer: B. Wandering behavior with flat affect.

Rationale:

A. Ambulatory and disoriented to place:
This documentation suggests that the client is physically able to walk but does not adequately capture the behavioral aspect of the observation. While the client may be ambulatory, merely stating disorientation does not convey the lack of engagement or emotional response, which is crucial in understanding the client's mental state and overall condition.

B. Wandering behavior with flat affect:
This option accurately reflects the observed behavior of the client. "Wandering behavior" captures the aimless walking, while "flat affect" describes the lack of emotional expression indicated by the blank stare. This documentation provides a clearer picture of the client's mental status, which is vital for further assessment and intervention.

C. Appears confused and depressed:
While confusion may be a relevant aspect of the client's condition, this statement lacks specificity regarding the observed behaviors. Depression cannot be accurately concluded from the blank expression alone, as it may not reflect sadness or mood but rather a cognitive or perceptual issue. More objective descriptors would enhance the clarity of the documentation.

D. Demonstrates signs of early dementia:
This option makes a definitive statement about the possibility of early dementia without sufficient evidence from the observation. While aimless walking and a blank expression can be associated with cognitive decline, diagnosing dementia requires comprehensive assessment and evaluation beyond a single observation. This phrasing could mislead healthcare providers regarding the client’s condition and may lead to premature conclusions about the client’s cognitive health.