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NIH Stroke Scale Group D Patient 1-6 Best Quiz
Test Correct Answers Actual Exam 2026/2027
Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
Group D: Patient 1 – Level of Consciousness, Orientation &
Commands (Questions 1-15)
Patient Case Introduction – Patient 1 (Mrs. Eleanor Vance):
Mrs. Vance is a 68-year-old woman brought to the ED by her
daughter after being found confused at home this morning. She
has a history of hypertension and atrial fibrillation. On arrival,
she opens her eyes to voice but seems drowsy. When asked what
month it is, she says "March" (it's actually November). When
asked her age, she says "I'm 65" (she's actually 68). When asked
to close and open her eyes, she does so slowly but correctly.
When asked to grip and release your hand, she does so on both
sides with mild delay.
Q1: You're assessing Mrs. Vance's level of consciousness using
item 1a of the NIHSS. She opens her eyes when you speak to
her name in a normal tone, but before that her eyes were closed
and she appeared to be sleeping. How do you score 1a?
A. 0 – Alert
,2
B. 1 – Not alert; arousable by minor stimulation
C. 2 – Not alert; requires repeated or strong stimulation
D. 3 – Unresponsive or responds only with reflex motor
movements
Correct Answer: B
Rationale: The best answer is B because the patient is not fully
alert—her eyes were closed and she appeared asleep—but she
does respond to voice, which counts as minor stimulation. This
matches the definition for a score of 1 on item 1a.
Q2: Continuing with Mrs. Vance, you ask her "What month is
it?" She looks at you blankly for about 5 seconds, then says "Is
it... springtime? Maybe March?" The actual month is November.
How do you score item 1b (orientation – question 1)?
A. 0 – Answers both orientation questions correctly
B. 1 – Answers one question correctly
C. 2 – Answers neither question correctly
D. 3 – Patient is aphasic or intubated and cannot be scored
Correct Answer: C
Rationale: This choice is correct because she did not provide the
correct answer to the month question. Even though she
attempted an answer, "March" is incorrect, so she gets credit for
,3
zero on this specific question. Her score for 1b will depend on
whether she gets the age question right as well.
Q3: You now ask Mrs. Vance "How old are you?" She pauses,
then says "Well, I turned 65 last year, so I guess I'm 65." Her
chart confirms she is actually 68 years old. Considering both
orientation questions together, what is her final score for item
1b?
A. 0
B. 1
C. 2
D. Cannot be determined without more information
Correct Answer: C
Rationale: This aligns with the NIHSS scoring guidelines
because item 1b scores 0 if both answers are correct, 1 if only
one is correct, and 2 if neither is correct. Since she got the
month wrong AND the age wrong, she earns a 2 for this item.
Q4: Moving to item 1c (commands), you ask Mrs. Vance to
"Close your eyes and open them." She stares at you for several
seconds, then slowly closes her eyes and reopens them after
about a 4-second delay. Is this a correct response for scoring
purposes?
, 4
A. Yes – she completed the task, even with delay
B. No – the response was too slow to count as correct
C. Partial credit should be given
D. The command should be repeated before deciding
Correct Answer: A
Rationale: The best answer is A because the NIHSS focuses on
whether the patient can perform the command, not how quickly
they do it. As long as she understands and completes the action,
it counts as a correct response, even if there's a delayed reaction
time.
Q5: Next, you ask Mrs. Vance to "Grip and release my hand
with your left hand." She looks at your hand, then slowly grips
your fingers and releases them after you say "okay, let go." How
would you score this portion of item 1c?
A. 0 – Performs both commands correctly
B. 1 – Performs one command correctly
C. 2 – Performs neither command correctly
D. 1 – Performs both but with clear effort/deficit
Correct Answer: A
NIH Stroke Scale Group D Patient 1-6 Best Quiz
Test Correct Answers Actual Exam 2026/2027
Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
Group D: Patient 1 – Level of Consciousness, Orientation &
Commands (Questions 1-15)
Patient Case Introduction – Patient 1 (Mrs. Eleanor Vance):
Mrs. Vance is a 68-year-old woman brought to the ED by her
daughter after being found confused at home this morning. She
has a history of hypertension and atrial fibrillation. On arrival,
she opens her eyes to voice but seems drowsy. When asked what
month it is, she says "March" (it's actually November). When
asked her age, she says "I'm 65" (she's actually 68). When asked
to close and open her eyes, she does so slowly but correctly.
When asked to grip and release your hand, she does so on both
sides with mild delay.
Q1: You're assessing Mrs. Vance's level of consciousness using
item 1a of the NIHSS. She opens her eyes when you speak to
her name in a normal tone, but before that her eyes were closed
and she appeared to be sleeping. How do you score 1a?
A. 0 – Alert
,2
B. 1 – Not alert; arousable by minor stimulation
C. 2 – Not alert; requires repeated or strong stimulation
D. 3 – Unresponsive or responds only with reflex motor
movements
Correct Answer: B
Rationale: The best answer is B because the patient is not fully
alert—her eyes were closed and she appeared asleep—but she
does respond to voice, which counts as minor stimulation. This
matches the definition for a score of 1 on item 1a.
Q2: Continuing with Mrs. Vance, you ask her "What month is
it?" She looks at you blankly for about 5 seconds, then says "Is
it... springtime? Maybe March?" The actual month is November.
How do you score item 1b (orientation – question 1)?
A. 0 – Answers both orientation questions correctly
B. 1 – Answers one question correctly
C. 2 – Answers neither question correctly
D. 3 – Patient is aphasic or intubated and cannot be scored
Correct Answer: C
Rationale: This choice is correct because she did not provide the
correct answer to the month question. Even though she
attempted an answer, "March" is incorrect, so she gets credit for
,3
zero on this specific question. Her score for 1b will depend on
whether she gets the age question right as well.
Q3: You now ask Mrs. Vance "How old are you?" She pauses,
then says "Well, I turned 65 last year, so I guess I'm 65." Her
chart confirms she is actually 68 years old. Considering both
orientation questions together, what is her final score for item
1b?
A. 0
B. 1
C. 2
D. Cannot be determined without more information
Correct Answer: C
Rationale: This aligns with the NIHSS scoring guidelines
because item 1b scores 0 if both answers are correct, 1 if only
one is correct, and 2 if neither is correct. Since she got the
month wrong AND the age wrong, she earns a 2 for this item.
Q4: Moving to item 1c (commands), you ask Mrs. Vance to
"Close your eyes and open them." She stares at you for several
seconds, then slowly closes her eyes and reopens them after
about a 4-second delay. Is this a correct response for scoring
purposes?
, 4
A. Yes – she completed the task, even with delay
B. No – the response was too slow to count as correct
C. Partial credit should be given
D. The command should be repeated before deciding
Correct Answer: A
Rationale: The best answer is A because the NIHSS focuses on
whether the patient can perform the command, not how quickly
they do it. As long as she understands and completes the action,
it counts as a correct response, even if there's a delayed reaction
time.
Q5: Next, you ask Mrs. Vance to "Grip and release my hand
with your left hand." She looks at your hand, then slowly grips
your fingers and releases them after you say "okay, let go." How
would you score this portion of item 1c?
A. 0 – Performs both commands correctly
B. 1 – Performs one command correctly
C. 2 – Performs neither command correctly
D. 1 – Performs both but with clear effort/deficit
Correct Answer: A
