The nurse is assessing a patient's cranial nerve function and asks the patient to stick out their tongue. Which cranial nerve is being tested?

Correct Answer: D

Rationale: The correct answer is D: Cranial nerve XII (hypoglossal nerve). When the nurse asks the patient to stick out their tongue, they are testing the function of the hypoglossal nerve, which innervates the muscles responsible for tongue movement. Cranial nerve X (vagus nerve) is responsible for various functions such as swallowing and speech. Cranial nerve VII (facial nerve) controls facial expressions. Cranial nerve IX (glossopharyngeal nerve) is involved in taste sensation and swallowing. Therefore, the hypoglossal nerve is specifically responsible for tongue movement, making it the correct answer in this context.

Correct Answer: A

Rationale: The correct answer is A: Gastrointestinal obstruction. A distended abdomen with tympany on percussion is indicative of trapped air in the intestines, commonly seen in gastrointestinal obstruction. This occurs when there is a blockage in the intestines, causing gas to accumulate and result in the distension. Ascites (B) is the accumulation of fluid in the abdominal cavity, which would present with dullness on percussion, not tympany. Pancreatitis (C) and Hepatomegaly (D) typically do not present with tympany on percussion and are not likely to cause a distended abdomen with this specific finding.

Correct Answer: B

Rationale: 37 degrees Celsius (oral), is correct as it equals 98.6°F, the standard adult oral temperature. Axillary ( 37°C) is higher than typical (~36.6°C). 36°C oral, is too low (96.8°F). 37.7°C oral (99.9°F), suggests fever. Oral readings, taken sublingually, are 0.5°C below rectal (37.5°C-38.1°C) and 0.5°C above axillary (36.5°C-37°C), balancing accuracy and convenience. This norm, established by Wunderlich in the 19th century, remains a clinical benchmark, varying slightly by time of day or individual. Nursing relies on 37°C oral for baseline health, making B the accurate choice per physiological standards.

Correct Answer: C

Rationale: Mercury thermometers pose risks due to toxicity if broken, making patient education vital. Encouraging alternative devices like digital thermometers is a proactive, safe recommendation, reducing exposure risk while maintaining functionality. Teaching safety about breakage is useful but incomplete without promoting alternatives. Telling patients to discard mercury thermometers in the trash is unsafe, as mercury requires special disposal, not regular waste. Restricting use to hospitals is impractical and ignores home needs. Choice C is correct because it aligns with public health guidelines (e.g., CDC) to phase out mercury thermometers, offering a practical, safe solution for home use, enhancing family safety and modernizing care practices.

Correct Answer: B

Rationale: Pyrexia (fever) requires temperature monitoring, making a thermometer essential. A stethoscope assesses heart/lung sounds, not temperature. A blood pressure cuff or sphygmomanometer measures pressure, not fever. Choice B is correct as thermometers directly track temperature changes, a fundamental tool in nursing to manage and document febrile states accurately.