STROKE · NIHSS CERTIFICATION
APEX NIH STROKE SCALE GROUP A PATIENT 1-6 (COMPLETE)
2026/2027!! 2026/2027
A+
Complete Domain Coverage for NIH Stroke Scale Scoring
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Level of Consciousness, Gaze and Visual Fields
Section 2: Facial Palsy, Motor Arm and Motor Leg
Section 3: Limb Ataxia, Sensory and Best Language
Section 4: Dysarthria, Extinction/Inattention and Score Interpretation
Section 5: Scoring Pitfalls, Special Situations and Clinical Application
STUVIAACTUALEXAM
, EXAMINATION INSTRUCTIONS
This examination assesses accurate application of the NIH Stroke Scale (NIHSS) scoring rules across all items, including level
of consciousness, motor, sensory, language, and neglect. Select the single best answer. Passing score is 80%.
SECTION 1: Level of Consciousness, Gaze and Visual Fields
Q1
A 68-year-old patient is examined for NIHSS Item 1a (Level of Consciousness). The patient is not alert but can be aroused by
minor stimulation to obey, answer, or respond. Which score is correct?
A. 0 - Alert; keenly responsive
B. 1 - Not alert; but arousable by minor stimulation to obey, answer, or respond
C. 2 - Not alert; requires repeated stimulation to attend, or is obtunded and requires strong or painful stimulation
D. 3 - Responds only with reflex motor or autonomic effects, or totally unresponsive
Correct Answer: B
Rationale:
Score 1 is assigned when the patient is not fully alert but can be aroused with minor stimulation to follow commands or respond. Score 2
requires repeated or painful stimulation.
Q2
For NIHSS Item 1b (LOC Questions), the patient is asked the month and his age. He answers the month correctly but gives an
incorrect age. How is this item scored?
A. 0 - Answers both questions correctly
B. 1 - Answers one question correctly
C. 2 - Answers neither question correctly
D. UN - Untestable because of intubation
Correct Answer: B
Rationale:
One correct and one incorrect response yields a score of 1. Only two correct answers score 0; neither correct scores 2.
Q3
A patient is asked to open and close the eyes and then to grip and release the non-paretic hand for Item 1c (LOC Commands).
The patient performs only the eye command correctly. What is the score?
A. 0 - Performs both tasks correctly
B. 1 - Performs one task correctly
C. 2 - Performs neither task correctly
D. 3 - Completely unresponsive
Correct Answer: B
Rationale:
Item 1c awards 1 point when only one of the two commands is performed correctly. Credit is given if an attempt is made but not completed
due to weakness.
Q4
During testing of Best Gaze (Item 2), the patient has a partial gaze palsy that can be overcome by the oculocephalic
maneuver. Which score applies?
A. 0 - Normal
B. 1 - Partial gaze palsy; gaze is abnormal in one or both eyes, but forced deviation or total gaze paresis is not present
C. 2 - Forced deviation, or total gaze paresis not overcome by the oculocephalic maneuver
D. UN - Untestable
Correct Answer: B
Rationale:
Partial gaze palsy that is not a forced deviation scores 1. Forced deviation or total paresis not overcome by oculocephalic testing scores 2.
Q5
Visual fields are tested by confrontation (Item 3). The patient has clear visual loss in one full hemifield. How is this scored?
A. 0 - No visual loss
B. 1 - Partial hemianopia
C. 2 - Complete hemianopia
D. 3 - Bilateral hemianopia (including cortical blindness)
Correct Answer: C
Rationale:
Complete hemianopia (dense loss of an entire visual hemifield) scores 2. Partial or quadrantanopia scores 1; bilateral blindness scores 3.
APEX NIH STROKE SCALE GROUP A PATIENT 1-6 (COMPLETE) 20... Page 2
APEX NIH STROKE SCALE GROUP A PATIENT 1-6 (COMPLETE)
2026/2027!! 2026/2027
A+
Complete Domain Coverage for NIH Stroke Scale Scoring
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Level of Consciousness, Gaze and Visual Fields
Section 2: Facial Palsy, Motor Arm and Motor Leg
Section 3: Limb Ataxia, Sensory and Best Language
Section 4: Dysarthria, Extinction/Inattention and Score Interpretation
Section 5: Scoring Pitfalls, Special Situations and Clinical Application
STUVIAACTUALEXAM
, EXAMINATION INSTRUCTIONS
This examination assesses accurate application of the NIH Stroke Scale (NIHSS) scoring rules across all items, including level
of consciousness, motor, sensory, language, and neglect. Select the single best answer. Passing score is 80%.
SECTION 1: Level of Consciousness, Gaze and Visual Fields
Q1
A 68-year-old patient is examined for NIHSS Item 1a (Level of Consciousness). The patient is not alert but can be aroused by
minor stimulation to obey, answer, or respond. Which score is correct?
A. 0 - Alert; keenly responsive
B. 1 - Not alert; but arousable by minor stimulation to obey, answer, or respond
C. 2 - Not alert; requires repeated stimulation to attend, or is obtunded and requires strong or painful stimulation
D. 3 - Responds only with reflex motor or autonomic effects, or totally unresponsive
Correct Answer: B
Rationale:
Score 1 is assigned when the patient is not fully alert but can be aroused with minor stimulation to follow commands or respond. Score 2
requires repeated or painful stimulation.
Q2
For NIHSS Item 1b (LOC Questions), the patient is asked the month and his age. He answers the month correctly but gives an
incorrect age. How is this item scored?
A. 0 - Answers both questions correctly
B. 1 - Answers one question correctly
C. 2 - Answers neither question correctly
D. UN - Untestable because of intubation
Correct Answer: B
Rationale:
One correct and one incorrect response yields a score of 1. Only two correct answers score 0; neither correct scores 2.
Q3
A patient is asked to open and close the eyes and then to grip and release the non-paretic hand for Item 1c (LOC Commands).
The patient performs only the eye command correctly. What is the score?
A. 0 - Performs both tasks correctly
B. 1 - Performs one task correctly
C. 2 - Performs neither task correctly
D. 3 - Completely unresponsive
Correct Answer: B
Rationale:
Item 1c awards 1 point when only one of the two commands is performed correctly. Credit is given if an attempt is made but not completed
due to weakness.
Q4
During testing of Best Gaze (Item 2), the patient has a partial gaze palsy that can be overcome by the oculocephalic
maneuver. Which score applies?
A. 0 - Normal
B. 1 - Partial gaze palsy; gaze is abnormal in one or both eyes, but forced deviation or total gaze paresis is not present
C. 2 - Forced deviation, or total gaze paresis not overcome by the oculocephalic maneuver
D. UN - Untestable
Correct Answer: B
Rationale:
Partial gaze palsy that is not a forced deviation scores 1. Forced deviation or total paresis not overcome by oculocephalic testing scores 2.
Q5
Visual fields are tested by confrontation (Item 3). The patient has clear visual loss in one full hemifield. How is this scored?
A. 0 - No visual loss
B. 1 - Partial hemianopia
C. 2 - Complete hemianopia
D. 3 - Bilateral hemianopia (including cortical blindness)
Correct Answer: C
Rationale:
Complete hemianopia (dense loss of an entire visual hemifield) scores 2. Partial or quadrantanopia scores 1; bilateral blindness scores 3.
APEX NIH STROKE SCALE GROUP A PATIENT 1-6 (COMPLETE) 20... Page 2
