During an assessment of the cranial nerves (CNS), the nurse finds the following asymmetry when the client smiles or frowns, uneven lifting of the eyebrows, and escape of air when the nurse presses against the right puffed cheek. The nurse recognized that these findings indicate dysfunction of which cranial nerve(s)?

Motor component of CN X and sensory component of CN VII

Motor and sensory component of CN XI

Motor component of CN IV

Motor component of CN VII

Answer and Explanation

The Correct Answer is D

A.   Dysfunction of the motor component of CN X (vagus nerve) and sensory component of CN VII (facial nerve) would present with different symptoms, such as difficulty swallowing and impaired taste sensation, not the observed facial asymmetry and puffing of cheeks.
B.   CN XI (accessory nerve) dysfunction primarily affects the sternocleidomastoid and trapezius muscles and wouldn't cause the observed facial asymmetry.
C.   Dysfunction of CN IV (trochlear nerve) leads to issues with downward and inward eye movement, not the facial asymmetry described.
D.   Dysfunction of the motor component of CN VII (facial nerve) leads to facial asymmetry during expressions and difficulty controlling facial muscles, which matches the observed findings.

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Correct Answer is D

Explanation

A. While prostate cancer risk increases with age, it's not rare for a 60-year-old man to have prostate cancer. This response might provide false reassurance.
B. Chemotherapy is not typically the primary treatment for benign prostatic hypertrophy (BPH) and doesn’t relate to the concerns raised by the client.
C. BPH is a chronic condition characterized by non-cancerous prostate enlargement, not temporary swelling that goes away.
D. BPH is commonly caused by hormonal changes and does not predispose a person to prostate cancer. It's important to differentiate between BPH and prostate cancer.

A. Report the finding, and refer the client to a specialist for further examination. B. Tell the client that a mass was felt, but is nothing to worry about. C. Instruct the client to return for a repeat assessment in 1 month. D. Continue the examination, and document the findings on the chart.

Correct Answer is A

Explanation

A firm, irregularly shaped mass found during a rectal examination could potentially indicate a serious condition such as a tumor or other pathology. It's essential to report such findings and refer the client to a specialist for further evaluation and appropriate diagnosis.
B. It's important not to dismiss or downplay the significance of finding a mass, as it could signify a serious health issue.
C. Waiting a month for reassessment could potentially delay necessary medical intervention if the mass is concerning.
D. While documentation is important, it's crucial to prioritize immediate reporting and referral for further evaluation when such findings are discovered.

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Naxlex Comprehensive Predictor Exams

A 60-year-old man has been told that he has benign prostatic hypertrophy (BPH). He expresses that his friend just died from prostate cancer and that he is concerned about dying from cancer. Which of the following is an appropriate response by the nurse?

Correct Answer is D

Explanation

The nurse is performing a rectal examination on a client and finds a firm, irregularly shaped mass. Which of the following is the next action the nurse should take?

Correct Answer is A

Explanation

An adolescent male is brought to the emergency department with complaints of excruciating pain in his left testicle. Which of the following should be the priority action by the nurse?

A nurse is assessing a client's cranial nerves. Which of the following methods should the nurse use to assess cranial nerve II?

A client drove himself to the urgent care center for, "Legs that look like balloons and difficulty walking." The nurse assesses 4+ edema of both legs based upon which finding?

A nurse is assessing a client's cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III?

The nurse is providing health promotion teaching to a group of clients. The nurse should include in her teaching which of the following populations has a greater risk factor for osteoporosis.

The nurse is performing a scrotal assessment on a male client. Which of the following findings of the scrotum should the nurse recognize as abnormal?

The nurse has completed a peripheral vascular assessment on a client. Which of the following would the nurse document as expected findings?