Cranial Nerves Lab Evaluation at Cape Fear Community College

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Free Cranial Nerves Lab Evaluation at Cape Fear Community College Questions

1.

Click on one area of the image to show where you would assess the facial nerve. Select the correct location on the face where the nurse would assess CN VII (Facial Nerve).

  • Forehead (raise eyebrows)

  • Cheek (smile or puff cheeks)

  • Jawline (clench teeth)

  • Tongue (stick tongue out)

Explanation

The facial nerve (CN VII) controls facial expressions. To assess it, the nurse asks the patient to smile, puff their cheeks, or show teeth and watches for symmetry. The cheek area is commonly observed because it shows muscle movement controlled by CN VII, helping identify weakness such as Bell's palsy.

2.

Cranial nerve eight (CN VIII), auditory, consists of the following branches: Select all that apply.

  • Cochlear

  • Vestibular

  • Maxillary

  • Ophthalmic

  • Mandibular

Explanation

A. Cochlear The cochlear branch carries auditory (hearing) information from the organ of Corti in the cochlea to the brainstem (cochlear nuclei). Hair cells transduce mechanical sound vibrations into neural impulses that travel via the cochlear nerve, enabling perception of pitch, loudness, and timbre. Damage to this branch commonly presents with sensorineural hearing loss, tinnitus, and difficulty understanding speech—especially in noisy environments. B. Vestibular The vestibular branch conveys balance and spatial orientation signals from the semicircular canals, utricle, and saccule to the vestibular nuclei. It detects angular and linear accelerations of the head, supporting gaze stabilization (via the vestibulo-ocular reflex) and postural control. Lesions produce vertigo, nystagmus, gait instability, and nausea, and are implicated in disorders such as vestibular neuritis and Ménière’s disease.
3.

What function is associated with the oculomotor nerve?

  • Eye movement via the superior oblique

  • Eye movement and pupil constriction

  • Eye movement via the lateral rectus

  • Eyesight

Explanation

B. Eye movement and pupil constriction The oculomotor nerve (Cranial Nerve III) controls most extraocular muscles, allowing the eye to move up, down, and medially. It also innervates the levator palpebrae superioris (eyelid elevation) and the sphincter pupillae muscle, causing pupil constriction. Dysfunction can result in ptosis, lateral deviation of the eye ("down and out"), and a dilated, non-reactive pupil.
4.

Ketamine administration can result in nystagmus. Which of the following cranial nerves is responsible for this phenomena?

  • Oculomotor

  • Cranial nerve 6

  • CN IV

Explanation

B. Cranial nerve 6 Cranial nerve VI (Abducens nerve) innervates the lateral rectus muscle, which abducts the eye. When ketamine is administered, it can affect ocular muscle control and cause nystagmus, including lateral gaze nystagmus. Because CN VI controls side-to-side eye movement, dysfunction or overstimulation of this pathway can contribute to the horizontal nystagmus often seen with ketamine use.
5.

Rapid administration of furosemide can cause damage to which of the following cranial nerves?

  • Trochlear

  • Vestibulocochlear

  • CN 7

Explanation

B. Vestibulocochlear Rapid IV administration of furosemide can be ototoxic, leading to damage of Cranial Nerve VIII (Vestibulocochlear nerve). This nerve controls hearing and balance. Ototoxicity may result in tinnitus, hearing loss, vertigo, and balance disturbances. To prevent this adverse effect, furosemide should be administered slowly and within recommended IV rate limits.
6.

Which cranial nerve is responsible for sight?

  • Trochlear

  • Cranial nerve four

  • CN II

  • Oculomotor nerve

Explanation

C. CN II Cranial Nerve II, the optic nerve, is responsible for transmitting visual information from the retina to the brain. It is the primary nerve involved in sight and visual processing. Damage to this nerve results in vision loss, visual field deficits, or blindness, depending on the location and severity of injury.
7.

Which of the following cranial nerves is responsible for elevating the upper eyelid?

  • CN 3

  • CN 4

  • CN 6

Explanation

A. CN 3 Cranial Nerve III (Oculomotor nerve) innervates the levator palpebrae superioris, the muscle responsible for elevating the upper eyelid. Damage to CN III results in ptosis (drooping eyelid), because the eyelid cannot be lifted properly without oculomotor function.
8.

Which of the following cranial nerves are responsible for swallowing and vocalization?

  • Facial

  • Glossopharyngeal

  • Hypoglossal

  • CN VIII

Explanation

The glossopharyngeal nerve (CN IX) plays a key role in swallowing and vocalization by innervating the pharyngeal muscles and contributing to control of the gag reflex. It coordinates movements needed for swallowing and assists in producing sound through its motor influence on the pharynx. Damage may result in difficulty swallowing (dysphagia), loss of gag reflex, and speech changes.

9.

A middle-aged man expresses to you that he is concerned that he cannot taste anything on the anterior portion of his tongue. What nerve(s) innervate this portion of the tongue?

  • Hypoglossal nerve

  • Trigeminal nerve

  • Glossopharyngeal nerve

  • Facial nerve

Explanation

B. Trigeminal nerve The trigeminal nerve (CN V), specifically the mandibular branch (V3 via the lingual nerve), provides general sensory innervation (touch, pain, temperature) to the anterior two-thirds of the tongue. While it does not carry taste fibers, it is essential for tactile sensation in the front of the tongue. D. Facial nerve The facial nerve (CN VII), via the chorda tympani, provides taste sensation to the anterior two-thirds of the tongue. Damage to CN VII results in loss of taste in this region. Therefore, taste disturbance in the anterior tongue is linked to dysfunction of the facial nerve.
10.

Which of the following cranial nerves do you assess for readiness to extubate or need to block for an awake fiber optic?

  • Glossopharyngeal

  • Hypoglossal

  • Facial

  • Spinal accessory

Explanation

A. Glossopharyngeal The glossopharyngeal nerve (CN IX) provides sensation to the posterior tongue, soft palate, and oropharynx, playing a key role in the gag reflex and airway protective reflexes. Before extubation, airway competence must be confirmed—adequate gag reflex and swallowing ability indicate readiness. During an awake fiber-optic intubation, the glossopharyngeal nerve is often blocked to reduce gagging and improve patient comfort.

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