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NIH Stroke Scale Group E – Study & Simulation Practice Updated Spring 2025 | Educational Use Only

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This NIH Stroke Scale (NIHSS) Group E study and simulation practice guide provides an updated, evidence-based review of the standardized stroke assessment tool used to evaluate and quantify neurological deficits in patients with suspected or confirmed stroke. The Spring 2025 edition integrates the most recent clinical guidelines and simulation-based learning strategies for nurses, medical students, and other healthcare professionals preparing for NIHSS certification or clinical competency validation. Key Learning Areas Overview of the NIH Stroke Scale structure and scoring Step-by-step assessment criteria for each item (LOC, gaze, visual fields, motor, sensory, language, neglect, etc.) Interpretation of total scores and severity levels Common pitfalls and interrater reliability tips Case-based simulation exercises for real-world application Practice questions with correct scoring keys and rationales

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NIH Stroke Scale Group E

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NIH Stroke Scale Group E – Study & Simulation Practice
Updated Spring 2025 | Educational Use Only


Overview of NIH Stroke Scale (NIHSS)

The NIH Stroke Scale objectively measures stroke-related neurologic deficits.
It evaluates 11 domains of function and provides a numeric score (0–42).
Lower scores = less impairment; higher scores = more severe stroke.

ITEM DOMAIN ASSESSED SCORING RANGE
1A Level of consciousness (LOC) 0–3
1B LOC Questions 0–2
1C LOC Commands 0–2
2 Best Gaze 0–2
3 Visual Fields 0–3
4 Facial Palsy 0–3
5A Motor Arm (Left) 0–4
5B Motor Arm (Right) 0–4
6A Motor Leg (Left) 0–4
6B Motor Leg (Right) 0–4
7 Limb Ataxia 0–2
8 Sensory 0–2
9 Language 0–3
10 Dysarthria 0–2
11 Extinction and Inattention (Neglect) 0–2


Group E – Six Case Simulations (Training Set)

(Simulated practice only; not real patient cases)

Each “Patient” example mirrors NIHSS Group E training logic.

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NIH Stroke Scale Group E

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