A patient has difficulty in smelling. The nurse assesses for which cranial nerve?

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

The first cranial nerve, CN I, is the olfactory nerve.
Its sole function is to transmit sensory information related to the sense of smell (olfaction) from the nasal cavity to the brain.
A deficit in the ability to smell, known as anosmia or hyposmia, points directly to a potential issue with the olfactory nerve.
Assessment involves testing the patient's ability to identify familiar scents with each nostril.

Option B: CN II is the Optic nerve. Its function is related to vision, not the sense of smell.
Option C: CN III is the Oculomotor nerve. It is a motor nerve that controls most eye movements, pupil constriction, and the position of the upper eyelid.
Option D: CN IV is the Trochlear nerve. It is a motor nerve that controls the superior oblique muscle, which is responsible for moving the eye downward and inward.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Cranial Nerve I (Olfactory) Function in acute care settings.
Assessing the sense of smell is a crucial part of a neurological exam, as anosmia (loss of smell) can be an early sign of neurodegenerative diseases like Parkinson's or Alzheimer's disease, or indicate head trauma affecting the cribriform plate.
Patient safety is a key concern for individuals with a compromised sense of smell, as they may be unable to detect dangers like gas leaks, smoke from a fire, or spoiled food.
What if the patient also reported double vision? The nurse would then need to expand the assessment to include cranial nerves III (Oculomotor), IV (Trochlear), and VI (Abducens), which control eye movements.

How to Approach the Question

First, identify the key symptom presented in the question: 'difficulty in smelling'.
Next, recall the 12 cranial nerves and their primary functions. This is a foundational knowledge recall question.
Match the symptom (smell) to the corresponding cranial nerve. The sense of smell is uniquely associated with the Olfactory nerve.
Select the option that correctly identifies the Olfactory nerve, which is CN I.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 125-127

E6 Medicine Macleod Clinical Examination 15e p. 148-150

Practise the full AIIMS Rishikesh & Jodhpur NO - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.