👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: facial paralysis · facial nerve palsy · one-sided face droop
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Use this quick-reference guide to spot, treat, and prevent Bell Palsy on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Mech
CN VII (facial) inflammation
Often post-viral, idiopathic
🩺 Signs
Unilateral facial droop
Can't close eye, drooling
Loss of taste, ↓ tearing
✅ Do
Protect eye: drops + patch
Corticosteroids early
Facial exercises, warm compress
🎓 Teach
Usually resolves wks-months
Chew on unaffected side
📚 Bell Palsy — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Bell palsy is acute, usually unilateral paralysis or weakness of the facial muscles caused by inflammation of cranial nerve VII (facial nerve), often linked to herpes simplex virus reactivation. It produces a sudden one-sided facial droop, inability to close the eye, and loss of the forehead wrinkle on the affected side. Unlike a stroke, it involves the WHOLE half of the face including the forehead. Most cases resolve within weeks to months.
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Key points
Understand these first
Affects cranial nerve VII (facial) and causes ipsilateral flaccid paralysis of the entire half of the face including the forehead, distinguishing it from central (stroke) causes that spare the forehead.
Hallmark signs: drooping mouth, inability to close the eye, flattened nasolabial fold, drooling, and loss of taste on the anterior two-thirds of the tongue.
Often preceded by a viral illness; herpes simplex virus is the most common associated cause.
Corticosteroids (prednisone) started within 72 hours of onset improve recovery; antivirals (acyclovir) may be added for moderate-to-severe cases.
Most patients recover fully within 3 to 6 months without permanent deficit.
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Nursing priorities
What to do, in order
Protect the affected eye: apply artificial tears during the day, lubricating ointment and an eye patch or taping the lid shut at night to prevent corneal drying and abrasion.
Administer prescribed corticosteroids early and teach the importance of starting within 72 hours.
Assess ability to chew and swallow; provide soft foods and have the patient chew on the unaffected side to prevent aspiration and pocketing.
Encourage facial muscle exercises and warm moist heat to maintain muscle tone and reduce discomfort.
Provide emotional support and reassurance that most cases resolve, addressing body-image concerns.
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Red flags — report now
Escalate immediately
Eye pain, redness, or vision changes signaling corneal abrasion or ulceration from inadequate eye protection.
New bilateral facial weakness, limb weakness, or other focal neuro deficits suggesting stroke or Guillain-Barre rather than Bell palsy.
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Patient teaching
What patients must know
Use artificial tears during the day and tape or patch the eye closed at night to prevent corneal damage.
Chew food on the unaffected side and eat soft foods to avoid choking and food pocketing.
Perform gentle facial massage and exercises in front of a mirror several times a day.
Take the full course of steroids as prescribed and do not stop abruptly.
Reassure that recovery usually takes weeks to a few months and is typically complete.
❓ Bell Palsy: NCLEX FAQs
What are the priority nursing interventions for Bell Palsy?
Protect the affected eye: apply artificial tears during the day, lubricating ointment and an eye patch or taping the lid shut at night to prevent corneal drying and abrasion. Administer prescribed corticosteroids early and teach the importance of starting within 72 hours. Assess ability to chew and swallow; provide soft foods and have the patient chew on the unaffected side to prevent aspiration and pocketing. Encourage facial muscle exercises and warm moist heat to maintain muscle tone and reduce discomfort.
What are the warning signs of Bell Palsy a nurse must report?
Eye pain, redness, or vision changes signaling corneal abrasion or ulceration from inadequate eye protection. New bilateral facial weakness, limb weakness, or other focal neuro deficits suggesting stroke or Guillain-Barre rather than Bell palsy.
What do I need to know about Bell Palsy for the NCLEX?
Affects cranial nerve VII (facial) and causes ipsilateral flaccid paralysis of the entire half of the face including the forehead, distinguishing it from central (stroke) causes that spare the forehead. Hallmark signs: drooping mouth, inability to close the eye, flattened nasolabial fold, drooling, and loss of taste on the anterior two-thirds of the tongue. Often preceded by a viral illness; herpes simplex virus is the most common associated cause. Corticosteroids (prednisone) started within 72 hours of onset improve recovery; antivirals (acyclovir) may be added for moderate-to-severe cases.
What patient teaching is important for Bell Palsy?
Use artificial tears during the day and tape or patch the eye closed at night to prevent corneal damage. Chew food on the unaffected side and eat soft foods to avoid choking and food pocketing. Perform gentle facial massage and exercises in front of a mirror several times a day. Take the full course of steroids as prescribed and do not stop abruptly.
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Quick Tip
Affects cranial nerve VII (facial) and causes ipsilateral flaccid paralysis of the entire half of the face including the forehead, distinguishing it from central (stroke) causes that spare the forehead.