WESLEYAN

AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

PERFORMANCE EVALUATION TOOL
Assessment of Cranial Nerves

NAME OF STUDENT:
Block #

Procedure: Assessment of Cranial Nerves

Procedure Rationale DONE NOT REMARKS

DONE
Purpose:
 To assess the function of cranial nerves
and detect any abnormalities.
Assessment:
 Inquire if the client has history of the
following: trauma, tingling or
numbness, tremors or tics, limping,
paralysis, uncontrolled muscle
movements, or problems with smell,
vision, taste, touch, or hearing.

Planning:
1. Prepare the client.
2. Prepare equipment/materials to be
used:
i. Coffee or vanilla granules
ii. Snellen’s Chart
iii. Tongue depressor
iv. Salt
v. Sugar
vi. Sterile gauze
vii. Pin
viii. Cotton
ix. Tuning fork
Procedure:
1 Explain to the client what you are going to
do, why it is necessary, and how he or she
can cooperate. Discuss how the results will
be used in planning further care or
treatments.
2 Wash hands and observe appropriate
infection control procedures.
3 Provide for client privacy.
4 To assess CN I (Olfactory):
Ask the client to close eyes and identify
different mild aromas such as coffee or
vanilla.
5 To assess CN II (Optic):
Ask the client to read Snellen’s chart, check
visual fields by confrontation; and conduct an
opthalmoscopic examination.
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

6 To assess CN III and IV (Oculomotor and
Trohlear):
Assess six ocular movements and pupil
reaction.
7 To assess CN V (Trigeminal):
a. While client looks upward, lightly
touch lateral sclera of eye with sterile gauze
to elicit blink reflex.
b. To test light sensation, have client
close eyes and wisp of cotton over client’s
forehead and paranasal sinuses.
c. To test deep sensation, use
alternation blunt and sharp ends of a safety
pin over same area.

8 To assess CN VI (Abducens):
Assess direction of gaze.
9 To assess CN VII (Facial):
Ask the client to smile, raise the eyebrows,
frown, puff out his cheeks, close his eyes
tightly. Ask the client to identify various taste
placed on tip and sides of tongue.
10 To assess CN VIII (Auditory):
Assess client’s ability to hear spoken word
and vibrations of tuning fork.
11 To assess CN IX (Glossopharyngeal):
Apply tastes on posterior tongue for
identification. Ask client to move tongue
from side to side and up and down
12 To assess CN X (Vagus):
Assessed with CN IX, assess client’s speech
for hoarseness.
13 To assess CN XI (Accessory):
Ask client to shrug shoulders against
resistance from your hands and to turn his
head to side against resistance from your
hand. Repeat for the other side.
14 To assess CN XII (Hypoglossal):
Ask client to protrude his tongue at midline,
then move it side to side
15 Secure patient’s comfort and safety.
16 Document all the findings
Evaluation:
1. Accurately perform assessment methods.
2. Detect any abnormalities in each cranial
nerve.
3. Report significant deviations from normal
to the physician.

Student’s Signature: Instructor’ Signature

Date: Date:
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

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