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What is the most effective method to assess cranial nerve I during a neurologic examination?

  1. Cover one nostril and identify scents

  2. Examine the turbinates with a speculum

  3. Apply pressure to the nasal tip

  4. Check airflow in both nostrils

The correct answer is: Cover one nostril and identify scents

The most effective method to assess cranial nerve I, which is the olfactory nerve, is to cover one nostril and identify scents. This approach directly evaluates the function of the olfactory nerve by presenting a specific smell to one side of the nasal cavity at a time. By occluding one nostril, you isolate the sense of smell on that side, allowing for a focused assessment. The patient can then be prompted to identify a familiar scent, which tests the sensory function of cranial nerve I. Additionally, this method is straightforward and ensures that external factors, such as airflow or the involvement of other nasal structures, do not interfere with the ability to perceive and identify scents. Assessing the ability to recognize odors can provide valuable information about the integrity of the olfactory system. Other methods, such as examining the turbinates with a speculum or checking airflow in both nostrils, do not specifically evaluate the sensory function of cranial nerve I. While nasal structure examination and airflow checks may be relevant in a comprehensive nasal assessment, they do not specifically test the olfactory capabilities. Similarly, applying pressure to the nasal tip does not pertain to the assessment of olfactory function and may not provide useful information regarding cranial nerve I.