A client is clenching the jaw closed to avoid taking a prescribed oral medication. The nurse can use this observation to confirm the client is demonstrating motor function of which cranial nerve?

Glossopharyngeal

Trigeminal

Vagus

Facial

Answer and Explanation

The Correct Answer is B

A.   The glossopharyngeal nerve is involved in several functions, including taste sensation on the posterior third of the tongue, salivation, and the sensation of the pharynx. It also plays a role in swallowing and gag reflex. However, it is not responsible for the movement of the jaw or clenching of the jaw.
B.   The trigeminal nerve is responsible for sensation in the face and also controls the muscles of mastication (chewing). It has both sensory and motor functions. The motor branches of the trigeminal nerve, specifically the mandibular division, innervate the muscles that allow for jaw movement, including clenching.
C.   The vagus nerve has a broad range of functions, including regulating heart rate, digestive tract motility, and some aspects of speech and swallowing. It does not control jaw movement or clenching, so it is not relevant to this observation.
D.   The facial nerve controls the muscles of facial expression, including movements like smiling, frowning, and closing the eyes. It is not involved in the motor control of the jaw or clenching actions.

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Correct Answer is D

Explanation

A. Concentration refers to the ability to focus on a specific task or thought for a period of time. While concentration is important for cognitive functioning, it is not the specific skill being assessed when interpreting the meaning of a proverb.
B. Attention is the ability to focus and direct mental resources towards a specific task or stimulus. While attention is necessary for understanding and processing information, the task of interpreting a proverb is more related to higher-level cognitive processes rather than just the ability to maintain focus.
C. Affect refers to the emotional state or mood of a person. It involves how emotions are expressed and experienced. Assessing affect involves observing the client’s emotional responses, not their ability to interpret abstract concepts. Therefore, affect is not the focus of this assessment.
D. Abstract reasoning is the ability to understand and interpret concepts and ideas that are not directly observable or tangible. It involves thinking beyond concrete facts to understand underlying meanings, patterns, and relationships. Interpreting a proverb, which involves understanding a figurative meaning rather than a literal one, is a test of abstract reasoning. The ability to grasp the deeper meaning behind “A penny saved is a penny earned” reflects the client's capacity for abstract reasoning.

A. Stationary soft palate on phonation B. Uvula and soft palate rising bilaterally C. Asymmetrical soft palate D. Deviation of uvula when client says "ah"

Correct Answer is B

Explanation

A. The soft palate should move during phonation. If it remains stationary, it could indicate a problem with cranial nerves IX and X. These nerves control the movement of the soft palate and the muscles involved in phonation.
B. This is the normal finding. During the assessment, when the patient says "ah," the uvula and soft palate should rise symmetrically. This movement indicates that cranial nerves IX and X are functioning properly. If the uvula and soft palate rise bilaterally, it means that both sides of the soft palate are being controlled correctly by these nerves.
C. Asymmetry in the soft palate could indicate dysfunction of cranial nerves IX and X. Normally, the soft palate should rise evenly on both sides when the patient says "ah." An asymmetrical soft palate suggests that one side is not functioning correctly, which may be due to nerve damage or weakness.
D. This is not a normal finding. If the uvula deviates to one side when the patient says "ah," it indicates a problem with the function of the cranial nerves. The deviation is usually towards the side opposite to the weak or affected side. This asymmetry in uvula movement can be due to a weakness or paralysis of the muscles on one side controlled by these nerves.

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A client is clenching the jaw closed to avoid taking a prescribed oral medication. The nurse can use this observation to confirm the client is demonstrating motor function of which cranial nerve?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During an assessment, the nurse asks a client to explain what the following means: "A penny saved is a penny earned." The nurse is assessing which of the following?

Correct Answer is D

Explanation

When assessing cranial nerves IX and X, which of the following would the nurse consider as a normal finding?

Correct Answer is B

Explanation

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