Which cellular adaptation would occur in a client who has enlargement of the cells in the heart due to heart failure?

Choice A reason: Warm skin indicates adequate blood flow and perfusion, often seen in normal or hyperemic states. Poor perfusion, due to reduced blood flow, typically causes cool skin as less warm blood reaches tissues, making this choice incorrect for poor perfusion.

Choice B reason: Pink nailbeds reflect good oxygenation and perfusion, as hemoglobin carries oxygen effectively to capillaries. Poor perfusion leads to pale or cyanotic nailbeds due to reduced blood flow or oxygen delivery, making this choice incorrect for indicating poor perfusion.

Choice C reason: Strong pulses indicate robust blood flow and adequate perfusion, as the heart pumps blood effectively to peripheral tissues. Poor perfusion is associated with weak or thready pulses due to low cardiac output, making this choice incorrect.

Choice D reason: Pale lips indicate poor perfusion, as reduced blood flow to peripheral tissues results in less hemoglobin delivering oxygen, causing pallor. This is a classic sign of hypoperfusion, often seen in shock or circulatory compromise, making this the correct choice.

Choice A reason: Autosomal dominant disorders affect both genders equally, as they are not sex-linked. Heterozygous individuals express the disorder, not just males, due to the dominant allele on an autosome. The idea of females being carriers only applies to X-linked recessive disorders, making this choice scientifically inaccurate.

Choice B reason: Autosomal dominant disorders are caused by mutations on autosomes, not the Y chromosome, which is sex-linked and primarily affects males. These disorders do not typically skip generations, as the dominant allele is expressed in every affected individual, making this choice incorrect.

Choice C reason: In autosomal dominant disorders, a single mutated allele is sufficient for expression. An affected parent (heterozygous) has one normal and one mutated allele, leading to a 50% chance of passing the mutated allele to each child, causing the disorder. This genetic inheritance pattern makes this the correct choice.

Choice D reason: In autosomal dominant disorders, there is no "carrier" state as in recessive disorders, because heterozygous individuals express the disorder. The 50% probability applies to inheriting the disorder itself, not a carrier genotype, which is a concept relevant to autosomal recessive disorders, making this choice incorrect.