EXAM PREP
PANCE Neuro Practice Questions
& Study Guide
2026/2027
Complete Questions Bank and Correct
Detailed Answers With Rationales ||
100% Guaranteed Pass || Brand New
Version
,A 75-year-old man is involved in a Central Cord Syndrome
motor vehicle accident and strikes the central cord syndrome involves loss of motor
his forehead on the windshield. He function that is more severe in the upper
complains of neck pain and severe extremities than in the lower extremities, and is
burning in his shoulders and arms. more severe in the hands. There is typically
His physical examination reveals hyperesthesia over the shoulders and arms.
weakness of his upper extremities. Anterior cord syndrome presents with paraplegia
What type of spinal cord injury does or quadriplegia, loss of lateral spinothalamic
this patient have? function with preservation of posterior column
A anterior cord syndrome function. Brown-Séquard syndrome consists of
B central cord syndrome weakness and loss of posterior column function on
C Brown-Séquard syndrome one side of the body distal to the lesion with
D complete cord transection contralateral loss of lateral spinothalamic function
E cauda equina syndrome one to two levels below the lesion. Complete cord
transection would affect motor and sensory
function distal to the lesion. Cauda equina
syndrome typically presents as low back pain with
radiculopathy.
,A 37-year-old man fell from a ladder Epidural Hematoma
as he finished hanging the Epidural hematoma most often results from a
Christmas lights on his house. The traumatic tear of the middle meningeal artery.
right side of his head hit the alley Although a lucid interval ranging from minutes to
cement, and he lost consciousness hours followed by altered mental status and focal
for about 1 minute; he woke up with deficits is typical for epidural hematoma, this
a headache, but he had no other clinical picture is only encountered in up to 1/3 of
complaints. A few hours later, the the patients. The collection of blood between the
patient is brought to the emergency skull and dura mater causes an evident mass
room by his neighbor because of an effect with ophthalmic nerve palsy and the
intense headache, confusion, and contralateral hemiparesis. Surgical evacuation of
left hand hemiparesis. On the clot via burr holes is the treatment of choice.
examination, the patient has a
bruise located over the right Subdural hematoma results from a traumatic
temporal region, mydriasis, and right rupture of the bridging veins that connect the
deviation of the right eye, cerebrum to the venous sinuses within the dura.
papilledema, and left extensor This venous hemorrhage will result in a gradual
plantar response. An emergency CT increase of the hematoma, with a progressive
scan of the head without contrast clinical picture over days or weeks. The CT scan
reveals a lens-shaped hyper-density will show a concave, crescent-shaped hyper-
under the right temporal bone with density compared to the convex, lens-shaped
mass effect and edema. What is the hyper-density in epidural hematoma.
most likely diagnosis?
Subarachnoid hemorrhage is the result of an
Answer Choices aneurysm rupture; the most common is the
1 Epidural hematoma congenital berry aneurysm. The clinical picture is
2 Subdural hematoma of a sudden, severe headache with meningeal
3 Subarachnoid hemorrhage irritation. A CT scan will show blood in the
4 Intracerebral parenchymal subarachnoid space, and a lumbar puncture will
hemorrhage reveal xanthochromia CSF.
5 Acute meningitis
Intracerebral parenchymal hemorrhage is most
likely caused by hypertension complicated with
Charcot-Bouchard aneurysms. The blood
accumulates into the brain substance and most
commonly involves the basal ganglia.
Acute meningitis is not associated with trauma.
Fever and signs of meningeal irritation dominate
the clinical picture. Lumbar puncture, indicated if
there are no focal neurological signs on clinical
examination, will be the diagnostic procedure. The
CT scan of the patient presented in this case is
characteristic for epidural hematoma, and there is
no indication for a lumbar puncture.
, A 31-year-old woman presents with Antibiotics
a purpural rash covering her arms, Antibiotics are the treatment of choice for
legs, and abdomen. She also has meningococcemia. The preferred drug for active
fever, chills, nausea, abdominal infection is penicillin G. For those allergic to
tenderness, tachycardia, and penicillin, chloramphenicol and cephalosporins (ie,
generalized myalgias. Prior to the cefotaxime, cefuroxime) may be used as
development of the rash, the patient alternatives.
noted that she had a headache,
cough, and sore throat. Laboratory Patients will also receive supportive care, but
studies were positive for Gram- antibiotic therapy must be initiated quickly if the
negative diplococci in the blood, patient is to survive. Intensive care placement may
along with thrombocytopenia and an be necessary if organ failure is imminent.
elevation in PMNs. Urinalysis Ventilatory support, inotropic support, and IV fluids
showed blood, protein, and casts. are necessary in some. If adrenal insufficiency
Vital signs are as follows: PB 92/66, occurs, corticosteroid replacement may be
P 96, RR 14, T 39. The patient considered. A central venous line helps to provide
denies any foreign travel and does large amounts of volume expanders and inotropic
not have any sick contacts. medications for adequate tissue perfusion.
However, she does work part time
as a nurse in a local hospital. Steroids have not been shown to play a major role
in the treatment of meningococcemia. However,
they have been used in addition to antibiotic
therapy. In the case of adrenal insufficiency, for
Question example, steroid replacement has been shown to
The patient is diagnosed with be beneficial.
Meningococcemia; she is admitted
to the hospital and placed in Transfusion does not generally play a major role in
respiratory isolation. What major treatment. If the patient suffers from a devastating
course of therapy should this patient coagulopathy, blood or blood products may be
receive? replaced as necessary.
Answer Choices Bactericidal/permeability-increasing protein is a
1 Steroids protein stored in the granules of neutrophils. It
2 Supportive care binds to endotoxin in vitro and neutralizes it. This
3 Antibiotics technique is experimental, and it is not used in
4 Transfusion everyday treatment of meningococcemia.
5 Bactericidal/permeability-
increasing protein
In myasthenia gravis, weakness is a Muscle Fasiculations
result of insufficient acetylcholine Signs of cholinergic overdosage include muscle
transmission at the neuromuscular fasciculation, rhinorrhea, lacrimation, salivation,
junction; however, weakness can increased bronchial secretions, nausea, or
also occur with overdosing of the diarrhea. The presence of any of these suggests
cholinergic medications used to treat that the patient's weakness may be due to
myasthenia. What symptom helps cholinergic crisis. The other signs are due to
differentiate a myasthenic crisis from weakness and can occur in either condition.
a cholinergic crisis?
Answer Choices
1 Respiratory failure
2 Bilateral ptosis
3 Muscle fasciculations
4 Diplopia
5 Normal muscle stretch reflexes
PANCE Neuro Practice Questions
& Study Guide
2026/2027
Complete Questions Bank and Correct
Detailed Answers With Rationales ||
100% Guaranteed Pass || Brand New
Version
,A 75-year-old man is involved in a Central Cord Syndrome
motor vehicle accident and strikes the central cord syndrome involves loss of motor
his forehead on the windshield. He function that is more severe in the upper
complains of neck pain and severe extremities than in the lower extremities, and is
burning in his shoulders and arms. more severe in the hands. There is typically
His physical examination reveals hyperesthesia over the shoulders and arms.
weakness of his upper extremities. Anterior cord syndrome presents with paraplegia
What type of spinal cord injury does or quadriplegia, loss of lateral spinothalamic
this patient have? function with preservation of posterior column
A anterior cord syndrome function. Brown-Séquard syndrome consists of
B central cord syndrome weakness and loss of posterior column function on
C Brown-Séquard syndrome one side of the body distal to the lesion with
D complete cord transection contralateral loss of lateral spinothalamic function
E cauda equina syndrome one to two levels below the lesion. Complete cord
transection would affect motor and sensory
function distal to the lesion. Cauda equina
syndrome typically presents as low back pain with
radiculopathy.
,A 37-year-old man fell from a ladder Epidural Hematoma
as he finished hanging the Epidural hematoma most often results from a
Christmas lights on his house. The traumatic tear of the middle meningeal artery.
right side of his head hit the alley Although a lucid interval ranging from minutes to
cement, and he lost consciousness hours followed by altered mental status and focal
for about 1 minute; he woke up with deficits is typical for epidural hematoma, this
a headache, but he had no other clinical picture is only encountered in up to 1/3 of
complaints. A few hours later, the the patients. The collection of blood between the
patient is brought to the emergency skull and dura mater causes an evident mass
room by his neighbor because of an effect with ophthalmic nerve palsy and the
intense headache, confusion, and contralateral hemiparesis. Surgical evacuation of
left hand hemiparesis. On the clot via burr holes is the treatment of choice.
examination, the patient has a
bruise located over the right Subdural hematoma results from a traumatic
temporal region, mydriasis, and right rupture of the bridging veins that connect the
deviation of the right eye, cerebrum to the venous sinuses within the dura.
papilledema, and left extensor This venous hemorrhage will result in a gradual
plantar response. An emergency CT increase of the hematoma, with a progressive
scan of the head without contrast clinical picture over days or weeks. The CT scan
reveals a lens-shaped hyper-density will show a concave, crescent-shaped hyper-
under the right temporal bone with density compared to the convex, lens-shaped
mass effect and edema. What is the hyper-density in epidural hematoma.
most likely diagnosis?
Subarachnoid hemorrhage is the result of an
Answer Choices aneurysm rupture; the most common is the
1 Epidural hematoma congenital berry aneurysm. The clinical picture is
2 Subdural hematoma of a sudden, severe headache with meningeal
3 Subarachnoid hemorrhage irritation. A CT scan will show blood in the
4 Intracerebral parenchymal subarachnoid space, and a lumbar puncture will
hemorrhage reveal xanthochromia CSF.
5 Acute meningitis
Intracerebral parenchymal hemorrhage is most
likely caused by hypertension complicated with
Charcot-Bouchard aneurysms. The blood
accumulates into the brain substance and most
commonly involves the basal ganglia.
Acute meningitis is not associated with trauma.
Fever and signs of meningeal irritation dominate
the clinical picture. Lumbar puncture, indicated if
there are no focal neurological signs on clinical
examination, will be the diagnostic procedure. The
CT scan of the patient presented in this case is
characteristic for epidural hematoma, and there is
no indication for a lumbar puncture.
, A 31-year-old woman presents with Antibiotics
a purpural rash covering her arms, Antibiotics are the treatment of choice for
legs, and abdomen. She also has meningococcemia. The preferred drug for active
fever, chills, nausea, abdominal infection is penicillin G. For those allergic to
tenderness, tachycardia, and penicillin, chloramphenicol and cephalosporins (ie,
generalized myalgias. Prior to the cefotaxime, cefuroxime) may be used as
development of the rash, the patient alternatives.
noted that she had a headache,
cough, and sore throat. Laboratory Patients will also receive supportive care, but
studies were positive for Gram- antibiotic therapy must be initiated quickly if the
negative diplococci in the blood, patient is to survive. Intensive care placement may
along with thrombocytopenia and an be necessary if organ failure is imminent.
elevation in PMNs. Urinalysis Ventilatory support, inotropic support, and IV fluids
showed blood, protein, and casts. are necessary in some. If adrenal insufficiency
Vital signs are as follows: PB 92/66, occurs, corticosteroid replacement may be
P 96, RR 14, T 39. The patient considered. A central venous line helps to provide
denies any foreign travel and does large amounts of volume expanders and inotropic
not have any sick contacts. medications for adequate tissue perfusion.
However, she does work part time
as a nurse in a local hospital. Steroids have not been shown to play a major role
in the treatment of meningococcemia. However,
they have been used in addition to antibiotic
therapy. In the case of adrenal insufficiency, for
Question example, steroid replacement has been shown to
The patient is diagnosed with be beneficial.
Meningococcemia; she is admitted
to the hospital and placed in Transfusion does not generally play a major role in
respiratory isolation. What major treatment. If the patient suffers from a devastating
course of therapy should this patient coagulopathy, blood or blood products may be
receive? replaced as necessary.
Answer Choices Bactericidal/permeability-increasing protein is a
1 Steroids protein stored in the granules of neutrophils. It
2 Supportive care binds to endotoxin in vitro and neutralizes it. This
3 Antibiotics technique is experimental, and it is not used in
4 Transfusion everyday treatment of meningococcemia.
5 Bactericidal/permeability-
increasing protein
In myasthenia gravis, weakness is a Muscle Fasiculations
result of insufficient acetylcholine Signs of cholinergic overdosage include muscle
transmission at the neuromuscular fasciculation, rhinorrhea, lacrimation, salivation,
junction; however, weakness can increased bronchial secretions, nausea, or
also occur with overdosing of the diarrhea. The presence of any of these suggests
cholinergic medications used to treat that the patient's weakness may be due to
myasthenia. What symptom helps cholinergic crisis. The other signs are due to
differentiate a myasthenic crisis from weakness and can occur in either condition.
a cholinergic crisis?
Answer Choices
1 Respiratory failure
2 Bilateral ptosis
3 Muscle fasciculations
4 Diplopia
5 Normal muscle stretch reflexes
