A nurse is integrating health promotion education into the assessment of a client's mouth, nose and throat. What interview question is most likely to identify a risk factor for oral cancer?

Choice A reason: Cranial nerve VIII (vestibulocochlear) governs hearing and balance, not tongue strength. A deficit here causes vertigo or deafness, not motor weakness in the tongue, making it unrelated to the observed decrease in muscle power during examination.
Choice B reason: Cranial nerve XII (hypoglossal) controls tongue movement and strength. Weakness here, as noted, suggests nerve damage, like in stroke or ALS, impairing the tongue’s ability to push against resistance, directly explaining the finding accurately.
Choice C reason: Cranial nerve VI (abducens) moves the eye laterally, not the tongue. A problem here causes diplopia, not tongue weakness, disconnecting it from the motor function loss observed in the client’s oral examination entirely here.
Choice D reason: Cranial nerve III (oculomotor) controls eye movement and pupil response, not tongue strength. Its dysfunction leads to ptosis or eye deviation, irrelevant to the tongue’s motor impairment noted in this neurological assessment fully.

Choice A reason: Chronic rhinitis affects nasal passages, not oral cancer risk, which ties to tobacco, alcohol, or HPV. This question targets sinus issues, missing key carcinogenic exposures or immunosuppression linked to squamous cell carcinoma in the mouth entirely here.

Choice B reason: Immunosuppressive therapy, like post-transplant drugs, raises oral cancer risk by impairing immune surveillance against HPV or malignant cells. This directly identifies a major risk factor, aligning with health promotion goals to detect oral cancer precursors effectively and accurately.

Choice C reason: Dental visit frequency reflects care access, not specific oral cancer risks like smoking. It’s indirect, missing direct links to immunosuppression or carcinogens, making it less effective for pinpointing etiology in a health promotion context fully here.

Choice D reason: Chewing or swallowing difficulty may signal advanced cancer, not risk factors. It’s a symptom, not a preventive focus, unlike immunosuppression, which precedes disease, reducing its utility for early identification in this educational assessment entirely and clearly.