A nurse is assessing a school-age child's cranial nerve function.
Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?

Show their teeth while smiling.

Follow a light in the six cardinal positions.

Shrug their shoulders against mild pressure.

Move their tongue in all directions.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Showing teeth while smiling assesses the facial nerve (cranial nerve VII), not the accessory nerve (cranial nerve XI) The facial nerve controls facial expressions, including smiling.

Choice B rationale:

Following a light in the six cardinal positions assesses extraocular eye movements, which are controlled by the oculomotor nerve (cranial nerve III), trochlear nerve (cranial nerve IV), and abducens nerve (cranial nerve VI) This action does not assess the accessory nerve.

Choice C rationale:

Shrugging the shoulders against mild pressure assesses the function of the accessory nerve (cranial nerve XI) The accessory nerve controls the sternocleidomastoid and trapezius muscles, which are responsible for head rotation and shoulder shrugging. Assessing the strength of these muscles helps evaluate the integrity of the accessory nerve.

Choice D rationale:

Moving the tongue in all directions assesses the hypoglossal nerve (cranial nerve XII), which controls tongue movements. This action does not assess the accessory nerve.

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Correct Answer is D

Explanation

Choice Arationale:

A temperature of 37.2°C (99°F) is slightly elevated but not a contraindication for the MMR vaccine. Low-grade fever is a common side effect of vaccines and is not a reason to withhold vaccination. The nurse should advise the parents to consult with the healthcare provider if the child has a moderate to high fever.

Choice Brationale:

Family history of seizures is not a contraindication for the MMR vaccine. The MMR vaccine is safe for individuals with a family history of seizures. However, if the child has a personal history of seizures, especially related to fever (febrile seizures), the healthcare provider should be consulted before vaccination.

Choice C rationale:

An upper respiratory infection 2 days ago is not a contraindication for the MMR vaccine. Minor illnesses without fever or systemic symptoms are not reasons to postpone routine vaccinations. The child should receive the vaccine as scheduled.

Choice D rationale:

Allergy to neomycin is the correct choice. Neomycin is an antibiotic that is sometimes present in vaccines, including the MMR vaccine. Individuals with a known allergy to neomycin should not receive vaccines containing this substance due to the risk of an allergic reaction. It is essential to screen for allergies to vaccine components to ensure the child's safety during vaccination.

A. "Avoid vigorous activity, such as bathing, immediately after feeding.” B. "Hold the infant in an upright position for 30 minutes after feeding.” C. "Enlarge the bottle's nipple opening when using thickened feedings.” D. "Prop the bottle during feedings.” E. "Feed the infant in a side-lying position.”

Correct Answer is B

Explanation

Choice A rationale:

Avoiding vigorous activity immediately after feeding is not directly related to managing gastroesophageal reflux. The rationale behind this is that keeping the infant upright after feeding helps prevent stomach contents from flowing back into the esophagus. Gravity can help reduce reflux symptoms. Vigorous activities do not impact reflux directly.

Choice B rationale:

Holding the infant in an upright position for 30 minutes after feeding is the correct choice. This position utilizes gravity to keep stomach contents down and prevents reflux. It allows time for the food to move from the stomach to the small intestine, reducing the likelihood of reflux. This intervention is widely recommended for infants with gastroesophageal reflux.

Choice C rationale:

Enlarging the bottle's nipple opening when using thickened feedings is not a recommended practice. Thickened feedings can help reduce reflux, but changing the nipple opening size is not necessary for managing reflux symptoms. The thickness of the feeding itself can help prevent regurgitation.

Choice D rationale:

Propping the bottle during feedings is not recommended. It can lead to aspiration, where the milk can enter the infant's airways, causing respiratory issues. It's essential for the infant to be held in an upright position during feedings to prevent reflux symptoms effectively.

Choice E rationale:

Feeding the infant in a side-lying position is not recommended for infants with gastroesophageal reflux. This position can increase the risk of regurgitation and aspiration. Keeping the infant upright, as mentioned in choice B, is the preferred position to minimize reflux symptoms.

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A nurse is assessing a school-age child's cranial nerve function.Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?

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A nurse is assessing a school-age child's cranial nerve function.
Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?