MSN Exam for Bell’s Palsy

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1) Oral steroids may help reduce the symptoms of a Bell’s Palsy.

  1. True
  2. False

2) A male client with Bell’s palsy asks the nurse what has caused this problem. The nurse’s response is based on an understanding that the cause is:

  1. Unknown, but possibly includes ischemia, viral infection, or an autoimmune problem
  2. Unknown, but possibly includes long-term tissue malnutrition and cellular hypoxia
  3. Primary genetic in origin, triggered by exposure to meningitis
  4. Primarily genetic in origin, triggered by exposure to neurotoxins

3) Bell’s palsy is a form of facial paralysis caused by a dysfunction of the 8th cranial nerve.

  1. True
  2. False

4) Failure of the eye to close properly can occur, which may result in damage to the cornea.

  1. True
  2. False

5) When the nurse performs a neurologic assessment on Anne Jones, her pupils are dilated and don’t respond to light.

  1. glaucoma
  2. damage to the third cranial nerve
  3. damage to the lumbar spine
  4. Bell’s palsy

6) The nurse is aware that Bell’s palsy affects which cranial nerve?

  1. 2nd CN (Optic)
  2. 3rd CN (Occulomotor)
  3. 4th CN (Trochlear)
  4. 7th CN (Facial)

7) Which of the following diseases has not been directly linked with Bell’s palsy?

  1. AIDS
  2. Diabetes
  3. Lyme disease
  4. Alzheimer’s disease

8) Bell’s palsy can be associated with arm and leg weakness and difficulty finding the right words.

  1. True
  2. False

9) The nurse has given the male client with Bell’s palsy instructions on preserving muscle tone in the face and preventing denervation. The nurse determines that the client needs additional information if the client states that he or she will:

  1. Exposure to cold and drafts
  2. Massage the face with a gentle upward motion
  3. Perform facial exercises
  4. Wrinkle the forehead, blow out the cheeks, and whistle

10) Bell’s palsy is a disorder of which cranial nerve?

  1. Facial (VII)
  2. Trigeminal (V)
  3. Vestibulocochlear (VIII)
  4. Vagus (X)
Answers and Rationales
  1. A. True . Oral steroids can improve outcome but need to be given early after the onset of symptoms.
  2. A. Unknown, but possibly includes ischemia, viral infection, or an autoimmune problem . Bell’s palsy is a one-sided facial paralysis from compression of the facial nerve. The exact cause is unknown, but may include vascular ischemia, infection, exposure to viruses such as herpes zoster or herpes simplex, autoimmune disease, or a combination of these factors.
  3. B. False. Bell’s palsy results from a dysfunction of the 7th or facial cranial nerve.
  4. A. True . To try and avoid corneal damage the lid can be taped shut at night and eye drops used to lubricate the eye.
  5. B. damage to the third cranial nerve . The third cranial nerve (oculomotor) is responsible for pupil constriction. When there is damage to the nerve, the pupils remain dilated and don’t respond to light. Glaucoma, lumbar spine injury, and Bell’s palsy won’t affect pupil constriction.
  6. D. 7th CN (Facial) . Bells’ palsy is the paralysis of the motor component of the 7th caranial nerve, resulting in facial sag, inability to close the eyelid or the mouth, drooling, flat nasolabial fold and loss of taste on the affected side of the face.
  7. D. Alzheimer’s disease
  8. B. False . These signs indicate a stroke and if present the patient needs urgent medical attention.
  9. A. Exposure to cold and drafts . Prevention of muscle atrophy with Bell’s palsy is accomplished with facial massage, facial exercises, and electrical stimulation of the nerves. Exposure to cold or drafts is avoided. Local application of heat to the face may improve blood flow and provide comfort.
  10. A. Facial (VII) . Bell’s palsy is characterized by facial dysfunction, weakness, and paralysis. Trigeminal neuralgia is a disorder of the trigeminal nerve and causes facial pain.Meniere’s syndrome is a disorder of the vestibulocochlear nerve. Guillain-Barre syndrome is a disorder of the vagus nerve.