NIHSS Final Exam Questions With All
Solved Solutions 2025\2026 Updated.
If a patient is not following commands, how can you assess visual fields? - Answer Visual
Threat:
0 - pt blinking in both eyes to threat
2 - blinks in only one eye
3 - patient is blind
Extinction / Inattention - Answer Have pt look at yr nose, hold both hands up and wiggle one
hand.
Ask pt to point to hand that is moving.
Wiggle both hands and ask pt to point or state which hands are moving.
Have pt close eyes, ask them to tell you which side you are touching or tapping: R, L, or both.
Check on pt's cheeks, arms, and legs.
0 - normal
1 - pt cannot see / feel both sides when hands are wiggling OR when pt is being touched both
sides at same time
2 pt cannot see both sides AND pt cannot feel both sides at same time
If pt has severe vision loss but no other issues w/ identifying stimulation - Score 0
Pt cannot follow commands - Score 0
Inattention - Answer
For NIHSS, a higher score signifies... - Answer more deficits (worse condition)
Level of Consciousness Test - Answer Observe pt's alertness
Call pt by name to awaken if asleep
If no response, physical stimulation
, 3 - only responds w/ reflex motor/autonomic effects
Level of Consciousness Questions - Answer What month is it?
How old are you?
0 - both answered correctly
1 - one answered correctly
2 - both answers wrong
For aphasic pts: give options, ask pt to nod at correct option
Level of Consciousness Commands - Answer Ask pt to follow 2 simple commands (e.g. open
and close eyes, grip hand)
0 - follows both commands
1 - follows 1 command
2 - follows no commands correctly
Best Gaze Score (horizontal eye movements) - Answer Ask pt to follow finger from side to side,
watch their eye movements
0 = Normal and smooth eye movements side to side
1 = Partial gaze, abnormal gaze in one or both eyes
2 = Forced eye deviation or total paresis, eyes stuck to one side or cannot pass midline
If pt does not follow commands, make eye contact and move from one side of bed to the other,
see if maintains eye contact
oculo-cephalic reflex - Answer Does pt's eye stay fixed on same object even if their head is
moved from side to side?
No eye movement across midline = negative oculo-cephalic reflex = doll's eye = Best Gaze score
of 2
Solved Solutions 2025\2026 Updated.
If a patient is not following commands, how can you assess visual fields? - Answer Visual
Threat:
0 - pt blinking in both eyes to threat
2 - blinks in only one eye
3 - patient is blind
Extinction / Inattention - Answer Have pt look at yr nose, hold both hands up and wiggle one
hand.
Ask pt to point to hand that is moving.
Wiggle both hands and ask pt to point or state which hands are moving.
Have pt close eyes, ask them to tell you which side you are touching or tapping: R, L, or both.
Check on pt's cheeks, arms, and legs.
0 - normal
1 - pt cannot see / feel both sides when hands are wiggling OR when pt is being touched both
sides at same time
2 pt cannot see both sides AND pt cannot feel both sides at same time
If pt has severe vision loss but no other issues w/ identifying stimulation - Score 0
Pt cannot follow commands - Score 0
Inattention - Answer
For NIHSS, a higher score signifies... - Answer more deficits (worse condition)
Level of Consciousness Test - Answer Observe pt's alertness
Call pt by name to awaken if asleep
If no response, physical stimulation
, 3 - only responds w/ reflex motor/autonomic effects
Level of Consciousness Questions - Answer What month is it?
How old are you?
0 - both answered correctly
1 - one answered correctly
2 - both answers wrong
For aphasic pts: give options, ask pt to nod at correct option
Level of Consciousness Commands - Answer Ask pt to follow 2 simple commands (e.g. open
and close eyes, grip hand)
0 - follows both commands
1 - follows 1 command
2 - follows no commands correctly
Best Gaze Score (horizontal eye movements) - Answer Ask pt to follow finger from side to side,
watch their eye movements
0 = Normal and smooth eye movements side to side
1 = Partial gaze, abnormal gaze in one or both eyes
2 = Forced eye deviation or total paresis, eyes stuck to one side or cannot pass midline
If pt does not follow commands, make eye contact and move from one side of bed to the other,
see if maintains eye contact
oculo-cephalic reflex - Answer Does pt's eye stay fixed on same object even if their head is
moved from side to side?
No eye movement across midline = negative oculo-cephalic reflex = doll's eye = Best Gaze score
of 2
