A severely injured client has been receiving morphine sulfate IM for pain for several weeks since his automobile accident.
His physician has recently increased the dosage to be administered every 4 hours. You recognize this as an example of:

Choice A rationale

Asking the client to stick out their tongue and move it from side to side, then up and down, directly assesses the function of the hypoglossal nerve (cranial nerve XII). This nerve innervates the intrinsic and extrinsic muscles of the tongue, controlling its movement, which is essential for speech and swallowing, thereby evaluating its motor integrity.

Choice B rationale

Asking the client to stick out their tongue primarily assesses general tongue protrusion, but does not provide as comprehensive an assessment of hypoglossal nerve function as evaluating its full range of motion. Unilateral weakness or deviation, which is indicative of nerve damage, is better observed with side-to-side and up-and-down movements.

Choice C rationale

Asking the client to cover one eye and read a note card assesses visual acuity and the function of the optic nerve (cranial nerve II). This technique evaluates the eye's ability to perceive details and is unrelated to the motor function of the tongue or the hypoglossal nerve.

Choice D rationale

Having the patient smile, frown, and puff their cheeks primarily assesses the facial nerve (cranial nerve VII). This nerve controls the muscles of facial expression, including those involved in smiling, frowning, and puffing out the cheeks, and is distinct from the hypoglossal nerve's role in tongue movement.

Choice A rationale

A stat medication order signifies an immediate and urgent administration of the drug, typically within 30 minutes of the order. This is for critical situations where delay could significantly impact patient outcome, requiring prompt action rather than nurse's judgment for necessity.

Choice B rationale

A PRN (pro re nata) medication order means "as needed.”. This type of order grants the nurse professional discretion to administer the medication based on their assessment of the patient's condition and the specific criteria outlined in the order, such as pain level or fever.

Choice C rationale

A scheduled medication order involves administering the drug at regularly prescribed intervals, such as every 8 hours or once daily. The timing is predetermined, and the nurse's primary role is adherence to the schedule, with less independent judgment regarding administration necessity.

Choice D rationale

A single-dose order is for a medication to be given only once at a specific time. This is often used for preoperative medications or diagnostic procedures. Like scheduled orders, the timing is set, and the nurse's judgment about the necessity of administration is not the primary factor.