NR 509 EXAM SCRIPT FINAL 2026 QUESTIONS
WITH FULL SOLUTIONS
◉ CN II (Optic) Answer: Vision; Visual field defects, blurred vision,
or blindness
◉ CN III (Oculomotor) Answer: Eye movement, pupil constriction,
eyelid elevation; Ptosis, anisocoria, diplopia, dilated pupil, and
inability to move the eye in certain directions
◉ CN IV (Trochlear) Answer: Eye movement (superior oblique);
Vertical diplopia, difficulty looking down and inward, leading to
double vision
◉ CN V (Trigeminal) Answer: Facial sensation, chewing; Loss of
sensation in the face, difficulty chewing, or facial pain (trigeminal
neuralgia)
◉ CN VI (Abducens) Answer: Lateral eye movement; Inability to
abduct the eye laterally, leading to double vision
◉ CN VII (Facial) Answer: Facial expression, anterior 2/3 taste;
Facial droop, inability to close the eye, loss of taste, and decreased
salivation
,◉ CN VIII (Vestibulocochlear) Answer: Hearing and balance;
Hearing loss, tinnitus (ringing in the ears), and balance issues
◉ CN IX (Glossopharyngeal) Answer: Posterior 1/3 taste, gag reflex;
Difficulty swallowing, loss of taste, and decreased gag reflex
◉ CN X (Vagus) Answer: Voice, swallowing, parasympathetics;
Hoarseness, dysphagia
◉ CN XI (Spinal Accessory) Answer: Shoulder shrug, head turn;
Weak trapezius/sternocleidomastoid, leading to weak shoulder
elevation and head turning
◉ CN XII (Hypoglossal) Answer: Tongue movement; Difficulty
speaking (dysarthria), tongue atrophy, or deviation of the tongue to
one side
◉ Normal CN assessment Answer: All functions above are intact,
symmetrical, and appropriate for age.
◉ Abnormal CN assessment Answer: Any loss, asymmetry, or
dysfunction as described above signals possible nerve damage or
neurological disorder.
, ◉ Moro Reflex Answer: A primitive reflex seen in infants; Normal
finding: When startled, an infant will extend arms and legs, then
quickly bring them back in.
◉ Abnormal Moro Reflex Answer: Persistence of the Moro reflex
beyond infancy, or absence in a newborn, may indicate neurological
problems.
◉ Babinski Sign Answer: A test of the plantar reflex, often used to
assess upper motor neuron function; Normal finding: In adults and
older children, stroking the sole of the foot causes toes to curl
downward (plantar flexion).
◉ Abnormal Babinski Sign Answer: If the big toe extends upward
and the other toes fan out (positive Babinski sign), this is normal in
infants up to about 2 years old, but abnormal in older children and
adults, suggesting a possible central nervous system disorder.
◉ Normal Pregnancy Changes Answer: Melasma, nasal congestion,
gingival enlargement, symmetric thyroid enlargement, upward and
leftward shift of the apical impulse, marked venous pattern on
breasts, darkened nipples/areolae, colostrum in late pregnancy,
purplish striae and linea nigra on the abdomen, gravid uterus with
increasing fundal height, relaxation/enlargement of vaginal and
vulvar structures.
WITH FULL SOLUTIONS
◉ CN II (Optic) Answer: Vision; Visual field defects, blurred vision,
or blindness
◉ CN III (Oculomotor) Answer: Eye movement, pupil constriction,
eyelid elevation; Ptosis, anisocoria, diplopia, dilated pupil, and
inability to move the eye in certain directions
◉ CN IV (Trochlear) Answer: Eye movement (superior oblique);
Vertical diplopia, difficulty looking down and inward, leading to
double vision
◉ CN V (Trigeminal) Answer: Facial sensation, chewing; Loss of
sensation in the face, difficulty chewing, or facial pain (trigeminal
neuralgia)
◉ CN VI (Abducens) Answer: Lateral eye movement; Inability to
abduct the eye laterally, leading to double vision
◉ CN VII (Facial) Answer: Facial expression, anterior 2/3 taste;
Facial droop, inability to close the eye, loss of taste, and decreased
salivation
,◉ CN VIII (Vestibulocochlear) Answer: Hearing and balance;
Hearing loss, tinnitus (ringing in the ears), and balance issues
◉ CN IX (Glossopharyngeal) Answer: Posterior 1/3 taste, gag reflex;
Difficulty swallowing, loss of taste, and decreased gag reflex
◉ CN X (Vagus) Answer: Voice, swallowing, parasympathetics;
Hoarseness, dysphagia
◉ CN XI (Spinal Accessory) Answer: Shoulder shrug, head turn;
Weak trapezius/sternocleidomastoid, leading to weak shoulder
elevation and head turning
◉ CN XII (Hypoglossal) Answer: Tongue movement; Difficulty
speaking (dysarthria), tongue atrophy, or deviation of the tongue to
one side
◉ Normal CN assessment Answer: All functions above are intact,
symmetrical, and appropriate for age.
◉ Abnormal CN assessment Answer: Any loss, asymmetry, or
dysfunction as described above signals possible nerve damage or
neurological disorder.
, ◉ Moro Reflex Answer: A primitive reflex seen in infants; Normal
finding: When startled, an infant will extend arms and legs, then
quickly bring them back in.
◉ Abnormal Moro Reflex Answer: Persistence of the Moro reflex
beyond infancy, or absence in a newborn, may indicate neurological
problems.
◉ Babinski Sign Answer: A test of the plantar reflex, often used to
assess upper motor neuron function; Normal finding: In adults and
older children, stroking the sole of the foot causes toes to curl
downward (plantar flexion).
◉ Abnormal Babinski Sign Answer: If the big toe extends upward
and the other toes fan out (positive Babinski sign), this is normal in
infants up to about 2 years old, but abnormal in older children and
adults, suggesting a possible central nervous system disorder.
◉ Normal Pregnancy Changes Answer: Melasma, nasal congestion,
gingival enlargement, symmetric thyroid enlargement, upward and
leftward shift of the apical impulse, marked venous pattern on
breasts, darkened nipples/areolae, colostrum in late pregnancy,
purplish striae and linea nigra on the abdomen, gravid uterus with
increasing fundal height, relaxation/enlargement of vaginal and
vulvar structures.
