A decrease in tongue strength is noted on examination of a client. The nurse interprets this as indicating a problem with which cranial nerve?
VIII
XII
VI
III
The Correct Answer is B
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.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Macular degeneration impairs central vision, not pupil size. Pinpoint pupils and lethargy suggest systemic effects, not retinal aging, making this unrelated to the neurological and ocular findings in this emergency setting entirely and fully here.
Choice B reason: Eye trauma may dilate pupils from injury, not pinpoint them. Lethargy and change per the significant other point to systemic causes, not local trauma, excluding this as the likely explanation for this presentation comprehensively here.
Choice C reason: Bilateral cataracts cloud lenses, not affecting pupil size or alertness. Pinpoint pupils with lethargy suggest a neurological cause, not lens opacity, rendering this irrelevant to the acute change observed in this client fully here.
Choice D reason: Narcotic use, like opioids, causes pinpoint pupils via cranial nerve III stimulation and lethargy from CNS depression. This matches the sudden change and symptoms, making it the most likely interpretation in this emergency case accurately here.
Correct Answer is D
Explanation
Choice A reason: Acute otitis media shows a red, bulging tympanic membrane due to bacterial infection and pus. A pearly gray, shiny appearance contrasts this, indicating no acute inflammation or fluid, ruling out this active middle ear condition entirely.
Choice B reason: Serous otitis media presents with amber fluid behind a retracted or neutral tympanic membrane, not pearly gray and shiny. This suggests no sterile effusion, distinguishing it from the normal, healthy membrane observed in this inspection clearly.
Choice C reason: Scarring from past infections appears as white, opaque patches on the tympanic membrane, not uniform pearly gray shininess. This finding lacks the irregular, thickened look of scar tissue, pointing to an unscathed membrane instead here.
Choice D reason: A pearly gray, shiny tympanic membrane is normal, reflecting light off an intact, healthy eardrum. This lacks signs of infection or fluid, aligning with standard anatomy where the membrane’s cone of light confirms its integrity fully.
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