A newborn is holding his head with his chin rotated toward the left and the ear approximating the right shoulder. Which muscle is primarily implicated?

Correct Answer: D

Rationale: The correct answer is D: Right sternocleidomastoid. The sternocleidomastoid muscle is responsible for rotating the head to the opposite side. In this case, with the chin rotated towards the left and ear close to the right shoulder, the right sternocleidomastoid is primarily implicated. The left sternocleidomastoid would cause the opposite head rotation. The cervical paraspinal muscles primarily provide support and stabilization to the spine, not head rotation.

Correct Answer: C

Rationale: The correct answer is C: Long thoracic nerve. Scapula winging is primarily caused by injury to the long thoracic nerve, which innervates the serratus anterior muscle responsible for stabilizing the scapula against the thoracic wall. Damage to this nerve results in dysfunction of the serratus anterior, leading to abnormal scapular movement. The other choices are incorrect because: A: Radial nerve - primarily involved in elbow, wrist, and finger extension, not scapular stabilization. B: Suprascapular nerve - innervates the supraspinatus and infraspinatus muscles, not directly related to scapular winging. D: Axillary nerve - innervates the deltoid and teres minor muscles, not directly involved in scapular stabilization.

Correct Answer: A

Rationale: The correct answer is A: Resistive exercises in that limb. Bony metastases can weaken bones and increase the risk of fractures. Resistive exercises can put excessive stress on the bones, potentially leading to fractures. It is important to focus on gentle, low-impact exercises to maintain mobility without risking further damage. Active range of motion exercises (choice B) can help maintain flexibility without stressing the bones. Bracing (choice C) can provide support and stability. Cold therapy (choice D) can help with pain and inflammation management but does not directly impact bone strength.

Correct Answer: B

Rationale: The correct answer is B: Clustering related cues. This critical thinking skill helps the nurse to see relationships among the data by grouping together related information. By clustering similar cues, the nurse can identify patterns, trends, and connections that may not be immediately obvious when data is scattered. This process aids in drawing meaningful conclusions and making informed decisions. Validation (choice A) involves confirming the accuracy and reliability of the data, not necessarily seeing relationships among them. Identifying gaps in data (choice C) focuses on recognizing missing information rather than analyzing relationships. Distinguishing relevant from irrelevant (choice D) is important in data analysis but does not specifically address the skill of seeing relationships among data.

Correct Answer: B

Rationale: The correct answer is B: Decreased muscle spasm. Ultraviolet radiation does not directly affect muscle spasms. Increased vascularization (A) can occur as a response to UV exposure, cell protein changes (C) can be induced by UV radiation, and UV radiation can have a bactericidal (D) effect by damaging microbial DNA. Therefore, choice B is the correct answer as it does not align with the known effects of UV radiation.