After performing an assessment of the oculocephalic reflex, the nurse suspects that the patient has an intracranial lesion. Which patient behavior supports the nurse's assessment findings?

Movement of the eye in the sideward direction occurs, with neck extension

When flexing the neck, eye movement is in the upward direction

Movement of the eye is in the opposite direction of the turned head

When extending the neck, eye movement is in the downward direction

Answer and Explanation

The Correct Answer is C

A.   The oculocephalic reflex test should cause the eyes to move in the opposite direction to the head turn, indicating intact brainstem function.
B.   Movement of the eyes in an upward direction upon neck flexion indicates an abnormal response, suggesting a lesion.
C.   A lesion could result in abnormal eye movement, as the eyes should move opposite to head movement.
D.   Eye movement in the downward direction during neck extension is not a normal response and suggests a brainstem issue.

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Correct Answer is C

Explanation

A. Put all used cosmetics in a plastic bag for one week to kill any bacteria before reusing: This is not a recommended intervention. Disinfecting or discarding the cosmetics would be better.
B. Disinfect contact lenses by soaking in a cleaning solution for 48 hrs: Bacterial conjunctivitis requires the patient to discard lenses for proper infection control.
C. Discard all opened or used contact lenses and lens care products: Discarding contaminated lenses and care products prevents reinfection.

D. Disinfect all lens care products with prescribed antibiotic drops for one-week post infection: This is not recommended as a general practice; lenses and solutions should be discarded instead.

A. Beware of changes in ICP related to leaking cerebrospinal fluid (CSF) B. Maintain hyper-oxygenation through use of a ventilator C. Use strict aseptic technique with all procedural dressing changes D. Administer IV mannitol (Osmitrol)

Correct Answer is C

Explanation

A. Monitoring for CSF leakage is crucial to avoid infection and to maintain ICP accuracy.
B. Hyper-oxygenation may be used in certain cases but is not the priority.
C. Aseptic technique for all procedures and dressing changes is critical to prevent infection.
D. Administering IV mannitol can be important, but aseptic technique is the priority to prevent infection.

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After performing an assessment of the oculocephalic reflex, the nurse suspects that the patient has an intracranial lesion. Which patient behavior supports the nurse's assessment findings?

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