APEX NIH STROKE SCALE GROUP A
ACTUAL EXAM 2026/2027 | Patients 1–6
Study Guide & Practice Review | Verified
Answers | Pass Guaranteed - A+ Graded
**Important Note**: The APEX NIH Stroke Scale certification exam uses video-based patient
scenarios. The questions below are representative practice items derived from verified answer keys
and clinical rationales for Group A (Patients 1-6) to help you master scoring accuracy and clinical
reasoning.
---
## Section 1: Level of Consciousness & Orientation
### Question 1 (Patient 1 – Item 1a)
Patient 1 is a 62-year-old male who presents with right-sided weakness. He is awake, alert, and responds
appropriately to questions without prompting. What is the correct Level of Consciousness (1a) score?
A) 0
B) 1
C) 2
D) 3
**Correct Answer: A (0)**
**Rationale**: A score of 0 on Item 1a is assigned when the patient is alert and keenly responsive,
responding spontaneously without requiring any stimulation. A score of 1 requires the patient to be
,drowsy but arousable by minor stimulation. A score of 2 indicates the patient requires repeated or
painful stimulation to attend. The description clearly indicates full alertness.
---
### Question 2 (Item 1a – LOC Scoring)
A patient opens their eyes only after repeated painful stimulus. How is Level of Consciousness (1a)
scored?
A) 0
B) 1
C) 2
D) 3
**Correct Answer: C (2)**
**Rationale**: Eye opening only to repeated or painful stimulation is scored as LOC 2. This indicates the
patient is not alert and requires significant stimulation to arouse. A score of 3 would indicate the patient
is unresponsive or responds only with reflex motor or autonomic effects.
---
### Question 3 (Item 1b – LOC Questions)
A 68-year-old man is evaluated after an acute ischemic stroke. He correctly states his age but cannot
name the current month despite repeated prompting. How should this be scored on Item 1b?
A) 0 – Answers both correctly
, B) 1 – Answers one correctly
C) 2 – Answers neither correctly
**Correct Answer: B (1)**
**Rationale**: Item 1b requires the patient to answer both the month and their age correctly to receive
a score of 0. Since the patient correctly answered only one of the two questions, the appropriate score
is 1. A score of 2 is reserved for patients who answer neither question correctly.
---
### Question 4 (Patient 2 – Item 1b)
When assessing LOC Questions (1b), what determines scoring?
A) Whether the patient attempts to answer
B) Accuracy of answers
C) Level of consciousness
D) Motor ability to speak
**Correct Answer: B (Accuracy of answers)**
**Rationale**: The NIHSS Item 1b specifically scores the accuracy of the patient's answers to the month
and age questions. Attempting to answer does not earn credit; only correct answers count. A patient
who responds "I don't know" to both questions scores 2.
---
ACTUAL EXAM 2026/2027 | Patients 1–6
Study Guide & Practice Review | Verified
Answers | Pass Guaranteed - A+ Graded
**Important Note**: The APEX NIH Stroke Scale certification exam uses video-based patient
scenarios. The questions below are representative practice items derived from verified answer keys
and clinical rationales for Group A (Patients 1-6) to help you master scoring accuracy and clinical
reasoning.
---
## Section 1: Level of Consciousness & Orientation
### Question 1 (Patient 1 – Item 1a)
Patient 1 is a 62-year-old male who presents with right-sided weakness. He is awake, alert, and responds
appropriately to questions without prompting. What is the correct Level of Consciousness (1a) score?
A) 0
B) 1
C) 2
D) 3
**Correct Answer: A (0)**
**Rationale**: A score of 0 on Item 1a is assigned when the patient is alert and keenly responsive,
responding spontaneously without requiring any stimulation. A score of 1 requires the patient to be
,drowsy but arousable by minor stimulation. A score of 2 indicates the patient requires repeated or
painful stimulation to attend. The description clearly indicates full alertness.
---
### Question 2 (Item 1a – LOC Scoring)
A patient opens their eyes only after repeated painful stimulus. How is Level of Consciousness (1a)
scored?
A) 0
B) 1
C) 2
D) 3
**Correct Answer: C (2)**
**Rationale**: Eye opening only to repeated or painful stimulation is scored as LOC 2. This indicates the
patient is not alert and requires significant stimulation to arouse. A score of 3 would indicate the patient
is unresponsive or responds only with reflex motor or autonomic effects.
---
### Question 3 (Item 1b – LOC Questions)
A 68-year-old man is evaluated after an acute ischemic stroke. He correctly states his age but cannot
name the current month despite repeated prompting. How should this be scored on Item 1b?
A) 0 – Answers both correctly
, B) 1 – Answers one correctly
C) 2 – Answers neither correctly
**Correct Answer: B (1)**
**Rationale**: Item 1b requires the patient to answer both the month and their age correctly to receive
a score of 0. Since the patient correctly answered only one of the two questions, the appropriate score
is 1. A score of 2 is reserved for patients who answer neither question correctly.
---
### Question 4 (Patient 2 – Item 1b)
When assessing LOC Questions (1b), what determines scoring?
A) Whether the patient attempts to answer
B) Accuracy of answers
C) Level of consciousness
D) Motor ability to speak
**Correct Answer: B (Accuracy of answers)**
**Rationale**: The NIHSS Item 1b specifically scores the accuracy of the patient's answers to the month
and age questions. Attempting to answer does not earn credit; only correct answers count. A patient
who responds "I don't know" to both questions scores 2.
---
