,2026 APEX NIH STROKE SCALE (NIHSS) – ALL
TEST GROUPS A–F
Complete Exam Answer Keys for Patients 1–6
| Latest 2026/2027 Edition
EXAM OVERVIEW
The NIH Stroke Scale (NIHSS) certification exam
consists of 6 patient scenarios per test group
(A–F) , scored across 15 items (1a–11) . Each
group presents unique neurological deficits,
testing your ability to differentiate key findings
like aphasia vs. dysarthria, ataxia vs.
weakness, and neglect.
Scoring
Item Assessment Area
Range
1a Level of Consciousness (LOC) 0–3
1b LOC Questions (Month, Age) 0–2
, Scoring
Item Assessment Area
Range
1c LOC Commands (Blink, Squeeze) 0–2
Best Gaze (Horizontal Eye
2 0–2
Movement)
3 Visual Fields 0–3
4 Facial Palsy 0–3
5a Motor Arm (Left) 0–4
5b Motor Arm (Right) 0–4
6a Motor Leg (Left) 0–4
6b Motor Leg (Right) 0–4
7 Limb Ataxia 0–2
8 Sensory 0–2
9 Best Language (Aphasia) 0–3
10 Dysarthria 0–2
TEST GROUPS A–F
Complete Exam Answer Keys for Patients 1–6
| Latest 2026/2027 Edition
EXAM OVERVIEW
The NIH Stroke Scale (NIHSS) certification exam
consists of 6 patient scenarios per test group
(A–F) , scored across 15 items (1a–11) . Each
group presents unique neurological deficits,
testing your ability to differentiate key findings
like aphasia vs. dysarthria, ataxia vs.
weakness, and neglect.
Scoring
Item Assessment Area
Range
1a Level of Consciousness (LOC) 0–3
1b LOC Questions (Month, Age) 0–2
, Scoring
Item Assessment Area
Range
1c LOC Commands (Blink, Squeeze) 0–2
Best Gaze (Horizontal Eye
2 0–2
Movement)
3 Visual Fields 0–3
4 Facial Palsy 0–3
5a Motor Arm (Left) 0–4
5b Motor Arm (Right) 0–4
6a Motor Leg (Left) 0–4
6b Motor Leg (Right) 0–4
7 Limb Ataxia 0–2
8 Sensory 0–2
9 Best Language (Aphasia) 0–3
10 Dysarthria 0–2
