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NIHSS Certification Practice Answer Key
Groups A–F | Patients 1–6 | 2026/2027 Version
Scoring Reminders:
• Each item scored individually.
• Total NIHSS range 0–42.
• Higher scores = more severe stroke.
• Score only what the patient actually does, not what you
think they can do.
• Do not coach.
Patient 1 – Group A
Clinical Scenario: 68-year-old with mild left facial droop and
subtle left arm drift; alert and oriented.
Item Score
1a LOC 0
1b LOC Questions (month, age) 0
1c LOC Commands 0
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Item Score
2 Best Gaze 0
3 Visual Fields 0
4 Facial Palsy 1 (minor left lower facial droop)
5 Motor Arm Left 1 (drifts but does not hit bed)
6 Motor Arm Right 0
7 Motor Leg Left 0
8 Motor Leg Right 0
9 Limb Ataxia 0
10 Sensory 0
11 Best Language 0
12 Dysarthria 0
13 Extinction/Inattention 0
NIHSS Certification Practice Answer Key
Groups A–F | Patients 1–6 | 2026/2027 Version
Scoring Reminders:
• Each item scored individually.
• Total NIHSS range 0–42.
• Higher scores = more severe stroke.
• Score only what the patient actually does, not what you
think they can do.
• Do not coach.
Patient 1 – Group A
Clinical Scenario: 68-year-old with mild left facial droop and
subtle left arm drift; alert and oriented.
Item Score
1a LOC 0
1b LOC Questions (month, age) 0
1c LOC Commands 0
, Page |2
Item Score
2 Best Gaze 0
3 Visual Fields 0
4 Facial Palsy 1 (minor left lower facial droop)
5 Motor Arm Left 1 (drifts but does not hit bed)
6 Motor Arm Right 0
7 Motor Leg Left 0
8 Motor Leg Right 0
9 Limb Ataxia 0
10 Sensory 0
11 Best Language 0
12 Dysarthria 0
13 Extinction/Inattention 0
