The nurse is assessing extraocular eye movements (EOM). Which action describes the correct assessment technique?

A. Ask the patient to clench their jaws: Clenching the jaw primarily assesses cranial nerve V (trigeminal nerve), which controls the muscles of mastication. It does not test the function of cranial nerve XI.

B. Ask the patient to raise eyebrows and smile: Raising the eyebrows and smiling evaluates cranial nerve VII (facial nerve), which controls facial expressions. This does not assess the accessory nerve responsible for shoulder and neck movement.

C. Ask the patient to swallow: Swallowing tests cranial nerves IX (glossopharyngeal) and X (vagus), which are involved in pharyngeal and laryngeal function. These actions are unrelated to cranial nerve XI function.

D. Ask the patient to shrug shoulders against resistance: Cranial nerve XI (accessory nerve) innervates the trapezius and sternocleidomastoid muscles, controlling shoulder elevation and head rotation. Asking the patient to shrug their shoulders against resistance is the correct method to assess strength and integrity of this nerve.

A. Increases cellular metabolism to enhance healing process: Applying ice actually slows cellular metabolism in the affected area, which helps reduce tissue damage and inflammation immediately after injury. Increased metabolism is not the goal of cold therapy in acute musculoskeletal injuries.

B. Increases perfusion to promote the delivery of essential nutrients: Cold application causes vasoconstriction, which decreases blood flow to the area temporarily, reducing edema and inflammation. It does not increase perfusion; in fact, increased perfusion occurs with heat therapy, not ice.

C. Increases vasoconstriction to decrease pain at the site of injury: Cold therapy induces vasoconstriction, which limits local blood flow and reduces swelling. It also slows nerve conduction, which decreases pain perception. This is the primary mechanism for using an ice pack immediately after an acute injury such as a sprain or contusion.

D. Increases muscle tension to decrease use of the extremity: Ice can cause temporary muscle stiffness, but the purpose is not to increase muscle tension to restrict movement. The main goal is to reduce inflammation and pain, which may incidentally limit movement but not through increased muscle tension.