A client is admitted to an acute care facility with a suspected dysfunction of the lower brain stem. The nurse should monitor this client closely for:

Choice A rationale

The spinal accessory nerve (cranial nerve XI) controls the sternocleidomastoid and trapezius muscles, which are responsible for movements of the head and shoulders. Dysfunction in this nerve would not affect the gag reflex.

Choice B rationale

The acoustic nerve (cranial nerve VIII) is responsible for hearing and balance. Dysfunction in this nerve would lead to hearing loss and balance issues, not an absent gag reflex.

Choice C rationale

The facial nerve (cranial nerve VII) controls muscles of facial expression and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue. Dysfunction here results in facial paralysis or weakness but not in the absence of a gag reflex.

Choice D rationale

The vagus nerve (cranial nerve X) innervates muscles of the pharynx and larynx, which are involved in swallowing and the gag reflex. Dysfunction in the vagus nerve would result in an absent gag reflex, which is why the nurse determines this as the issue.

Choice A rationale

Irregular bones have complex shapes that do not fit into the other categories (long, short, or flat bones). They include bones such as the vertebrae and facial bones, which have specialized functions but are not primarily responsible for protecting vital organs.

Choice B rationale

Flat bones, such as the sternum, ribs, and skull bones, are designed to protect vital organs. They provide broad surfaces for muscle attachment and serve as protective barriers for organs like the brain, heart, and lungs.

Choice C rationale

Long bones, such as the femur and humerus, are primarily responsible for supporting the weight of the body and facilitating movement. While they contribute to the overall structure of the body, they are not specifically designed for organ protection.

Choice D rationale

Short bones, such as the carpals and tarsals, provide support and stability with limited movement. They are not primarily involved in the protection of vital organs.