1.
Type in the correct cranial nerve.
Assess vision in each eye with a Snellen chart.
Explanation
Normal FIndings: Based on previous ability to see and use of visual aids, the patient should be able to see with both eyes. Lifespan Considerations: Adults and older adults: Test vision and visual fields; visual acuity should be appropriate for age.
2.
Type in the correct cranial nerve.
Assessment:
Assess the ability to feel light, dull, and sharp sensations on the face.
With the patient’s eyes closed, check whether sensation is the same on both sides of the face. Stroke the cheek with a wisp of cotton for light touch, with a closed safety pin for dull touch, and with a tongue depressor for sharp touch. If the sharp point of a safety pin is used to assess sharp touch, avoid scratching the surface of the skin and discard the pin after use.
Assess the corneal reflex by touching the corneal surface with a wisp of sterile cotton.
The reflex may be absent or decreased in patients who wear contact lenses.
Explanation
Normal findings: The ability to feel light, dull, and sharp sensations should be intact. The patient should blink when the corneal surface is touched. Lifespan Consideration: Be careful not to scratch the patient, especially older adults with frail skin.
3.
Assessment: Assess extraocular movements by asking the patient to follow your finger as you write an H in the air. Assess PERRL (pupils equal, round, and reactive to light) by covering one eye at a time and shining a bright light directly into the uncovered eye using a penlight or the ophthalmoscope. Assess for ptosis (drooping eyelids).
Which cranial nerves are being assessed? (Select all that apply)
Correct Answer(s)
A. CN III
B. CN IV
D. CN VI
Explanation
This assessment tests the III (oculomotor), IV (trochlear), and VI (abducens) nerves. Normal findings include extraocular movements should be present bilaterally, and pupils should be equal, round, and reactive to light. Also, eyelids should NOT droop.
4.
Type in the correct cranial nerve that is being assessed.
Assessment: Assess the ability to taste sweet, sour, and salt on the anterior two thirds of the tongue by asking the patient to stick out the tongue and applying a salty, sweet, or sour substance. Assess the ability to frown, show teeth, blow out cheeks, raise eyebrows, smile, and close eyes tightly.
Correct Answer(s)
CN VII, Cranial nerve VII, nerve VII, VII, 7, seven, facial, facial nerve
Explanation
Normal findings include: The ability to taste sweet, sour, and salt should be intact.The patient should be able to frown, show teeth, blow out cheeks, raise eyebrows, smile, and close eyes tightly. Muscle movement should be equal bilaterally.
Lifespan Considerations: Older adults: Taste diminishes as part of the normal aging process. Ask the patient about dietary habits to ensure nutritional needs are being met.
5.
Type the correct cranial nerve that is being assessed.
Assessment: Assess the ability to hear the ticking of a watch and whispered and spoken words.
Correct Answer(s)
CN VIII, VIII, eight, 8, cranial nerve 8, acoustic
Explanation
Normal findings: The patient should be able to hear with both ears.
6.
Assessment: Observe for a symmetric rise of the soft palate and uvula as the patient says “ah.” Assess the gag reflex by touching the back of patient’s throat with a tongue depressor. If the gag reflex is intact, observe the patient swallowing a small drink of water. Assess the ability to taste salty, sweet, and sour substances on the posterior third of the tongue.
Correct Answer(s)
C. CN IX
D. CN X
Explanation
This assessment tests the IX (glossopharyngeal) and X (vagus) nerves. Normal findings: The patient should be able to swallow without difficulty, have the symmetrical rise of the soft palate, have intact gag reflex, and taste appropriate.
7.
Type in the correct cranial nerve that is being assessed.
Assess the patient’s ability to shrug the shoulders while you exert downward pressure.
Assess the patient’s ability to turn the head to each side against the resistance of your hand.
In both cases, observe for symmetry, strength, and size of muscles.
Correct Answer(s)
CN XI, 11th, 11th cranial nerve, cranial nerve XI, nerve XI, spinal accessory
Explanation
Normal findings: The patient should be able to shrug the shoulders and turn the head against resistance.
8.
Type in the cranial nerve that is being assessed.
Assess the patient’s ability to stick out the tongue and move it from side to side against the resistance of a tongue depressor.
Correct Answer(s)
CN XII, nerve XII, 12, 12th, twelve, cranial nerve 12, cranial nerve XII, hypoglossal
Explanation
Normal findings: The patient should be able to stick out the tongue and move it from side to side against resistance.