Advanced Health Assessment Practice Exam

The findings of elevated nail edges and wider, rounder fingertips are indicative of late clubbing, a condition that is often associated with chronic respiratory diseases and other systemic issues. In late clubbing, the distal phalanges of the fingers or toes become enlarged, leading to the characteristic bulbous appearance. This occurs due to increased vascularity and changes in the underlying connective tissue, which can result from a variety of conditions, including lung disease, heart disease, or certain cancers.

Understanding the pathophysiology of clubbing helps to explain why this physical manifestation occurs. For instance, in chronic hypoxia or certain malignancies, the body may adapt by altering blood flow and tissue growth in extremities, leading to the observed finger changes.

The other conditions listed, such as psoriasis, acute respiratory distress, and chronic fatigue syndrome, do not typically present with the specific findings of elevated nail edges and bulbous fingertips. Psoriasis is more associated with nail pitting and discoloration rather than clubbing. Acute respiratory distress may lead to cyanosis or signs of respiratory distress but wouldn’t typically cause clubbing without a chronic underlying issue. Chronic fatigue syndrome presents with systemic fatigue and does not exhibit the radial nail changes seen in clubbing.