Difficulty: Medium
Average Score: 78%
Simulated
A nurse is assessing a client's cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III?
Correct answer
B
Rationale
To assess cranial nerve III (oculomotor nerve), the nurse should check the pupillary response to light. This is because cranial nerve III controls the constriction of the pupil in response to light. By shining a light into the client's eyes, the nurse can observe the pupillary response, looking for equal and brisk constriction. This assessment helps to determine the integrity of cranial nerve III function. Observing for facial symmetry (choice A) is related to cranial nerve VII (facial nerve). Testing visual acuity (choice C) is related to cranial nerves II (optic nerve) and V (trigeminal nerve). Eliciting the gag reflex (choice D) is related to cranial nerves IX (glossopharyngeal nerve) and X (vagus nerve).