The nurse is preparing to measure the visual acuity of a client. The nurse should recognize that which of the following cranial nerve should be assessed:
VI
V
II
III
The Correct Answer is C
A. VI
Cranial Nerve VI is the Abducent Nerve, which controls the movement of the lateral rectus muscle, allowing the eye to move laterally (abduct). Dysfunction of this nerve can cause difficulty in moving the eye outward.
B. V
Cranial Nerve V is the Trigeminal Nerve. It has both sensory and motor functions. Sensory functions include providing sensation to the face, sinuses, and teeth. Motor functions include controlling the muscles used for chewing (mastication).
C. II
Cranial Nerve II is the Optic Nerve. It is purely a sensory nerve responsible for vision. The optic nerve carries visual information from the retina of the eye to the brain.
D. III
Cranial Nerve III is the Oculomotor Nerve. It is primarily a motor nerve but also has some autonomic functions. It controls most of the eye movements (except lateral movement controlled by VI) and regulates the size of the pupil and the shape of the lens in the eye for focusing.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. When bronchial breath sounds are auscultated in the trachea.
Auscultating bronchial breath sounds in the trachea is a normal finding, as the trachea is close to the upper airway, and this is where bronchial sounds are normally heard. However, if these sounds are heard in the peripheral lung fields, it can indicate an abnormal condition.
B. When the client is experiencing excessive sneezing from a tree pollen allergy.
Excessive sneezing due to allergies would not typically result in increased breath sounds. Allergies may cause nasal congestion, but they don't directly lead to increased breath sounds.
C. When the client is resting in bed and not experiencing respiratory issues.
If a client is at rest and not experiencing any respiratory issues, breath sounds should typically be normal. There would be no reason to expect increased breath sounds in this scenario.
D. When the bronchial tree is obstructed by secretions.
Increased breath sounds, such as wheezing or rhonchi, can be auscultated when there is an obstruction in the bronchial tree due to secretions, narrowing of the airways, or other causes. These sounds are typically abnormal and indicate an issue with air movement through the airways.
Correct Answer is A
Explanation
A. Wheezes:
Wheezes are continuous, high-pitched, whistling lung sounds that are heard especially during expiration and sometimes during inspiration. They are caused by the rapid movement of air through narrowed or constricted airways, which is common in conditions like asthma. Wheezing is a characteristic adventitious sound associated with asthma and other obstructive respiratory disorders.
B. Whispered Pectoriloquy:
Whispered Pectoriloquy is an increased loudness of whispering noted during auscultation with a stethoscope on the lung fields. This phenomenon occurs when sound is transmitted clearly through consolidated or compressed lung tissue, making whispered sounds more distinct. It is a sign of lung consolidation, often seen in conditions like pneumonia.
C. Bronchial Sounds:
Bronchial sounds are harsh, high-pitched sounds heard over the trachea and the large bronchi. These sounds are normally heard during expiration. If they are heard over peripheral lung areas, it can indicate consolidation or compression of lung tissue, possibly due to pneumonia or tumor.
D. Bronchophony:
Bronchophony is a phenomenon in which spoken sounds are heard more clearly and distinctly through the stethoscope on auscultation of the lungs. Normally, sounds are muffled during auscultation. Increased clarity of spoken sounds can indicate lung consolidation, similar to whispered pectoriloquy, and is often associated with conditions like pneumonia.
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