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A nurse is collecting data about cranial nerve function from an adult client. Which of the following images depicts the method the nurse should use to check the function of the hypoglossal cranial nerve (XII)?

Image A

B.

C.

Image B

Image C

Image D

Image A

Image B

Image C

Image D

Answer and Explanation

The Correct Answer is A

A. The hypoglossal nerve is tested by checking for tongue deviation.

B. This action tests the facial nerve

C. This action tests the trigeminal nerve

D. This action tests the spinal accessory nerve

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Correct Answer is A, B, C, D, E

Explanation

To set up a sterile field for changing a dressing on an abdominal wound, the nurse should perform the following steps in sequence: First, prepare a dry work surface above waist level to ensure that the sterile field is maintained at a height that minimizes the risk of contamination. Next, open the outside cover of the sterile kit and carefully remove the dust cover, which protects the inner contents from contamination. Then, grasp the outermost flap of the sterile kit and open it away from the body, avoiding any abrupt movements that could compromise sterility. After that, open each side flap of the sterile kit individually, pulling them to the side and making sure not to reach over the sterile field. Finally, open the innermost lower flap of the sterile kit while standing away from the sterile field to prevent contamination from the nurse's clothing or body. These steps help maintain the sterility of the dressing and the instruments, which is crucial for preventing infection at the wound site.

A. Notify the provider of the client's refusal. B. Document the refusal in the client's medical record. C. Inform the client of the potential consequences of their refusal. D. Return the medication to the medication cabinet.

Correct Answer is C

Explanation

A. While eventually informing the provider may be necessary, it's important for the nurse to first address the client's concerns directly.
B. Documenting the refusal is important but should occur after addressing the client's concerns.
C. This action allows the nurse to educate the client about the potential risks of not taking the medication, facilitating informed decision-making.
D. Returning the medication is premature until the client's concerns have been addressed and a decision has been made regarding the medication.

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A nurse is collecting data about cranial nerve function from an adult client. Which of the following images depicts the method the nurse should use to check the function of the hypoglossal cranial nerve (XII)? Image A B. C. Image B Image C Image D

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to set up a sterile field to change a sterile dressing on a client's abdominal wound. Identify the sequence of steps the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Correct Answer is A, B, C, D, E

Explanation

A nurse is caring for a client who refuses their morning dose of antihypertensive medication. The client tells the nurse, "I'm not going to take this medication because it makes me sick and dizzy." Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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A nurse is reinforcing teaching with a client who has an ostomy. Which of the following statements by the client indicates an understanding of the teaching?

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A nurse is caring for a client who is confused and has a prescription for wrist restraints. Which of the following actions should the nurse take?

A nurse is collecting data about cranial nerve function from an adult client. Which of the following images depicts the method the nurse should use to check the function of the hypoglossal cranial nerve (XII)?

Image A

B.

C.

Image B

Image C

Image D