Assessment (2026)
William Paterson University (WPU) – Practice
Examination
Questions 1–200
SECTION 1: Neurological Assessment & Cranial
Nerves (Questions 1–60)
1. A 30-year-old female reports feeling very
unsteady and having difficulty maintaining her
balance. What area of the brain would the nurse
practitioner be concerned about with these
findings?
A. Thalamus
B. Brainstem
C. Cerebellum
D. Extrapyramidal tract
,Answer: C
Rationale: The cerebellum coordinates balance,
posture, and voluntary movement. Lesions or
dysfunction commonly present with an unsteady
gait, difficulty maintaining balance, and falls, which
are key concerns in a neurological assessment.
2. Which cranial nerve is assessed by asking the
patient to shrug their shoulders against
resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Accessory)
D. CN XII (Hypoglossal)
Answer: C
Rationale: The spinal accessory nerve (CN XI)
innervates the trapezius and sternocleidomastoid
muscles. The shoulder shrug primarily tests the
trapezius muscle, making CN XI the specific nerve
assessed by this maneuver.
, 3. During an assessment of the cranial nerves, the
x x x x x x x
nurse practitioner finds asymmetry when the
x x x x x x
patient frowns or smiles, uneven lifting of the
x x x x x x x x
eyebrows, sagging of the lower eyelid, and escape
x x x x x x x x
of air when pressure is applied to the right puffed
x x x x x x x x x x
cheek. This would indicate dysfunction of which
x x x x x x x
cranial nerve?
x x
A. Motor component of cranial nerve VII (Facial)
x x x x x x
B. Motor component of cranial nerve IV (Trochlear)
x x x x x x
C. Motor and sensory component of cranial nerve XI
x x x x x x x
(Accessory)
x
D. Motor component of cranial nerve X (Vagus) and
x x x x x x x
sensory component of cranial nerve VII
x x x x x x
Answer: A x
Rationale: Cranial nerve VII (Facial) controls muscles of
x x x x x x x
facial expression. Asymmetry with smiling, eyebrow
x x x x x x
raise, and cheek puffing indicates a motor deficit of CN
x x x x x x x x x x
VII, not ocular or spinal accessory nerves.
x x x x x x x