A patient who has been in the hospital for 3 months starts to experience white patches on their tongue and roof of their mouth, they also have trouble swallowing, what do they likely have?

Choice A reason: Assessing pupils tests cranial nerves II (optic) and III (oculomotor), evaluating visual acuity and pupillary response, not cranial nerve I (olfactory), which governs smell. Pupil assessment is irrelevant to olfactory function, making this choice incorrect for testing the sense of smell.

Choice B reason: Cranial nerve I, the olfactory nerve, is responsible for the sense of smell. Instructing the client to identify a scent, such as coffee or vanilla, directly tests this nerve’s function. This is a standard neurological assessment method to evaluate olfactory integrity, making it the correct choice.

Choice C reason: Performing facial expressions tests cranial nerve VII (facial), which controls facial muscle movement. This is unrelated to cranial nerve I, which solely mediates olfaction. Facial expression assessment cannot evaluate smell, rendering this choice inappropriate for the specified cranial nerve test.

Choice D reason: Reading the Snellen chart tests cranial nerve II (optic) for visual acuity, not cranial nerve I, which is dedicated to smell perception. Visual testing does not assess olfactory function, making this choice incorrect for evaluating the olfactory nerve’s sensory capabilities.

Choice A reason: Pain level assessment is important but unrelated to orientation, which evaluates mental state via time, place, and person questions. Assuming pain assesses orientation risks missing cognitive deficits, delaying diagnosis of delirium or dementia, critical for tailoring care and interventions in patients with altered mental status.

Choice B reason: Personal hygiene reflects self-care ability, not orientation to time, place, or person, which assesses mental state. Assuming hygiene evaluates orientation misguides assessment, risking oversight of cognitive impairments, essential for diagnosing conditions like Alzheimer’s or acute confusion, requiring targeted interventions in clinical practice.

Choice C reason: Orientation questions assess mental state, evaluating cognitive function through awareness of time, place, and person. This detects impairments in conditions like delirium or dementia, guiding care planning. Accurate assessment ensures timely interventions, critical for managing cognitive decline and supporting patient safety and communication in healthcare settings.

Choice D reason: Family medical history provides genetic context but doesn’t assess orientation, which targets mental state. Assuming history evaluates orientation risks missing cognitive issues, delaying diagnosis of acute or chronic cognitive impairments, critical for implementing cognitive support or pharmacological interventions in patients with suspected mental status changes.