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NIH Stroke Scale (NIHSS) Cheat Sheet & Practice Questions | Updated 2025–2026 | NCLEX & HESI Prep

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Get exam-ready with this NIH Stroke Scale (NIHSS) Cheat Sheet & QBank, fully updated for 2025–2026. Includes complete scoring breakdown, interpretation tips, patient scenarios, and practice questions with correct answers and rationales. Perfect for nursing students, NCLEX & HESI exams, stroke certification, and neuro rotation prep. Covers Level of Consciousness, Motor Response, Gaze, Language, and more Includes realistic practice questions and answer key Designed for NCLEX-RN, HESI, EMT, and clinical training A+ Graded | Verified | Printable | FAST stroke response mastery

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Stroke
Study online at https://quizlet.com/_2lo91w

Understand the basic cerebral anatomy

Have an understanding of the different
L1 Learning objectives types of stroke

Be able to discuss the signs and symp-
toms associated with stroke
Stroke is a brain injury caused by an
What is stroke abnormality of the blood supply to a part
of the brain. (Caplan, 2006)
Why stroke is important (essay intro ma- Stroke is the 3rd leading cause of death
terial) in the world (Hankey, 1999)

A lack of blood or a cut off supply. Polar
opposite to Haemorrhagic...which is too
much blood. 4/5 Strokes are Ischemic.
(Caplan, 2006)

Thrombosis = "Rust build up in the pipes"
Cholesterol coating the walls (Atherscle-
rosis) resulting in a blood clot
(can be treated by surgery unblocking?)
(Caplan, 2006)

Embolism = particles breaking loose and
Ischaemic stroke blocking a distant artery (Caplan, 2006)

Systemic hypoperfusion = abnormal per-
formance of the heart leading to low
pressure in the system, or inadequte
blood and fluid being pumped around
(Caplan, 2006)

Thrombosis and Embolism = specific
blockages and damage to specific brain
areas (focal abnormalities)
Systemic hypoperfusion = more diffuse
leading to light-headedness, dizziness,


, Stroke
Study online at https://quizlet.com/_2lo91w
confusion, damage to sight and hearing,
pale, weak (Caplan, 2006)
Temporary blockages caused by an em-
bolus that passes or inadequacy of blood
flow through a narrowed artery (Caplan,
2006)

THey warn of the possibility of a stroke as
they are the same symptoms as a stroke
Transient Ischaemic attack (TIA)
but only lasting a couple minutes or an
hour (Caplan, 2006)

Approximately 10% to 15% of patients
who suffer a TIA
will have strokes within 3 months (Alpert,
2011)

bleeding inside the skull either into the
brain or into fluid surrounding the brain
(Caplan, 2006)

Intracerebral hemorrhages = Hemor-
rhages within the pia mater and arach-
noid. Hematoma is localized and causes
damage to one specific area (Caplan,
2006)

Subarachnoid Hemorrhage = Sudden re-
Haemorrhagic Stroke
lease of blood under high pressure in-
creases pressure in the skull causing
sudden onset headache, vomiting and
a lapse in brain function and confusion
and unable to remember anything. Also
associated with a general decrease in
brain function as it is not just in one spe-
cific area as blood flows everywhere and
the pressure increases everywhere too
(Caplan, 2006)



,Stroke
Study online at https://quizlet.com/_2lo91w
Subdural hemorrhages = head injury
based trauma tearing veins...bleeding
can be slow resulting in brain dysfunc-
tion may be delayed for weeks (Caplan,
2006)

Epidural hemorrhages = head injury
based trauma tearing arteries...so blood
is released faster and symptoms develop
soon after (Caplan, 2006)


Dependant on where in brain matter in-
jury occurs
Left hemisphere= weakness and loss of
Area of damage feeling in right limbs and loss of normal
left vs right hemisphere speech (Caplan, 2006)
Cerebellum
Brainstem Cerebellum= dizziness and loss of bal-
ance (Caplan, 2006)
Stroke is increasing in prevalence across
the world especially in developing coun-
tries. Stroke can be long term and cost
Feigin, 2003 from 60000-240000$ across a lifetime.
More people are surviving strokes how-
ever with mortality rates dropping. (All of
this is in general from a meta analysis)

Overall, women have a lower risk of
stroke compared to men, but this dis-
parity diminishes following menopause
when they have more strokes and worse
outcomes as compared to men. Unless
Wilson, 2013
replacement hormones are used.


80% don't call within 10 mins



, Stroke
Study online at https://quizlet.com/_2lo91w
woman better at recognising signs but
worse at going
Numbness or weakness (motor cortex,
primary somatosensory cortex) ....droop
on side of face??

Sudden trouble speaking and under-
standing others (Broca's area, Wer-
nicke's area)
Grady et al 2014 Signs and symptoms
Problems with vision

Sudden dizziness or loss of balance or
coordination

Sudden severe headache
Be able to discuss initial assessment and
treatments for stroke.

Have an understanding of how brain in-
L2 Learning objectives
jury following a stroke can progress.

Be able to outline and discuss how
strokes can be prevented
Of those who suffer a first stroke, approx-
imately
(Alpert, 2011)
20% die within 12 months of the inci-
dence.
Weakness of arm or leg on one side of
body
Numbness of face, arm, leg on one side
Temporary loss of vision in one eye
TIA symptoms Double vision
Loss of ability to speak normally
Incoordination of the limbs or walking
Dizziness and loss of balance (Caplan,
2006)
Diagnosing stroke steps

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