The nurse is performing a neurologic assessment on a client diagnosed with a stroke and cannot elicit a gag reflex. This deficit is related to which of the following cranial nerves?
Trigeminal nerve.
Facial nerve.
Glossopharyngeal nerve.
Vagus nerve.
Correct Answer : C,D
Choice A rationale
The trigeminal nerve is responsible for facial sensation and motor functions like chewing, not related to gag reflex impairment.
Choice B rationale
The facial nerve controls facial expressions, taste sensations, and other functions but does not influence the gag reflex.
Choice C rationale
The glossopharyngeal nerve (cranial nerve IX) plays a crucial role in the gag reflex as it innervates part of the pharynx and is responsible for sensory functions in the throat.
Choice D rationale
The vagus nerve (cranial nerve X) also contributes to the gag reflex, providing motor innervation to the pharyngeal muscles and aiding in swallowing and speech functions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Intravenous phenobarbital can be used to treat status epilepticus, but it is not the first-line drug due to its slower onset of action compared to benzodiazepines. Rapid intervention is critical in status epilepticus, and phenobarbital is generally reserved for refractory cases.
Choice B rationale
Oral phenytoin is used for long-term control of seizures but is not effective for immediate cessation of status epilepticus. It takes longer to reach therapeutic levels and is not suitable for acute management.
Choice C rationale
Intravenous diazepam is a benzodiazepine with a rapid onset of action, making it effective in stopping seizures immediately. It enhances GABA activity, which has an inhibitory effect on neuronal firing, providing quick control of status epilepticus. This rapid effect is crucial for minimizing neuronal damage and other complications.
Choice D rationale
Oral lorazepam is effective for long-term management of seizures but is not appropriate for immediate treatment of status epilepticus. The oral route delays absorption and onset of action, making it unsuitable for acute seizure control. .
Correct Answer is D
Explanation
Choice A rationale
Stupor refers to a state of near-unconsciousness or insensibility, where the patient can be briefly aroused by vigorous or repeated stimuli.
Choice B rationale
Somnolence refers to a state of strong desire for sleep or sleeping for unusually long periods (drowsiness), but it is not as severe as stupor or coma.
Choice C rationale
Normal consciousness means the patient is awake, alert, and responsive to their environment with no neurological deficits.
Choice D rationale
A score of 6 on the Glasgow Coma Scale indicates deep coma, where the patient has minimal to no response to stimuli, indicating severe brain injury.
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