1) I can use McNemar's with only 5 scores ? I know this violates assumptions for using Pearson's chi square test and I'd hae to use Fsher exact instead.

2) If I use McNemar's, can my table look like Pre-test (0,1,2,3) x Post-test (0,1,2,3) ?

Someone suggested I count the number of participants whose scores increased (c), decreased (a) or did not change (b) and use the formula (c-a)^2 / (c+a) ? However, this seems like I am directly counting the change rather than calculating it from scores.

Any help would be greatly appreciated! Thanks!