NIH Stroke Scale Group A Test Answers
(Patients 16) – Complete Study Guide
2025/2026
IMPORTANT NOTE ABOUT THIS EXAM
The NIH Stroke Scale (NIHSS) certification exam uses video scenarios where clinicians must score
a standardized neurological assessment. The official certification test from APEX Innovations
features specific video vignettes for Group A Patients 16. While the exact video content is
proprietary, this study guide covers the complete NIHSS scoring methodology, item bitem
interpretation, and clinical reasoning required to pass the certification exam.
This guide is organized into sections covering:
1. NIHSS Fundamentals and Administration Rules
2. Item by Item Scoring with Clinical Scenarios
3. Group A Patient Scenario Practice
4. Certification Exam Strategies
SECTION 1: NIHSS FUNDAMENTALS (Questions 140)
Question 1
How many components does the current NIH Stroke Scale (NIHSS) consist of?
A) 8 components
B) 11 components
C) 15 components
D) 20 components
Answer: B) 11 components
Rationale: The current NIHSS consists of 11 components, reduced from the original 15. These
include Level of Consciousness (1a, 1b, 1c), Best Gaze, Visual Fields, Facial Palsy, Motor Arm,
Motor Leg, Limb Ataxia, Sensory, Best Language, Dysarthria, and Extinction/Inattention.
,Question 2
What is the total possible score range for the NIH Stroke Scale?
A) 010
B) 025
C) 042
D) 050
Answer: C) 042
Rationale: The NIHSS total score ranges from 0 to 42. Higher scores indicate more severe stroke
deficits. A score of 0 indicates no stroke symptoms, while scores above 21 indicate severe stroke.
Question 3
Which of the following is a fundamental rule for administering the NIHSS?
A) Coach the patient to achieve their best performance
B) Score what you see, not what you think
C) Allow the patient to practice each task before scoring
D) Score the patient's best response during the exam
Answer: B) Score what you see, not what you think
Rationale: The NIHSS requires scoring based on the patient's actual performance, not expected
performance. Other key rules include scoring the first response (except for Item 9 Best Language)
and not coaching the patient.
Question 4
When administering the NIHSS, the patient's performance should be:
A) Rescored as the assessment progresses
B) Based on the best performance observed
C) Scored on the first response (with one exception)
D) Based on coaching and encouragement
,Answer: C) Scored on the first response (with one exception)
Rationale: The NIHSS requires scoring the patient's first response, not their best response, except
for Item 9 (Best Language) where the examiner scores the best language ability.
Question 5
What is the passing score required for NIHSS certification?
A) 80%
B) 85%
C) 90%
D) 93% or higher
Answer: D) 93% or higher
Rationale: The NIHSS certification exam requires a passing score of 93% or higher. Retakes are
unlimited until passed. The certification is valid for 12 years depending on the test group.
Question 6
Which organization developed the NIH Stroke Scale?
A) American Heart Association
B) World Health Organization
C) National Institutes of Health (NIH)
D) Centers for Disease Control
Answer: C) National Institutes of Health (NIH)
Rationale: The NIH Stroke Scale was developed through research supported by the National
Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.
Question 7
The NIHSS was originally developed for what purpose?
A) Emergency room triage only
, B) Research use in clinical trials
C) Patient rehabilitation planning
D) Longterm care assessment
Answer: B) Research use in clinical trials
Rationale: The NIHSS was originally designed for research use in acute stroke trials. It has since
become the gold standard clinical tool for assessing stroke severity.
Question 8
Which of the following statements about administering the NIHSS is CORRECT?
A) Items should be assessed in any order convenient for the examiner
B) The patient's performance cannot be rescored
C) The patient should be coached to ensure best performance
D) The score reflects how the patient performs the task on the first attempt
Answer: D) The score reflects how the patient performs the task on the first attempt
Rationale: The NIHSS scoring is based on the patient's first response to each item, not on their best
performance after coaching.
Question 9
How is Item 1a (Level of Consciousness) scored for a patient who is alert and fully responsive?
A) 0
B) 1
C) 2
D) 3
Answer: A) 0
Rationale: A score of 0 is given for Level of Consciousness when the patient is alert and keenly
responsive.
(Patients 16) – Complete Study Guide
2025/2026
IMPORTANT NOTE ABOUT THIS EXAM
The NIH Stroke Scale (NIHSS) certification exam uses video scenarios where clinicians must score
a standardized neurological assessment. The official certification test from APEX Innovations
features specific video vignettes for Group A Patients 16. While the exact video content is
proprietary, this study guide covers the complete NIHSS scoring methodology, item bitem
interpretation, and clinical reasoning required to pass the certification exam.
This guide is organized into sections covering:
1. NIHSS Fundamentals and Administration Rules
2. Item by Item Scoring with Clinical Scenarios
3. Group A Patient Scenario Practice
4. Certification Exam Strategies
SECTION 1: NIHSS FUNDAMENTALS (Questions 140)
Question 1
How many components does the current NIH Stroke Scale (NIHSS) consist of?
A) 8 components
B) 11 components
C) 15 components
D) 20 components
Answer: B) 11 components
Rationale: The current NIHSS consists of 11 components, reduced from the original 15. These
include Level of Consciousness (1a, 1b, 1c), Best Gaze, Visual Fields, Facial Palsy, Motor Arm,
Motor Leg, Limb Ataxia, Sensory, Best Language, Dysarthria, and Extinction/Inattention.
,Question 2
What is the total possible score range for the NIH Stroke Scale?
A) 010
B) 025
C) 042
D) 050
Answer: C) 042
Rationale: The NIHSS total score ranges from 0 to 42. Higher scores indicate more severe stroke
deficits. A score of 0 indicates no stroke symptoms, while scores above 21 indicate severe stroke.
Question 3
Which of the following is a fundamental rule for administering the NIHSS?
A) Coach the patient to achieve their best performance
B) Score what you see, not what you think
C) Allow the patient to practice each task before scoring
D) Score the patient's best response during the exam
Answer: B) Score what you see, not what you think
Rationale: The NIHSS requires scoring based on the patient's actual performance, not expected
performance. Other key rules include scoring the first response (except for Item 9 Best Language)
and not coaching the patient.
Question 4
When administering the NIHSS, the patient's performance should be:
A) Rescored as the assessment progresses
B) Based on the best performance observed
C) Scored on the first response (with one exception)
D) Based on coaching and encouragement
,Answer: C) Scored on the first response (with one exception)
Rationale: The NIHSS requires scoring the patient's first response, not their best response, except
for Item 9 (Best Language) where the examiner scores the best language ability.
Question 5
What is the passing score required for NIHSS certification?
A) 80%
B) 85%
C) 90%
D) 93% or higher
Answer: D) 93% or higher
Rationale: The NIHSS certification exam requires a passing score of 93% or higher. Retakes are
unlimited until passed. The certification is valid for 12 years depending on the test group.
Question 6
Which organization developed the NIH Stroke Scale?
A) American Heart Association
B) World Health Organization
C) National Institutes of Health (NIH)
D) Centers for Disease Control
Answer: C) National Institutes of Health (NIH)
Rationale: The NIH Stroke Scale was developed through research supported by the National
Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.
Question 7
The NIHSS was originally developed for what purpose?
A) Emergency room triage only
, B) Research use in clinical trials
C) Patient rehabilitation planning
D) Longterm care assessment
Answer: B) Research use in clinical trials
Rationale: The NIHSS was originally designed for research use in acute stroke trials. It has since
become the gold standard clinical tool for assessing stroke severity.
Question 8
Which of the following statements about administering the NIHSS is CORRECT?
A) Items should be assessed in any order convenient for the examiner
B) The patient's performance cannot be rescored
C) The patient should be coached to ensure best performance
D) The score reflects how the patient performs the task on the first attempt
Answer: D) The score reflects how the patient performs the task on the first attempt
Rationale: The NIHSS scoring is based on the patient's first response to each item, not on their best
performance after coaching.
Question 9
How is Item 1a (Level of Consciousness) scored for a patient who is alert and fully responsive?
A) 0
B) 1
C) 2
D) 3
Answer: A) 0
Rationale: A score of 0 is given for Level of Consciousness when the patient is alert and keenly
responsive.
