Critical Care Registered Nurse (CCRN) Practice Exam

When assessing CN X, what should be observed regarding the soft palate?

1. The uvula should be midline upon phonation

2. The palate should remain flat

3. The uvula should be displaced to one side

4. The soft palate should droop symmetrically

The correct answer is: The uvula should be midline upon phonation

When assessing cranial nerve X, also known as the vagus nerve, observing the position of the uvula during phonation is crucial. The correct response indicates that the uvula should be midline upon phonation. This is important because the vagus nerve plays a key role in innervating the muscles of the soft palate, specifically the levator veli palatini, which elevates the soft palate during swallowing and speaking. If the uvula is midline while the patient phonates, it suggests that both sides of the soft palate are functioning properly and that the vagus nerve is intact. If there is a deviation of the uvula to one side, it may indicate weakness or paralysis of the muscles on the opposite side, which can occur with vagus nerve dysfunction. In contrast to this, if the palate remains flat, or if there is symmetric drooping or displacement of the uvula, these would suggest impairment of soft palate function, indicating potential problems with cranial nerve function. Each of those conditions points to possible neural or muscular deficits that can affect swallowing and vocalization. Thus, ensuring that the uvula is midline during assessment is an indicator of healthy function of cranial nerve X and the integrity of the soft palate.