NIH Stroke Scale (NIHSS) Complete Answer Key 2026 | Test Groups A–F (Patients 1–6) | Spring Updated Questions & Rationales

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NIH Stroke Scale (NIHSS) Complete Answer Key

All Test Groups A-F (Patients 1-6) – Updated Spring 2025

200 Questions with Verified Solutions & Detailed Rationales




EXAM OVERVIEW

Feature Detail


Assessment Name NIH Stroke Scale (NIHSS)


Purpose Standardized assessment of stroke severity


Number of Items 15 items


Score Range 0-42 (higher = more severe)


Categories 0=Normal, 1-4=Minor, 5-15=Moderate, 16-20=Moderate-Severe, 21-42=Severe


Test Groups A-F (Patients 1-6)


Administration Time 5-10 minutes


Certification Required Yes (must renew every 1-2 years)




Sure pass

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SECTION 1: NIHSS OVERVIEW & SCORING PRINCIPLES
(Questions 1-15)



Question 1:
What is the total possible score range on the NIH Stroke Scale?
A) 0-10
B) 0-22
C) 0-42
D) 0-50

Correct Answer: C) 0-42

Rationale: The NIHSS consists of 15 items with a total possible score of 42. Higher scores
indicate more severe stroke deficits. A score of 0 indicates no stroke symptoms, while 42
represents the most severe neurological impairment.




Question 2:
A score of 5 on the NIHSS indicates:
A) No stroke symptoms
B) Minor stroke
C) Moderate stroke
D) Severe stroke

Correct Answer: B) Minor stroke

Rationale: NIHSS score categories: 0 = normal, 1-4 = minor stroke, 5-15 = moderate
stroke, 16-20 = moderate-severe, 21-42 = severe. A score of 5 represents minor stroke
symptoms requiring monitoring and treatment.




Question 3:
How many items are included in the NIH Stroke Scale?

Sure pass

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A) 10
B) 12
C) 15
D) 18

Correct Answer: C) 15

Rationale: The NIHSS includes 15 standardized assessment items covering level of
consciousness, language, motor function, sensory function, and coordination. Each item
assesses a specific neurological function affected by stroke.




Question 4:
Which of the following is NOT assessed in the NIH Stroke Scale?
A) Level of consciousness
B) Visual fields
C) Bowel and bladder function
D) Language

Correct Answer: C) Bowel and bladder function

Rationale: The NIHSS assesses LOC, visual fields, motor function, sensory function,
language, and coordination. Bowel and bladder function are not included in the NIHSS as
they are not acute stroke severity indicators.




Question 5:
What is the maximum score for the Level of Consciousness (1a) item?
A) 1
B) 2
C) 3
D) 4

Correct Answer: C) 3

Rationale: LOC (Item 1a) is scored 0-3: 0 = alert, 1 = drowsy but arousable, 2 = obtunded,
3 = unresponsive. This is one of the most critical items as it reflects overall brain function.


Sure pass

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Question 6:
What is the maximum score for the Best Gaze (Item 2)?
A) 1
B) 2
C) 3
D) 4

Correct Answer: B) 2

Rationale: Best Gaze (Item 2) is scored 0-2: 0 = normal, 1 = partial gaze palsy, 2 = forced
deviation. Gaze deviation can indicate hemispheric stroke or brainstem involvement.




Question 7:
What is the maximum score for the Visual Fields (Item 3)?
A) 1
B) 2
C) 3
D) 4

Correct Answer: C) 3

Rationale: Visual Fields (Item 3) is scored 0-3: 0 = no visual loss, 1 = partial hemianopia, 2
= complete hemianopia, 3 = bilateral hemianopia. Visual field deficits indicate damage to
the visual pathways.




Question 8:
A patient who is completely aphasic with no comprehensible speech would score:
A) 1 on Best Language
B) 2 on Best Language
C) 3 on Best Language
D) 4 on Best Language

Correct Answer: B) 2 on Best Language

Sure pass