The nurse is performing a cranial nerve assessment and asks the patient to follow a moving target with their eyes. Which cranial nerve is being tested?

Correct Answer: B

Rationale: The correct answer is B: Cranial nerve III (oculomotor nerve). This nerve controls most eye movements, including tracking a moving target. Cranial nerve II (optic nerve) is responsible for vision, not eye movements. Cranial nerve IV (trochlear nerve) controls downward and inward eye movements, not tracking. Cranial nerve VI (abducens nerve) controls lateral eye movements, not tracking. Therefore, the oculomotor nerve is specifically being tested in this scenario.

Correct Answer: C

Rationale: Blue is for oral and red is for rectal, is correct based on common conventions in medical settings. Electronic thermometers often use color-coded probes to prevent cross-contamination: blue for oral use and red for rectal, reflecting their distinct anatomical applications. Blue and red are both for oral, ignores site-specific hygiene needs. Blue is for rectal and red is for oral, reverses the typical standard. Blue and red are both for rectal, disregards oral measurement needs. This color system aids quick identification, ensuring the oral probe isnt used rectally (risking infection) and vice versa. While manufacturer variations exist, C aligns with widespread nursing practice for clarity and safety, making it the correct answer.

Correct Answer: A

Rationale: A pulse deficit is the difference between the apical (heart) and radial (peripheral) pulse rates, indicating not all heartbeats reach the periphery, often due to weak contractions or arrhythmias. Here, an 8 beats/min difference fits this definition. Pulse amplitude describes the strength or volume of the pulse, not a rate difference. Ventricular rhythm refers to the hearts rhythm pattern, not a deficit. Heart arrhythmia is a broad term for irregular rhythms but doesnt specifically denote the apical-radial gap. Choice A is correct as it precisely describes the phenomenon observed, reflecting nursing terminology for documenting discrepancies in pulse assessment. This finding may prompt further cardiac evaluation, highlighting the importance of accurate documentation in patient care.

Correct Answer: A

Rationale: In emergencies, rapid pulse detection is critical. Carotid is easily accessible, strong, and reliable even in low perfusion, making it standard (e.g., CPR). Apical requires a stethoscope, slowing assessment. Radial may be weak in shock. Temporal is less prominent. Choice A is correct, aligning with emergency protocols (e.g., AHA) for quick, effective pulse checks in urgent scenarios.

Correct Answer: B

Rationale: Chronic lung disease (e.g., COPD) with smoking risks CO2 retention; cautious oxygen use prevents suppressing hypoxic drive while addressing shortness of breath. Paper bag is for hyperventilation. High oxygen risks respiratory depression. CO2 worsens hypoxia. Choice B is correct, per respiratory nursing guidelines.