https://www.stuvia.com/en-us/user/Lectdavian
Shadow Health Neurological Assessment –
Samuel Green Case Study
Original Practice Exam (2026)
Multiple-Choice Questions with Correct Answers & Detailed Rationales
Note: The following questions are original practice questions inspired by common
neurological assessment concepts used in nursing education and virtual simulation.
They are not copied from or intended to reproduce any proprietary Shadow Health
case or assessment.
Question 1
During a neurological assessment, which finding best indicates that the patient's
cranial nerve II (optic nerve) is functioning normally?
A. Symmetrical facial movements
B. Visual acuity of 20/20 with intact visual fields
C. Ability to shrug both shoulders equally
D. Midline tongue protrusion
Correct Answer: B. Visual acuity of 20/20 with intact visual fields
Rationale
Cranial nerve II is responsible for vision. Normal visual acuity and intact peripheral
vision demonstrate proper optic nerve function.
Question 2
When assessing orientation, which question best evaluates a patient's awareness of
time?
A. "Can you tell me your full name?"
B. "Where are you right now?"
https://www.stuvia.com/en-us/user/Lectdavian
,https://www.stuvia.com/en-us/user/Lectdavian
C. "What is today's date?"
D. "Can you squeeze my hands?"
Correct Answer: C. What is today's date?
Rationale
Orientation is commonly assessed by determining whether the patient is oriented to
person, place, time, and situation. Asking today's date evaluates orientation to time.
Question 3
A patient demonstrates 5/5 muscle strength in all extremities. How should the nurse
interpret this finding?
A. Mild muscle weakness
B. Moderate weakness requiring assistance
C. Normal muscle strength
D. Complete paralysis
Correct Answer: C. Normal muscle strength
Rationale
A grade of 5/5 represents full muscle strength against full resistance and is
considered normal.
Question 4
Which assessment finding requires the highest priority follow-up?
A. Equal hand grips bilaterally
B. Pupils equal, round, and reactive to light
C. Sudden unilateral arm weakness with slurred speech
D. Normal gait
Correct Answer: C. Sudden unilateral arm weakness with slurred speech
Rationale
https://www.stuvia.com/en-us/user/Lectdavian
, https://www.stuvia.com/en-us/user/Lectdavian
Sudden unilateral weakness and slurred speech are potential signs of an acute stroke
and require immediate evaluation.
Question 5
Which cranial nerve is primarily responsible for facial muscle movement?
A. Cranial Nerve II
B. Cranial Nerve V
C. Cranial Nerve VII
D. Cranial Nerve XII
Correct Answer: C. Cranial Nerve VII
Rationale
The facial nerve (CN VII) controls facial expressions, eyelid closure, and several other
facial muscle functions.
Question 6
When assessing pupils, the abbreviation PERRLA indicates:
A. Pupils Equal, Round, Reactive to Light and Accommodation
B. Pupils Even, Reactive, Responsive, Light Adapted
C. Pupils Equal, Responsive, Regular, Light Adjusted
D. Pupils Reactive, Equal, Round, Light Adapted
Correct Answer: A. Pupils Equal, Round, Reactive to Light and Accommodation
Rationale
PERRLA is a standard neurological assessment finding indicating normal pupil size
and response.
https://www.stuvia.com/en-us/user/Lectdavian
Shadow Health Neurological Assessment –
Samuel Green Case Study
Original Practice Exam (2026)
Multiple-Choice Questions with Correct Answers & Detailed Rationales
Note: The following questions are original practice questions inspired by common
neurological assessment concepts used in nursing education and virtual simulation.
They are not copied from or intended to reproduce any proprietary Shadow Health
case or assessment.
Question 1
During a neurological assessment, which finding best indicates that the patient's
cranial nerve II (optic nerve) is functioning normally?
A. Symmetrical facial movements
B. Visual acuity of 20/20 with intact visual fields
C. Ability to shrug both shoulders equally
D. Midline tongue protrusion
Correct Answer: B. Visual acuity of 20/20 with intact visual fields
Rationale
Cranial nerve II is responsible for vision. Normal visual acuity and intact peripheral
vision demonstrate proper optic nerve function.
Question 2
When assessing orientation, which question best evaluates a patient's awareness of
time?
A. "Can you tell me your full name?"
B. "Where are you right now?"
https://www.stuvia.com/en-us/user/Lectdavian
,https://www.stuvia.com/en-us/user/Lectdavian
C. "What is today's date?"
D. "Can you squeeze my hands?"
Correct Answer: C. What is today's date?
Rationale
Orientation is commonly assessed by determining whether the patient is oriented to
person, place, time, and situation. Asking today's date evaluates orientation to time.
Question 3
A patient demonstrates 5/5 muscle strength in all extremities. How should the nurse
interpret this finding?
A. Mild muscle weakness
B. Moderate weakness requiring assistance
C. Normal muscle strength
D. Complete paralysis
Correct Answer: C. Normal muscle strength
Rationale
A grade of 5/5 represents full muscle strength against full resistance and is
considered normal.
Question 4
Which assessment finding requires the highest priority follow-up?
A. Equal hand grips bilaterally
B. Pupils equal, round, and reactive to light
C. Sudden unilateral arm weakness with slurred speech
D. Normal gait
Correct Answer: C. Sudden unilateral arm weakness with slurred speech
Rationale
https://www.stuvia.com/en-us/user/Lectdavian
, https://www.stuvia.com/en-us/user/Lectdavian
Sudden unilateral weakness and slurred speech are potential signs of an acute stroke
and require immediate evaluation.
Question 5
Which cranial nerve is primarily responsible for facial muscle movement?
A. Cranial Nerve II
B. Cranial Nerve V
C. Cranial Nerve VII
D. Cranial Nerve XII
Correct Answer: C. Cranial Nerve VII
Rationale
The facial nerve (CN VII) controls facial expressions, eyelid closure, and several other
facial muscle functions.
Question 6
When assessing pupils, the abbreviation PERRLA indicates:
A. Pupils Equal, Round, Reactive to Light and Accommodation
B. Pupils Even, Reactive, Responsive, Light Adapted
C. Pupils Equal, Responsive, Regular, Light Adjusted
D. Pupils Reactive, Equal, Round, Light Adapted
Correct Answer: A. Pupils Equal, Round, Reactive to Light and Accommodation
Rationale
PERRLA is a standard neurological assessment finding indicating normal pupil size
and response.
https://www.stuvia.com/en-us/user/Lectdavian
