NP Neurology Board Review Exam: High-
Yield Disorders & Clinical Scenarios (150
Questions, Answers And Rationale
2025/2026
1. A 72-year-old patient presents with a shuffling gait, resting tremor,
and bradykinesia. Which diagnosis is most likely?
A. Essential tremor
B. Parkinson’s disease
C. Huntington’s disease
D. Myasthenia gravis
Rationale: Parkinson’s disease presents with the triad of resting
tremor, rigidity, and bradykinesia.
2. A positive Kernig’s sign is most commonly associated with:
A. Stroke
B. Multiple sclerosis
C. Meningitis
D. Bell’s palsy
Rationale: Kernig’s sign indicates meningeal irritation, typically seen
in meningitis.
3. A 30-year-old female with episodes of optic neuritis and sensory
changes likely has:
A. ALS
B. Guillain-Barré syndrome
C. Multiple sclerosis
D. Myasthenia gravis
,Rationale: Recurrent neurologic dysfunction separated by time and
place suggests MS.
4. First-line therapy for absence seizures is:
A. Phenytoin
B. Carbamazepine
C. Ethosuximide
D. Valproate
Rationale: Ethosuximide is the gold standard for absence seizures.
5. A 68-year-old male with sudden unilateral weakness and slurred
speech most likely has:
A. Migraine
B. Ischemic stroke
C. Parkinson’s disease
D. Spinal cord lesion
Rationale: Acute focal deficits point to an ischemic stroke until proven
otherwise.
6. Which cranial nerve controls lateral eye movement?
A. CN III
B. CN VI
C. CN IV
D. CN V
Rationale: The abducens nerve (CN VI) controls lateral rectus muscle
movement.
7. Initial treatment for myasthenia gravis:
A. Baclofen
B. Pyridostigmine
C. Levodopa
,D. Interferon-beta
Rationale: Pyridostigmine is a cholinesterase inhibitor that improves
neuromuscular transmission.
8. A “thunderclap headache” is most concerning for:
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Trigeminal neuralgia
Rationale: Sudden severe headache is classic for SAH.
9. The most common cause of peripheral neuropathy in the U.S.:
A. Alcohol use
B. Diabetes mellitus
C. Renal failure
D. Chemotherapy
Rationale: Diabetic neuropathy is the leading cause of peripheral
neuropathy.
10. A patient with unilateral facial paralysis including forehead
involvement likely has:
A. Stroke
B. Bell’s palsy
C. MS
D. Meningitis
Rationale: Forehead involvement indicates a peripheral lesion like
Bell’s palsy.
11. The Glasgow Coma Scale assesses:
A. Cranial nerve function
B. Cerebellar function
, C. Level of consciousness
D. Motor strength
Rationale: The GCS evaluates eye opening, verbal response, and
motor response to assess consciousness.
12. A patient with progressive muscle weakness, fasciculations, and
no sensory loss most likely has:
A. Multiple sclerosis
B. Amyotrophic lateral sclerosis (ALS)
C. Myasthenia gravis
D. Peripheral neuropathy
Rationale: ALS affects motor neurons only, sparing sensory function.
13. Which medication is first-line for acute migraine attacks?
A. Propranolol
B. Sumatriptan
C. Topiramate
D. Amitriptyline
Rationale: Triptans are first-line abortive therapy for migraines.
14. A positive Babinski sign indicates:
A. Peripheral nerve injury
B. Upper motor neuron lesion
C. Lower motor neuron lesion
D. Cerebellar disease
Rationale: Babinski reflex suggests corticospinal tract dysfunction.
15. Which condition is associated with Guillain-Barré syndrome?
A. Gradual ascending weakness
B. Hyperreflexia
C. Recent infection
Yield Disorders & Clinical Scenarios (150
Questions, Answers And Rationale
2025/2026
1. A 72-year-old patient presents with a shuffling gait, resting tremor,
and bradykinesia. Which diagnosis is most likely?
A. Essential tremor
B. Parkinson’s disease
C. Huntington’s disease
D. Myasthenia gravis
Rationale: Parkinson’s disease presents with the triad of resting
tremor, rigidity, and bradykinesia.
2. A positive Kernig’s sign is most commonly associated with:
A. Stroke
B. Multiple sclerosis
C. Meningitis
D. Bell’s palsy
Rationale: Kernig’s sign indicates meningeal irritation, typically seen
in meningitis.
3. A 30-year-old female with episodes of optic neuritis and sensory
changes likely has:
A. ALS
B. Guillain-Barré syndrome
C. Multiple sclerosis
D. Myasthenia gravis
,Rationale: Recurrent neurologic dysfunction separated by time and
place suggests MS.
4. First-line therapy for absence seizures is:
A. Phenytoin
B. Carbamazepine
C. Ethosuximide
D. Valproate
Rationale: Ethosuximide is the gold standard for absence seizures.
5. A 68-year-old male with sudden unilateral weakness and slurred
speech most likely has:
A. Migraine
B. Ischemic stroke
C. Parkinson’s disease
D. Spinal cord lesion
Rationale: Acute focal deficits point to an ischemic stroke until proven
otherwise.
6. Which cranial nerve controls lateral eye movement?
A. CN III
B. CN VI
C. CN IV
D. CN V
Rationale: The abducens nerve (CN VI) controls lateral rectus muscle
movement.
7. Initial treatment for myasthenia gravis:
A. Baclofen
B. Pyridostigmine
C. Levodopa
,D. Interferon-beta
Rationale: Pyridostigmine is a cholinesterase inhibitor that improves
neuromuscular transmission.
8. A “thunderclap headache” is most concerning for:
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Trigeminal neuralgia
Rationale: Sudden severe headache is classic for SAH.
9. The most common cause of peripheral neuropathy in the U.S.:
A. Alcohol use
B. Diabetes mellitus
C. Renal failure
D. Chemotherapy
Rationale: Diabetic neuropathy is the leading cause of peripheral
neuropathy.
10. A patient with unilateral facial paralysis including forehead
involvement likely has:
A. Stroke
B. Bell’s palsy
C. MS
D. Meningitis
Rationale: Forehead involvement indicates a peripheral lesion like
Bell’s palsy.
11. The Glasgow Coma Scale assesses:
A. Cranial nerve function
B. Cerebellar function
, C. Level of consciousness
D. Motor strength
Rationale: The GCS evaluates eye opening, verbal response, and
motor response to assess consciousness.
12. A patient with progressive muscle weakness, fasciculations, and
no sensory loss most likely has:
A. Multiple sclerosis
B. Amyotrophic lateral sclerosis (ALS)
C. Myasthenia gravis
D. Peripheral neuropathy
Rationale: ALS affects motor neurons only, sparing sensory function.
13. Which medication is first-line for acute migraine attacks?
A. Propranolol
B. Sumatriptan
C. Topiramate
D. Amitriptyline
Rationale: Triptans are first-line abortive therapy for migraines.
14. A positive Babinski sign indicates:
A. Peripheral nerve injury
B. Upper motor neuron lesion
C. Lower motor neuron lesion
D. Cerebellar disease
Rationale: Babinski reflex suggests corticospinal tract dysfunction.
15. Which condition is associated with Guillain-Barré syndrome?
A. Gradual ascending weakness
B. Hyperreflexia
C. Recent infection
