The nurse is speaking to the client and suspects a weakness in eye muscle after observing the eyes cross.
What test should the nurse administer to further assess this problem?

Choice A rationale

Alcohol consumption, obesity, diabetes, stress, and high cholesterol are all significant risk factors for heart disease. However, smoking is not listed in this choice. Smoking is a major risk factor for heart disease as it damages the lining of the arteries, leads to the build-up of fatty deposits (atherosclerosis), and increases the risk of heart attacks and strokes.

Choice B rationale

Smoking, hypertension, obesity, diabetes, and high cholesterol are all major risk factors for heart disease. Smoking contributes to the development of atherosclerosis and increases the risk of heart attacks. Hypertension, or high blood pressure, strains the heart and blood vessels, increasing the risk of heart disease. Obesity is linked to multiple risk factors, including high cholesterol, diabetes, and hypertension. Diabetes can cause damage to blood vessels and increase the risk of cardiovascular complications. High cholesterol contributes to the formation of plaques in the arteries, leading to atherosclerosis.

Choice C rationale

Personality type is not a major risk factor for heart disease. Although certain personality traits, such as Type A behavior (characterized by competitiveness, urgency, and hostility), have been associated with increased stress and a higher risk of cardiovascular events, they are not considered primary risk factors. High cholesterol, diabetes, and smoking are significant risk factors, but this choice does not include hypertension or obesity, which are also crucial risk factors for heart disease.

Choice D rationale

Family history, hypertension, stress, and age are important risk factors for heart disease, but this choice does not include some key factors such as smoking, obesity, or diabetes. Family history of heart disease can indicate a genetic predisposition to cardiovascular conditions. Hypertension and stress contribute to cardiovascular risk, and age is a non-modifiable risk factor as the risk of heart disease increases with age. However, the absence of smoking, obesity, and diabetes makes this choice less comprehensive in assessing heart disease risk factors. .

Choice A rationale

The sides of the mouth being symmetric when the patient smiles indicate intact function of the facial cranial nerve (CN VII). This nerve controls the muscles responsible for facial expressions, including smiling, frowning, and closing the eyes. Symmetry in these actions suggests that the facial nerve is functioning properly and that there is no nerve damage or weakness.

Choice B rationale

The patient's eyes moving to the left, right, up, down, and obliquely during conversation are functions of the oculomotor nerve (CN III), trochlear nerve (CN IV), and abducens nerve (CN VI), not the facial cranial nerve (CN VII). These nerves work together to control the movements of the eye muscles, enabling the eyes to move in different directions and maintain proper alignment.

Choice C rationale

Periodic blinking of the eyelids involves the oculomotor nerve (CN III) and the facial nerve (CN VII). The oculomotor nerve controls the muscles that lift the eyelid, while the facial nerve controls the muscles that close the eyelid. Blinking is a coordinated action involving both nerves, but the observation alone is not sufficient to determine the integrity of CN VII.

Choice D rationale

The patient moistening the lips with the tongue involves the function of the hypoglossal nerve (CN XII), which controls the movements of the tongue. The hypoglossal nerve is responsible for the motor control of most of the tongue muscles, allowing for actions like licking the lips, speaking, and swallowing. It is not related to the facial cranial nerve (CN VII).