The nurse provides care for a client with chronic obstructive pulmonary disease experiencing hypoxia. Which assessment prompts the nurse to immediately report findings to the health care provider?

Choice A reason: Verbalizing understanding by repeating the technique shows comprehension but does not confirm skill. Insulin administration requires practical ability to ensure accuracy and safety. Demonstration is superior, as verbalization alone may miss errors in technique, per patient education and skill-based learning principles.

Choice B reason: Demonstrating the insulin technique back to the nurse confirms understanding and competency, ensuring safe self-administration at home. This return demonstration validates psychomotor skills, critical for correct dosing and preventing complications like hypoglycemia, aligning with effective teaching outcomes, per nursing education standards.

Choice C reason: Signing a form documents acknowledgment but not understanding or skill. Insulin administration requires observed performance to confirm competence. A signature does not verify the ability to perform the technique, risking errors, per patient education and legal documentation standards.

Choice D reason: Repeating facts shows knowledge but not practical ability to administer insulin. Technique requires psychomotor skills, assessed through demonstration. Knowledge alone may not prevent administration errors, making demonstration essential for discharge readiness, per diabetes education and skill validation protocols.

Choice A reason: Cranial nerve I (olfactory) assesses smell, not facial movements. Smiling or frowning involves facial muscles, unrelated to olfactory function. Testing nerve I involves odor identification, not motor actions, making it irrelevant to this assessment, per cranial nerve examination protocols.

Choice B reason: Cranial nerves II (optic) and III (oculomotor) control vision and eye movement, not facial expressions. Actions like smiling or puffing cheeks involve facial muscles, not pupil response or gaze, which are tested for II and III, per neurological assessment standards.

Choice C reason: Cranial nerve VII (facial) controls facial expressions, including smiling, frowning, wrinkling the forehead, and puffing cheeks. Testing these actions assesses motor function, confirming nerve integrity. This is a key part of neurological exams, detecting deficits like Bell’s palsy, per cranial nerve assessment guidelines.

Choice D reason: Cranial nerve VII (vestibulocochlear VIII (auditory) assesses hearing and balance, not facial movements. Actions like smiling or puffing cheeks are unrelated to auditory or vestibular function, making this nerve irrelevant to the described assessment, per neurological examination protocols.