NIH Stroke Scale (NIHSS) All Test
Groups A-F (Patients 1-6) Practice
Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
Section 1: NIHSS Fundamentals
1. What is the primary purpose of the NIH Stroke Scale?
A. Determine the patient's long-term rehabilitation needs
B. Quantify neurological impairment caused by stroke
C. Determine the patient's blood pressure target
D. Diagnose the type of stroke
Rationale: The NIHSS provides a standardized measure of
neurological deficits in patients with acute stroke.
2. How many major assessment items are included in the NIHSS?
A. 8
B. 10
C. 15
D. 20
Rationale: The NIHSS consists of 15 scored neurological assessment
items, although some contain multiple components.
3. Which NIHSS item assesses level of consciousness?
A. 2
B. 1a
,C. 3
D. 4
Rationale: Item 1a evaluates the patient's overall level of
consciousness.
4. A patient is awake, alert, and responds appropriately to the
examiner. What score should be assigned for LOC?
A. 1
B. 0
C. 2
D. 3
Rationale: An alert patient with no impairment of consciousness
receives a score of 0 for item 1a.
5. Which NIHSS component assesses orientation using questions?
A. 1a
B. 1b
C. 1c
D. 2
Rationale: Item 1b evaluates LOC questions, traditionally asking the
patient's age and the current month.
6. If a patient correctly answers both LOC questions, the score is:
A. 1
B. 2
C. 0
D. 3
Rationale: Correctly answering both questions results in a score of 0.
7. If a patient answers one LOC question correctly and one
incorrectly, the score is:
,A. 1
B. 0
C. 2
D. 3
Rationale: One correct answer earns 1 point on item 1b.
8. If a patient answers neither LOC question correctly, the score is:
A. 1
B. 2
C. 3
D. 0
Rationale: Failure to answer either question correctly earns 2 points.
9. What is assessed by NIHSS item 1c?
A. Language
B. LOC commands
C. Facial weakness
D. Sensory loss
Rationale: Item 1c evaluates the patient's ability to follow two simple
commands.
10. Which pair represents the standard commands used for NIHSS
item 1c?
A. Stand and walk
B. Speak and swallow
C. Open/close the eyes and grip/release the hand
D. Raise both legs and sit upright
Rationale: The standard commands assess simple motor responses
involving the eyes and hand.
11. A patient performs both LOC commands correctly. What is the
score?
, A. 1
B. 0
C. 2
D. 3
Rationale: Correctly following both commands earns 0 points.
12. A patient follows one of the two LOC commands but cannot
follow the other. What score is appropriate?
A. 1
B. 0
C. 2
D. 3
Rationale: Following one command correctly earns 1 point.
13. A patient cannot follow either LOC command. What score is
appropriate?
A. 0
B. 1
C. 2
D. 3
Rationale: Failure to follow both commands earns 2 points.
14. Which NIHSS item evaluates horizontal eye movements?
A. 1c
B. 2
C. 3
D. 4
Rationale: Item 2 assesses gaze.
15. A patient has normal horizontal extraocular movements
without forced deviation. What gaze score is assigned?
Groups A-F (Patients 1-6) Practice
Questions And Correct Answers
(Verified Answers) Plus Rationale 2026
Q&A| Instant Download Pdf
Section 1: NIHSS Fundamentals
1. What is the primary purpose of the NIH Stroke Scale?
A. Determine the patient's long-term rehabilitation needs
B. Quantify neurological impairment caused by stroke
C. Determine the patient's blood pressure target
D. Diagnose the type of stroke
Rationale: The NIHSS provides a standardized measure of
neurological deficits in patients with acute stroke.
2. How many major assessment items are included in the NIHSS?
A. 8
B. 10
C. 15
D. 20
Rationale: The NIHSS consists of 15 scored neurological assessment
items, although some contain multiple components.
3. Which NIHSS item assesses level of consciousness?
A. 2
B. 1a
,C. 3
D. 4
Rationale: Item 1a evaluates the patient's overall level of
consciousness.
4. A patient is awake, alert, and responds appropriately to the
examiner. What score should be assigned for LOC?
A. 1
B. 0
C. 2
D. 3
Rationale: An alert patient with no impairment of consciousness
receives a score of 0 for item 1a.
5. Which NIHSS component assesses orientation using questions?
A. 1a
B. 1b
C. 1c
D. 2
Rationale: Item 1b evaluates LOC questions, traditionally asking the
patient's age and the current month.
6. If a patient correctly answers both LOC questions, the score is:
A. 1
B. 2
C. 0
D. 3
Rationale: Correctly answering both questions results in a score of 0.
7. If a patient answers one LOC question correctly and one
incorrectly, the score is:
,A. 1
B. 0
C. 2
D. 3
Rationale: One correct answer earns 1 point on item 1b.
8. If a patient answers neither LOC question correctly, the score is:
A. 1
B. 2
C. 3
D. 0
Rationale: Failure to answer either question correctly earns 2 points.
9. What is assessed by NIHSS item 1c?
A. Language
B. LOC commands
C. Facial weakness
D. Sensory loss
Rationale: Item 1c evaluates the patient's ability to follow two simple
commands.
10. Which pair represents the standard commands used for NIHSS
item 1c?
A. Stand and walk
B. Speak and swallow
C. Open/close the eyes and grip/release the hand
D. Raise both legs and sit upright
Rationale: The standard commands assess simple motor responses
involving the eyes and hand.
11. A patient performs both LOC commands correctly. What is the
score?
, A. 1
B. 0
C. 2
D. 3
Rationale: Correctly following both commands earns 0 points.
12. A patient follows one of the two LOC commands but cannot
follow the other. What score is appropriate?
A. 1
B. 0
C. 2
D. 3
Rationale: Following one command correctly earns 1 point.
13. A patient cannot follow either LOC command. What score is
appropriate?
A. 0
B. 1
C. 2
D. 3
Rationale: Failure to follow both commands earns 2 points.
14. Which NIHSS item evaluates horizontal eye movements?
A. 1c
B. 2
C. 3
D. 4
Rationale: Item 2 assesses gaze.
15. A patient has normal horizontal extraocular movements
without forced deviation. What gaze score is assigned?
