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NIHSS Group A – 50 Practice Questions with
Answers and Rationale
1. Level of Consciousness (LOC)
A patient is alert and responsive to questions without any prompting. What is the LOC score?
A. 0
B. 1
C. 2
D. 3
Answer: 0
Rationale: Fully alert and responsive = 0 points.
2. LOC Questions
When asked their age and the current month, the patient answers both correctly. Score?
A. 0
B. 1
C. 2
D. 3
Answer: 0
Rationale: Correct answers for both questions = 0 points.
3. LOC Commands
Patient is asked to open and close eyes and grip and release their hand. Completes all correctly.
Score?
A. 0
B. 1
C. 2
D. 3
Answer: 0
Rationale: Full compliance = 0 points.
2026 2027 GRADED A+
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4. LOC Questions
Patient answers only one of two orientation questions correctly. Score?
A. 0
B. 1
C. 2
D. 3
Answer: 1
Rationale: One correct answer = 1 point.
5. LOC Commands
Patient attempts to follow commands but cannot complete both tasks. Score?
A. 0
B. 1
C. 2
D. 3
Answer: 1
Rationale: Partial compliance = 1 point.
6. Best Gaze
Patient moves eyes fully in all directions without nystagmus or limitation. Score?
A. 0
B. 1
C. 2
Answer: 0
Rationale: Normal gaze = 0 points.
7. Best Gaze
Patient cannot look left voluntarily but moves right without issue. Score?
A. 0
B. 1
C. 2
Answer: 1
Rationale: Partial gaze palsy = 1 point.
2026 2027 GRADED A+
NIHSS Group A – 50 Practice Questions with
Answers and Rationale
1. Level of Consciousness (LOC)
A patient is alert and responsive to questions without any prompting. What is the LOC score?
A. 0
B. 1
C. 2
D. 3
Answer: 0
Rationale: Fully alert and responsive = 0 points.
2. LOC Questions
When asked their age and the current month, the patient answers both correctly. Score?
A. 0
B. 1
C. 2
D. 3
Answer: 0
Rationale: Correct answers for both questions = 0 points.
3. LOC Commands
Patient is asked to open and close eyes and grip and release their hand. Completes all correctly.
Score?
A. 0
B. 1
C. 2
D. 3
Answer: 0
Rationale: Full compliance = 0 points.
2026 2027 GRADED A+
, 2|Page
4. LOC Questions
Patient answers only one of two orientation questions correctly. Score?
A. 0
B. 1
C. 2
D. 3
Answer: 1
Rationale: One correct answer = 1 point.
5. LOC Commands
Patient attempts to follow commands but cannot complete both tasks. Score?
A. 0
B. 1
C. 2
D. 3
Answer: 1
Rationale: Partial compliance = 1 point.
6. Best Gaze
Patient moves eyes fully in all directions without nystagmus or limitation. Score?
A. 0
B. 1
C. 2
Answer: 0
Rationale: Normal gaze = 0 points.
7. Best Gaze
Patient cannot look left voluntarily but moves right without issue. Score?
A. 0
B. 1
C. 2
Answer: 1
Rationale: Partial gaze palsy = 1 point.
2026 2027 GRADED A+
