HESI (Health and Environmental Sciences Institute) Health Assessment Practice Test

What assessment finding would a nurse expect in a patient diagnosed with emphysema?

1. Anasarca

2. Scleroderma

3. Pedal erythema

4. Clubbing of the nails

The correct answer is: Clubbing of the nails

In patients diagnosed with emphysema, one of the common clinical findings is clubbing of the nails. This occurs due to chronic hypoxia, which is a hallmark of emphysema as the condition impairs lung function and reduces oxygen exchange. As a result, the body reacts by increasing blood flow to the distal parts of the body, including the fingers and toes, which can lead to the characteristic thickening and rounding of the distal phalanges seen in clubbing. Clubbing is generally associated with chronic respiratory and cardiac conditions that cause prolonged oxygen deprivation. In emphysema, the destruction of alveoli leads to decreased surface area for gas exchange, resulting in the patient often experiencing lower oxygen levels over time, which can manifest as clubbing in the nails. Other conditions listed, such as anasarca (generalized swelling), scleroderma (a connective tissue disease), and pedal erythema (redness of the feet), are not specifically linked to emphysema and reflect different pathological processes or other underlying conditions. Thus, clubbing provides a more direct association with the long-term effects of emphysema and its impact on the respiratory system and oxygenation status.