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A nurse is assessing a client's cranial nerve VII. Which of the following responses should the nurse expect?

The client's pupils constrict in response to light.

The client's tongue is in a midline position:

The client has a symmetrical smile.

The client turns their head against resistance.

Answer and Explanation

The Correct Answer is C

A. This response is associated with cranial nerve II, the optic nerve.

B. Tongue position is associated with cranial nerve XII, the hypoglossal nerve.

C. A symmetrical smile is indicative of cranial nerve VII, the facial nerve.

D. This action is associated with cranial nerve XI, the accessory nerve.

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Correct Answer is A

Explanation

A. This response is appropriate because it shows empathy, respect, and interest in the client's feelings and thoughts. It also invites the client to explore and clarify their meaning of purpose and how it relates to their retirement.
B. This response is dismissive of the client’s concern.

C. While hobbies can be fulfilling, this response does not address the client's feelings of purposelessness directly.
D. This response minimizes the client's feelings and does not offer constructive solutions to address their concerns.

A. Room number B. Telephone number C. Patient’s name D. Diagnosis

Correct Answer is C

Explanation

A. Using the room number to identify a patient is not reliable since many clients may share it.
B. The telephone number is not typically used for client identification during assessments.
C. The nurse should use the client's name to properly identify the client before performing any assessment or intervention. This is a standard safety measure that helps to prevent errors and ensure quality care.
D. The diagnosis is important for providing appropriate care but is not used for client identification during assessments.

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A nurse is assessing a client's cranial nerve VII. Which of the following responses should the nurse expect?

Nursing Test Bank

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