NIH Stroke Scale Group E Test (Patients 1–6) 2026 | Practice
Questions & Answers | Complete Study Guide
Prepare for the NIH Stroke Scale (NIHSS) Group E Test covering Patients 1–6 with this
comprehensive study guide featuring practice questions, verified answers, and detailed
rationales. This resource reviews NIHSS scoring principles, neurological assessment techniques,
level of consciousness, gaze, visual fields, facial palsy, motor function, limb ataxia, sensory
deficits, language, dysarthria, extinction, and inattention. Designed to strengthen stroke
assessment skills and improve certification readiness, this guide is ideal for nurses, physicians,
EMS professionals, and healthcare providers.
PATIENT 1 – "Pretty ok, older white man with mustache and
blue eyes"
Item Score Description
1a. LOC 0 Alert, keenly responsive
1b. LOC Questions 0 Answers both questions correctly (month and age)
1c. LOC Commands 0 Performs both tasks correctly (open/close eyes, make fist/release)
2. Best Gaze 0 Normal; full extraocular movements, no conjugate deviation
3. Visual 0 No visual loss
4. Facial Palsy 0 Normal symmetric movement
,Item Score Description
5a. Motor Arm – Left 0 No drift; maintains arm position for 10 seconds
5b. Motor Arm – Right 0 No drift; maintains arm position for 10 seconds
6a. Motor Leg – Left 0 No drift; maintains leg position for 5 seconds
6b. Motor Leg – Right 1 Drift; leg drifts down before 5 seconds, does not hit bed
7. Limb Ataxia 0 No ataxia; finger-nose and heel-shin testing intact
Mild sensory loss; reports reduced pinprick sensation on right arm
8. Sensory 1
and leg compared to left
9. Best Language 0 No aphasia; names objects, repeats phrases, fluent speech
10. Dysarthria 0 Normal articulation
11.
0 No neglect; attends to bilateral stimulation
Extinction/Inattention
Total Score: 2
PATIENT 2 – "1,2,3,4,5 and a 1/2"
Item Score Description
, Item Score Description
1a. LOC 0 Alert, keenly responsive
1b. LOC Questions 1 Answers one question correctly (either month or age, but not bo
1c. LOC Commands 0 Performs both tasks correctly
2. Best Gaze 0 Normal horizontal eye movements
3. Visual 0 No visual loss
4. Facial Palsy 1 Minor facial weakness; slight asymmetry, nasolabial flattening
5a. Motor Arm – Left 0 No drift
5b. Motor Arm – Right 4 No movement; right arm does not move against gravity
6a. Motor Leg – Left 0 No drift
Some effort against gravity; leg drifts to bed, but has some
6b. Motor Leg – Right 3
movement
7. Limb Ataxia 0 No ataxia
8. Sensory 1 Mild sensory loss
9. Best Language 1 Mild-to-moderate aphasia; obvious naming errors or paraphasia
10. Dysarthria 0 Normal articulation
Questions & Answers | Complete Study Guide
Prepare for the NIH Stroke Scale (NIHSS) Group E Test covering Patients 1–6 with this
comprehensive study guide featuring practice questions, verified answers, and detailed
rationales. This resource reviews NIHSS scoring principles, neurological assessment techniques,
level of consciousness, gaze, visual fields, facial palsy, motor function, limb ataxia, sensory
deficits, language, dysarthria, extinction, and inattention. Designed to strengthen stroke
assessment skills and improve certification readiness, this guide is ideal for nurses, physicians,
EMS professionals, and healthcare providers.
PATIENT 1 – "Pretty ok, older white man with mustache and
blue eyes"
Item Score Description
1a. LOC 0 Alert, keenly responsive
1b. LOC Questions 0 Answers both questions correctly (month and age)
1c. LOC Commands 0 Performs both tasks correctly (open/close eyes, make fist/release)
2. Best Gaze 0 Normal; full extraocular movements, no conjugate deviation
3. Visual 0 No visual loss
4. Facial Palsy 0 Normal symmetric movement
,Item Score Description
5a. Motor Arm – Left 0 No drift; maintains arm position for 10 seconds
5b. Motor Arm – Right 0 No drift; maintains arm position for 10 seconds
6a. Motor Leg – Left 0 No drift; maintains leg position for 5 seconds
6b. Motor Leg – Right 1 Drift; leg drifts down before 5 seconds, does not hit bed
7. Limb Ataxia 0 No ataxia; finger-nose and heel-shin testing intact
Mild sensory loss; reports reduced pinprick sensation on right arm
8. Sensory 1
and leg compared to left
9. Best Language 0 No aphasia; names objects, repeats phrases, fluent speech
10. Dysarthria 0 Normal articulation
11.
0 No neglect; attends to bilateral stimulation
Extinction/Inattention
Total Score: 2
PATIENT 2 – "1,2,3,4,5 and a 1/2"
Item Score Description
, Item Score Description
1a. LOC 0 Alert, keenly responsive
1b. LOC Questions 1 Answers one question correctly (either month or age, but not bo
1c. LOC Commands 0 Performs both tasks correctly
2. Best Gaze 0 Normal horizontal eye movements
3. Visual 0 No visual loss
4. Facial Palsy 1 Minor facial weakness; slight asymmetry, nasolabial flattening
5a. Motor Arm – Left 0 No drift
5b. Motor Arm – Right 4 No movement; right arm does not move against gravity
6a. Motor Leg – Left 0 No drift
Some effort against gravity; leg drifts to bed, but has some
6b. Motor Leg – Right 3
movement
7. Limb Ataxia 0 No ataxia
8. Sensory 1 Mild sensory loss
9. Best Language 1 Mild-to-moderate aphasia; obvious naming errors or paraphasia
10. Dysarthria 0 Normal articulation
