A nurse is teaching a newly licensed nurse about the peripheral nervous system. Which of the following statements should the nurse make?

A. Ask the client to read a Snellen chart. Cranial nerve II (optic nerve) is responsible for vision, including visual acuity, peripheral vision, and light perception. A Snellen chart is used to assess distance vision by having the client read letters at a standardized distance. Additional tests for cranial nerve II include the confrontation test for peripheral vision and ophthalmoscopic examination to assess the optic disc and retina.
B. Ask the client to identify scented aromas. This test evaluates cranial nerve I (olfactory nerve), which controls the sense of smell. The nurse would test this nerve by having the client close one nostril at a time and identify familiar scents, such as coffee or vanilla. Impairment in olfactory function can be caused by sinus infections, head trauma, neurodegenerative diseases (e.g., Parkinson’s or Alzheimer’s), or aging, but it is not related to cranial nerve II.
C. Ask the client to clench his teeth. This assessment evaluates cranial nerve V (trigeminal nerve), which controls facial sensation and the muscles of mastication (chewing). The nurse would assess motor function by asking the client to clench their teeth while palpating the masseter and temporalis muscles for strength. Sensory function is assessed by light touch or sharp/dull discrimination on the face. This nerve does not play a role in vision or visual acuity.
D. Listen to the client's speech. Speech evaluation involves cranial nerves IX (glossopharyngeal), X (vagus), and XII (hypoglossal), which coordinate swallowing, phonation (voice production), and tongue movement. Impairment of these nerves can result in dysphonia (hoarse voice), dysarthria (slurred speech), or difficulty swallowing. While speech issues may sometimes indicate neurological deficits, they do not assess the function of cranial nerve II, which is solely responsible for vision.

A: "Provide a non-skid mat to alleviate plate movement." Using a non-skid mat can help prevent the plate from moving, but it does not address the specific issue of homonymous hemianopsia, which affects the client's visual field and ability to see food on one side.
B: "Remind the client to look for food on the left side of the tray." This strategy directly addresses the challenge posed by homonymous hemianopsia, which results in the loss of vision in half of the visual field. Reminding the client to scan the left side of the tray helps ensure that they can locate and eat their food more effectively.
C: "Encourage the use of the wide grip utensils." While using wide grip utensils may assist with grip and dexterity, it does not specifically address the visual field deficit caused by homonymous hemianopsia. This option does not improve the client’s ability to see the food they need to eat.
D: "Encourage the client to use his right hand when feeding himself." Using the right hand may not be beneficial for the client. If the client has right-sided stroke effects, using the right hand could be difficult due to weakness or hemiparesis. Promoting the use of the unaffected side is usually more effective in fostering independence in eating.