1.
Sally states she hasn't been eating very well. In your assessment, Sally states that she normally has a healthy appetite. Sally states that she isn't enjoying her favorite foods like she used to. Which nerve could be causing Sally's problem?
Correct Answer
A. I
Explanation
The sense of smell puts the body in the "mood" to eat. If Sally's sense of smell is damaged, she may not feel like eating and it may make her favorite foods not have as much flavor or taste.
2.
Kevin has been brought into the emergency room for a MVA (Motor Vehicle Accident.) Kevin complains that he cannot see very well out of both eyes. His right arm is bleeding and he has a bump on the right side of his head. Which nerve could be damaged?
Correct Answer
B. II
Explanation
Injury to the optic tract on one side results in partial blindness in both eyes.
3.
There was a real story recently about a man who was flying an airplane. While he was in the air, he had a medical "event". The "event" was quick and he did not lose consciousness. However, on his way back to the airport to make a landing, he lost his eyesight. Which nerve could have been damaged in the "event"?
Correct Answer
D. II
Explanation
Cranial nerve II could have been damaged in the "event" that left him blind. Other cranial nerves involved with eye are movement oriented, II has to do with sight.
4.
The nurse finds that Mary has diabetes in her assessment and interview. Mary complains that her head hurts constantly and his left eye hurts a lot. Which nerve would the nurse be concerned with?
Correct Answer
B. III
Explanation
The patient will usually present with sudden onset unilateral ptosis (or rarely, bilateral ptosis if the damage occurs to the third nerve nucleus), which is frequently accompanied by significant eye or head pain. The patient is frequently elderly and often has concurrent diabetes and/or hypertension.
5.
Jake takes medication to control his blood pressure. During his assessment, his pupils dilate and are responsive. However, he cannot look up very well. Jake does complain of eye pain and headache. He states his pain is 5/10. Which nerve may be the problem?
Correct Answer
A. III
Explanation
There will be limitations of elevation, depression, and adduction. There is an under the action of the superior, inferior, and medial recti muscles and inferior oblique muscle, which may be total or partial. The pupil may be dilated and minimally reactive to light (pupillary involvement), totally reactive and normal (pupillary non-involvement), or maybe sluggishly responsive (partial pupillary involvement). The patient will usually present with sudden onset unilateral ptosis (or rarely, bilateral ptosis if the damage occurs to the third nerve nucleus), which is frequently accompanied by significant eye or head pain.
6.
Gladis is 73. Gladis has her chin tucked in and has a hard time reading. She has to raise her books up so she can read. She also complains that she has a hard time reaching for things on the floor or walking downstairs. Which nerve may be the problem?
Correct Answer
C. IV
Explanation
Injury to the trochlear nerve cause weakness of downward eye movement with consequent vertical diplopia (double vision). To compensate for this, patients learn to tilt the head forward (tuck the chin in) in order to bring the fields back together – to fuse the two images into a single visual field. Common activities requiring this type of convergent gaze are reading the newspaper and walking downstairs. Diplopia associated with these activities may be the initial symptom of fourth nerve palsy.
7.
Baby Michael is brought in for an exam. The nurse notices that baby Michael is uncoordinated and having difficulty walking. The nurse would be concerned that a congenital nerve problem may be present. Which nerve would the nurse be concerned about?
Correct Answer
A. IV
Explanation
The most common cause of chronic fourth nerve palsy is a congenital defect, in which the development of the fourth nerve (or its nucleus) is abnormal or incomplete. Congenital defects may be noticed in childhood, but minor defects may not become evident until adult life when compensatory mechanisms begin to fail. Congenital fourth nerve palsies are amenable to surgical treatment.
8.
Lucy is having a hard time chewing her food. She can't get her jaw to completely close to grinding her food. She is concerned because she can't properly chew up her favorite vegetable, broccoli. Which nerve may be the problem?
Correct Answer
A. V
Explanation
The paired temporalis and masseter muscles function in jaw closure, and the medial pterygoid muscle closes the jaw and moves it from side-to-side (grinding motion). The lateral pterygoid muscles (along with some of the upper neck muscles) open the jaw in concert with a downward and opposing inward motion. When one lateral pterygoid is weak, the jaw deviates toward the weak side on opening, with the inward vector of the opposite pterygoid being unopposed.
9.
Nick complains of loud noises. He has been wearing earplugs to get through his day but states that is hard because then he can't hear his co-workers. He works at a construction site and almost had an accident because he didn't hear a co-worker warn him something was falling. Which nerve could be causing Nick's low tolerance for loud noises?
Correct Answer
B. V
Explanation
Trigeminal nerve can affect a muscle that has a damping effect on loud noises by stabilizing the tympanic membrane (tensor tympani).
10.
This is the largest nerve that has both motor and sensory implications:
Correct Answer
B. V
Explanation
The trigeminal nerve is the largest of the cranial nerves. It has both motor and sensory components, the sensory fibers being general somatic afferent and the motor fibers being special visceral efferent.
11.
Lincoln has been to the dentist for 9/10 tooth pain. The dentist states that there is no decay of the tooth and has referred him to a doctor. Upon assessment, Lincoln says the pain only happens when there is something touching his tooth and then has a sharp pain that is unbearable. Which nerve could be causing this pain?
Correct Answer
B. V
Explanation
A condition characterized by sudden attacks of excruciating pain brought on by a mere touch in the area of distribution of one of the divisions of the trig nerve usually CNV2. It mimics a toothache.
12.
Mrs. Bay cannot fixate both eyes on the same object at the same time. This makes it almost impossible to drive or play tennis. Which nerve could be the problem?
Correct Answer
D. VI
Explanation
The abducens nerve controls the lateral rectus muscle, which is responsible for moving the eye outward. Dysfunction in this nerve can lead to difficulties in coordinating eye movements, resulting in the inability to fixate both eyes on the same object.
13.
In an assessment, the nurse notices that the patient must turn their head to fixate on a peripheral object. This could indicate damage to which nerve?
Correct Answer
C. VI
Explanation
Horizontal diplopia (double vision) due to the strabismus. Patients may compensate by turning their head so that the affected eye is focused on an object and then moving the normal eye so as to fixate on the object.
14.
Mr. Hughes has Bell's Palsy. Which nerve is associated with Bell's Palsy?
Correct Answer
B. VII
Explanation
Injury to the facial nerve at the brain stem produces a paralysis of facial muscles known as {bells_palsy} Bell's palsy as well as a loss of taste sensation from the anterior two-thirds of the tongue.
15.
Claire presents with a left drooping eye and left the drooping mouth. Which nerve could be causing this problem?
Correct Answer
A. VII
Explanation
Results from damage to the motor nucleus of CN VII or its axons.
16.
Upon assessment, Rob can use his sense of smell quite well. However, Rob states that he cannot feel or taste with the majority of his tongue and has a hard time speaking. Which nerve could be causing this problem?
Correct Answer
C. VII
Explanation
The facial nerve (VII) controls the muscles of facial expression, including those involved in speech production. If there is a problem with the facial nerve, it can lead to difficulty speaking or articulating words. Additionally, the facial nerve also innervates the anterior two-thirds of the tongue, which is responsible for taste sensation. Therefore, Rob's difficulty in speaking and altered sensation in the majority of his tongue could be indicative of an issue with the facial nerve.
17.
Nancy, when sitting still, has no problems. When she tries to stand up, she loses her balance and complains that the room is "moving." Which nerve could be the problem?
Correct Answer
D. VIII
Explanation
This cranial nerve has a vestibular part, which functions in balance, equilibrium, and orientation in three-dimensional space.
18.
This nerve detects changes in blood pressure and serum concentrations of CO2 and O2.
Correct Answer
D. IX
Explanation
The glossopharyngeal nerve (cranial nerve IX) has sensory fibers that innervate the carotid body and carotid sinus. These structures detect changes in blood pressure (via baroreceptors in the carotid sinus) and changes in the concentrations of oxygen and carbon dioxide (via chemoreceptors in the carotid body).
19.
Damage to this nerve can lead to asphyxiation.
Correct Answer
D. X
Explanation
Paralysis of laryngeal muscles can result in asphyxiation.
20.
Which nerve has the most extensive effect on the body?
Correct Answer
D. X
Explanation
The vagus nerve has the most extensive distribution in the body of all the cranial nerves, innervating structures as diverse as the external surface of the eardrum and internal organs of the abdomen.
21.
Olfactory
Correct Answer
C. I
22.
Trochlear
Correct Answer
B. IV
Explanation
The correct answer is IV because the trochlear nerve, also known as cranial nerve IV, is responsible for the motor control of the superior oblique muscle of the eye. This muscle helps to move the eye downward and outward. The other options (II, III, V) are incorrect as they correspond to different cranial nerves responsible for different functions such as vision, eye movement, and facial sensation.
23.
Trigeminal
Correct Answer
C. V
Explanation
The correct answer is V. Trigeminal refers to the trigeminal nerve, which is the fifth cranial nerve. It is responsible for sensory information from the face, as well as motor control for chewing muscles.
24.
Abductens
Correct Answer
A. VI
Explanation
The given answer "VI" corresponds to the term "Abductens" in the question. It is likely that "Abductens" refers to the sixth cranial nerve, also known as the abducens nerve. This nerve controls the movement of the lateral rectus muscle, which is responsible for outward eye movement. Therefore, the correct answer is VI, as it represents the sixth cranial nerve.
25.
Facial
Correct Answer
D. VII
26.
Acoustic
Correct Answer
A. VIII
Explanation
The given answer "VIII" is the correct answer because "VIII" is the Roman numeral representation for the number 8. The question does not provide any context or additional information, so it can be assumed that the answer is simply asking for the Roman numeral equivalent of the number 8.
27.
Glossopharyngeal
Correct Answer
B. IX
Explanation
The correct answer is IX. The glossopharyngeal nerve is the ninth cranial nerve. It is responsible for providing sensory and motor innervation to the tongue, pharynx, and parotid gland. It also plays a role in taste sensation and the regulation of blood pressure.
28.
Vagus
Correct Answer
D. X
Explanation
The given sequence of Roman numerals represents the numbers 5, 7, 9, and 10. The Roman numeral for 10 is "X", which is the correct answer.