CRANIAL NERVES NP ASSESSMENT EXAM/CRANIAL
NERVES NP ASSESSMENT ACTUAL EXAM 2026
COMPLETE EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS MOST RECENT EXAM A NEW
UPDATED VERSION LATEST 2026-2027 (100%
CORRECT VERIFIED ANSWERS) FULLY REVISED
EXAM ALREADY GRADED A+
A 68-year-old male with hypertension and diabetes presents for a routine
exam. During assessment of cranial nerve III, you note that his right pupil is
dilated and unreactive to light, with the eye deviated downward and outward.
What is the most likely diagnosis?
A) Horner's syndrome
B) Right abducens nerve palsy
C) Right oculomotor nerve palsy
D) Right trochlear nerve palsy
Answer: C
The pupil-involving oculomotor nerve palsy presents with a dilated, unreactive
pupil and the eye in a "down and out" position due to the unopposed actions of
the lateral rectus (CN VI) and superior oblique (CN IV). This is a
neurosurgical emergency until an aneurysm is ruled out.
,A patient complains of double vision when looking to the left. On
examination, the left eye does not abduct past the midline. Which cranial
nerve is most likely affected?
A) Left oculomotor nerve
B) Left trochlear nerve
C) Left abducens nerve
D) Left optic nerve
Answer: C
The abducens nerve innervates the lateral rectus muscle, which is responsible
for abduction of the eye. Failure of abduction on the left indicates a left CN VI
palsy, which is the most common isolated ocular nerve palsy in adults.
During a funduscopic exam, you note that the patient's optic disc is pale and
sharply demarcated. The patient reports gradual loss of peripheral vision.
Which cranial nerve is involved?
A) Optic nerve
B) Oculomotor nerve
C) Trigeminal nerve
D) Facial nerve
Answer: A
Optic atrophy is characterized by a pale, white optic disc with sharp margins.
It results from damage to the optic nerve (CN II) and leads to visual field
defects, often beginning with peripheral vision loss.
A 45-year-old female presents with acute vertigo, nausea, and horizontal
nystagmus that changes direction with gaze. Which type of lesion does this
suggest?
,A) Peripheral vestibular lesion
B) Central brainstem lesion
C) Middle ear pathology
D) Cerebellopontine angle tumor
Answer: B
Central vestibular lesions (e.g., brainstem stroke) produce nystagmus that
changes direction with gaze and is not suppressed by visual fixation. Peripheral
lesions typically cause horizontal or rotatory nystagmus that does not change
direction and is suppressed by fixation.
You test the corneal reflex. Touching the right cornea elicits no blink in either
eye, but touching the left cornea elicits a bilateral blink. Where is the lesion?
A) Right facial nerve
B) Left facial nerve
C) Right trigeminal nerve
D) Left trigeminal nerve
Answer: C
The corneal reflex afferent limb is the trigeminal nerve (CN V1). If touching
the right cornea fails to elicit a blink, the right trigeminal nerve is lesioned. The
efferent facial nerves are intact because touching the left cornea produces a
bilateral blink.
A patient presents with a "mask-like" facies, inability to wrinkle the right
forehead, and right eye lagophthalmos. What is the most likely diagnosis?
A) Right central facial nerve palsy
B) Right peripheral facial nerve palsy
C) Left central facial nerve palsy
, D) Myasthenia gravis
Answer: B
Peripheral facial nerve palsy (CN VII) involves both the upper and lower face,
causing inability to raise the eyebrow, close the eye, and flatten the nasolabial
fold. Central lesions spare the forehead due to bilateral cortical innervation.
During gag reflex assessment, touching the right posterior pharynx yields no
response, and the uvula deviates to the left. Which cranial nerve is affected?
A) Right glossopharyngeal nerve
B) Left glossopharyngeal nerve
C) Right vagus nerve
D) Left vagus nerve
Answer: C
The gag reflex afferent is CN IX (glossopharyngeal) and efferent is CN X
(vagus). Absent gag on the right indicates a right CN IX or CN X lesion. Uvula
deviation to the left indicates the right vagus nerve is affected, as the uvula
deviates away from the side of the lesion.
A patient has difficulty swallowing and reports nasal regurgitation. The soft
palate does not elevate on the left, and the uvula deviates to the right. Which
nerve is damaged?
A) Left glossopharyngeal nerve
B) Right glossopharyngeal nerve
C) Left vagus nerve
D) Right vagus nerve
Answer: C
NERVES NP ASSESSMENT ACTUAL EXAM 2026
COMPLETE EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS MOST RECENT EXAM A NEW
UPDATED VERSION LATEST 2026-2027 (100%
CORRECT VERIFIED ANSWERS) FULLY REVISED
EXAM ALREADY GRADED A+
A 68-year-old male with hypertension and diabetes presents for a routine
exam. During assessment of cranial nerve III, you note that his right pupil is
dilated and unreactive to light, with the eye deviated downward and outward.
What is the most likely diagnosis?
A) Horner's syndrome
B) Right abducens nerve palsy
C) Right oculomotor nerve palsy
D) Right trochlear nerve palsy
Answer: C
The pupil-involving oculomotor nerve palsy presents with a dilated, unreactive
pupil and the eye in a "down and out" position due to the unopposed actions of
the lateral rectus (CN VI) and superior oblique (CN IV). This is a
neurosurgical emergency until an aneurysm is ruled out.
,A patient complains of double vision when looking to the left. On
examination, the left eye does not abduct past the midline. Which cranial
nerve is most likely affected?
A) Left oculomotor nerve
B) Left trochlear nerve
C) Left abducens nerve
D) Left optic nerve
Answer: C
The abducens nerve innervates the lateral rectus muscle, which is responsible
for abduction of the eye. Failure of abduction on the left indicates a left CN VI
palsy, which is the most common isolated ocular nerve palsy in adults.
During a funduscopic exam, you note that the patient's optic disc is pale and
sharply demarcated. The patient reports gradual loss of peripheral vision.
Which cranial nerve is involved?
A) Optic nerve
B) Oculomotor nerve
C) Trigeminal nerve
D) Facial nerve
Answer: A
Optic atrophy is characterized by a pale, white optic disc with sharp margins.
It results from damage to the optic nerve (CN II) and leads to visual field
defects, often beginning with peripheral vision loss.
A 45-year-old female presents with acute vertigo, nausea, and horizontal
nystagmus that changes direction with gaze. Which type of lesion does this
suggest?
,A) Peripheral vestibular lesion
B) Central brainstem lesion
C) Middle ear pathology
D) Cerebellopontine angle tumor
Answer: B
Central vestibular lesions (e.g., brainstem stroke) produce nystagmus that
changes direction with gaze and is not suppressed by visual fixation. Peripheral
lesions typically cause horizontal or rotatory nystagmus that does not change
direction and is suppressed by fixation.
You test the corneal reflex. Touching the right cornea elicits no blink in either
eye, but touching the left cornea elicits a bilateral blink. Where is the lesion?
A) Right facial nerve
B) Left facial nerve
C) Right trigeminal nerve
D) Left trigeminal nerve
Answer: C
The corneal reflex afferent limb is the trigeminal nerve (CN V1). If touching
the right cornea fails to elicit a blink, the right trigeminal nerve is lesioned. The
efferent facial nerves are intact because touching the left cornea produces a
bilateral blink.
A patient presents with a "mask-like" facies, inability to wrinkle the right
forehead, and right eye lagophthalmos. What is the most likely diagnosis?
A) Right central facial nerve palsy
B) Right peripheral facial nerve palsy
C) Left central facial nerve palsy
, D) Myasthenia gravis
Answer: B
Peripheral facial nerve palsy (CN VII) involves both the upper and lower face,
causing inability to raise the eyebrow, close the eye, and flatten the nasolabial
fold. Central lesions spare the forehead due to bilateral cortical innervation.
During gag reflex assessment, touching the right posterior pharynx yields no
response, and the uvula deviates to the left. Which cranial nerve is affected?
A) Right glossopharyngeal nerve
B) Left glossopharyngeal nerve
C) Right vagus nerve
D) Left vagus nerve
Answer: C
The gag reflex afferent is CN IX (glossopharyngeal) and efferent is CN X
(vagus). Absent gag on the right indicates a right CN IX or CN X lesion. Uvula
deviation to the left indicates the right vagus nerve is affected, as the uvula
deviates away from the side of the lesion.
A patient has difficulty swallowing and reports nasal regurgitation. The soft
palate does not elevate on the left, and the uvula deviates to the right. Which
nerve is damaged?
A) Left glossopharyngeal nerve
B) Right glossopharyngeal nerve
C) Left vagus nerve
D) Right vagus nerve
Answer: C
