ETS Domain: Foundations

Praxis 5331 Cranial Nerves Questions

Cranial nerve items on the Praxis 5331 are almost always scenario-based: a patient presents with a specific speech, voice, or swallowing deficit and you identify the involved nerve or predict the resulting pattern. Rote memorization of the 12 nerves is not enough — ETS asks you to map function to symptom.

Why this topic matters

Cranial nerve knowledge underlies most motor speech, voice, and dysphagia items — roughly 15-20% of the exam touches CN function.
The same fact (e.g. CN X innervates the vocal folds) shows up in voice, dysphagia, and neuro items — one concept, many question types.
Wrong CN identification is one of the most common reasons candidates miss motor speech and dysphagia questions.

High-yield concepts

CN V (trigeminal): mastication, jaw movement, facial sensation for feeding.
CN VII (facial): lower face weakness in UMN lesions, full facial in LMN (Bell's palsy).
CN IX (glossopharyngeal): pharyngeal sensation, gag reflex, taste posterior 1/3 of tongue.
CN X (vagus): velum, pharynx, larynx — recurrent laryngeal branch = vocal fold abduction/adduction.
CN XI (spinal accessory): SCM and trapezius — head/neck positioning for swallow.
CN XII (hypoglossal): tongue movement — deviation toward the lesion in LMN.

Sample practice questions

Try answering before revealing the rationale — mark misses to retry later.

Q1.An adult patient presents with a hoarse, breathy voice and weak cough three days after thyroid surgery. Which cranial nerve is most likely damaged?

A.CN VII
B.CN IX
C.CN X
D.CN XII

Show answer & rationale

Correct: C. The recurrent laryngeal branch of CN X (vagus) is a common iatrogenic injury during thyroid surgery. Unilateral damage produces a paralyzed vocal fold, breathy hoarseness, and a weak cough because the fold cannot fully adduct.

Q2.A patient's tongue deviates to the right on protrusion. Which cranial nerve is impaired and on which side?

A.Left CN XII
B.Right CN XII
C.Left CN VII
D.Right CN X

Show answer & rationale

Correct: B. In a lower motor neuron lesion of CN XII (hypoglossal), the tongue deviates toward the side of the lesion because the intact genioglossus on the opposite side pushes it that way. Right deviation = right CN XII involvement.

Q3.A patient shows drooping of the entire right side of the face, including inability to close the right eye. This pattern most likely reflects:

A.Left UMN CN VII lesion
B.Right LMN CN VII lesion (e.g., Bell's palsy)
C.Right UMN CN V lesion
D.Bilateral CN X lesion

Show answer & rationale

Correct: B. LMN CN VII damage affects the entire ipsilateral face, including the forehead and eye closure. UMN CN VII lesions spare the forehead because upper facial muscles receive bilateral cortical input.

Common wrong-answer traps

Confusing UMN vs LMN CN VII patterns — always ask whether the forehead is spared.
Assuming tongue deviates AWAY from the lesion (it deviates TOWARD in LMN CN XII).
Missing that a weak cough alone can point to CN X, not just to respiratory weakness.

Study moves this week

Draw a 2-column chart: nerve → speech/swallow function → classic deficit. Rewrite from memory each night for one week.
For each nerve, write one sentence linking it to a Praxis scenario you have seen (e.g., 'CN VII → post-stroke facial droop → labial sound weakness').
Quiz yourself on unilateral vs bilateral vs UMN vs LMN patterns — most missed items live here.

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FAQ

How many cranial nerve questions are on the Praxis 5331?

ETS doesn't publish per-topic counts, but cranial nerve knowledge is embedded in roughly 10-15 items across motor speech, voice, and dysphagia scenarios.

Do I need to memorize all 12 cranial nerves for the Praxis?

You should know all 12 by name and function, but only 6 (V, VII, IX, X, XI, XII) drive nearly every question. Master those cold.

Are cranial nerve questions purely recall?

No — nearly all are applied. You'll be given a symptom pattern and asked to identify the nerve, predict a deficit, or choose the correct assessment.

Praxis 5331 Cranial Nerves Questions

Why this topic matters

High-yield concepts

Sample practice questions

Common wrong-answer traps

Study moves this week

Want 400+ scenario questions with rationales?

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