A nurse is getting ready to conduct a cranial nerve examination on a patient.
What steps should the nurse take to examine cranial nerve XI (Spinal Accessory)?
Check the patient’s visual acuity using a Snellen chart.
Whisper in one of the patient’s ears while blocking the other.
Observe the patient’s ability to turn their head from side to side.
Ask the patient to identify specific smells.
Ask the patient to identify specific smells.
The Correct Answer is C
Choice A rationale
Checking the patient’s visual acuity using a Snellen chart is used to assess cranial nerve II (Optic), not cranial nerve XI (Spinal Accessory)3.
Choice B rationale
Whispering in one of the patient’s ears while blocking the other is a method used to assess cranial nerve VIII (Vestibulocochlear), not cranial nerve XI4.
Choice C rationale
Observing the patient’s ability to turn their head from side to side is a correct method to assess cranial nerve XI. This nerve innervates the sternocleidomastoid and trapezius muscles, which are responsible for turning the head and shrugging the shoulders respectively.
Choice D rationale
Asking the patient to identify specific smells is used to assess cranial nerve I (Olfactory), not cranial nerve XI3.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale
Repentance is not typically included in the five stages of grief as outlined by psychiatrist Elisabeth Kübler-Ross.
Choice B rationale
Bargaining is one of the five stages of grief. It often involves the individual making deals or promises to a higher power in an attempt to reverse or lessen the loss.
Choice C rationale
Depression is a stage of grief where the individual may experience intense feelings of sadness, hopelessness, and despair.
Choice D rationale
Acceptance is the final stage of grief, where the individual begins to accept the reality of their loss.
Choice E rationale
Anger is a stage of grief where the individual may feel intense anger towards the situation, themselves, or others.
Correct Answer is C
Explanation
Choice A rationale
Reporting the APs to the charge nurse may seem like an appropriate action, but it does not directly address the conflict. It’s important for the nurse to take an active role in conflict resolution, rather than passing the responsibility to someone else.
Choice B rationale
Allowing the APs to resolve their issues might be a good idea in some situations, but it’s not the best choice here. As a nurse, it’s part of your role to ensure that conflicts are resolved in a way that promotes a positive and productive work environment. By simply allowing the APs to resolve their issues, you’re not taking an active role in conflict resolution.
Choice C rationale
Confronting the APs to discuss their argument is the best choice. This action demonstrates conflict resolution because the nurse is taking an active role in addressing the issue. By discussing the argument with the APs, the nurse can help them understand each other’s perspectives and find a solution that works for everyone.
Choice D rationale
Telling the APs they are acting immaturely is not an effective way to resolve conflict. This approach is likely to escalate the conflict rather than resolve it. It’s important to approach conflicts with a goal of understanding and resolution, rather than placing blame or making judgments.
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