A nurse is completing an assessment of a 78-year-old client's face, ears, nose, and mouth. Which of the following is an unexpected finding in an older adult client during a physical assessment?

A. The teeth look a uniformed yellow is an expected finding in older adults. With aging, enamel wears down, exposing the yellowish dentin underneath, and lifelong habits such as coffee, tea, smoking, or certain foods contribute to tooth discoloration. This is a normal age-related change and not indicative of disease. B. Facial skin appears wrinkled is also an expected finding. Aging causes loss of elasticity, thinning of the dermis, decreased collagen, and reduced subcutaneous fat, resulting in wrinkles, sagging skin, and fine lines. Sun exposure and cumulative environmental factors further accentuate these changes. Wrinkling of the skin is typical in a 78-year-old and not concerning on its own. C. The tongue appears smooth is unexpected in a healthy older adult. A smooth tongue, also called atrophic glossitis, can indicate nutritional deficiencies, particularly vitamin B12, folate, or iron deficiency, or may be related to chronic illness, dehydration, or infection. A healthy tongue in older adults may have some slight fissures or papillary atrophy, but a fully smooth surface is abnormal and warrants further evaluation, including nutritional assessment and lab testing. D. The nasal septum appears deviated can be considered a benign, age-related or acquired change. Mild septal deviation is common due to minor trauma earlier in life or gradual structural changes with age. Unless it causes nasal obstruction, frequent nosebleeds, or sinus infections, it is not clinically concerning.