NIHSS CERTIFICATION TEST QUESTIONS AND ANSWERS 2025/2026

NIHSS CERTIFICATION TEST QUESTIONS AND ANSWERS 2025/2026 11 components of NIHSS 1. LOC (Question & Command) 2. Gaze 3. Visual field 4. Facial palsy 5. Upper extremity 6. Lower extremity 7. Limb ataxia 8. Sensory 9. Best language 10. Dysarthria 11. Extinction & inattention1A - LOC 0 = Alert 1 = Not alert; aroused with minor verbal stimulation 2 = Not alert; requires strong or painful stimulation 3 = Reflex movements only or totally unresponsive (COMA ~ try rub on chest) --- 1a. Level of Consciousness: The investigator must choose a response, even if a full evaluation is prevented by such obstacles as an endotracheal tube, language barrier, orotracheal trauma/bandages. A 3 is scored only if the patient makes no movement (other than reflexive posturing) in response to noxious stimulation.* 1B - LOC Questions (2)Month of year Patient age ----- 0 = Answers both questions correctly 1 = Answers one question correctly 2 = Answers neither question correctly --- 1b. LOC Questions: The patient is asked the month and his/her age. The answer must be correct - there is no partial credit for being close. Aphasic and stuporous patients who do not comprehend the questions will score 2. Patients unable to speak because of endotracheal intubation, orotracheal trauma, severe dysarthria from any cause, language barrier or any other problem not secondary to aphasia are given a 1. It is important that only the initial answer be graded and that the examiner not "help" the patient with verbal or non-verbal cues.*