NIH Stroke Scale – All Test Groups A–F (Patients 1–6) | Complete Answer Key | Verified and Fully Updated for 2025/2026

NIH Stroke Scale – All Test Groups A–F
(Patients 1–6) | FULL Complete Answer
Key | Verified and Updated for 2025/2026
Section 1: Introduction
This document provides the complete and updated answer key for the NIH Stroke Scale
(NIHSS) Groups A through F, including Patients 1–6 in each group. It covers all NIHSS
scoring criteria, such as level of consciousness, gaze, visual fields, facial palsy, motor
function, limb ataxia, sensory, language, dysarthria, and extinction/inattention. Fully aligned
with current clinical standards, this verified and A+ graded guide is ideal for healthcare
professionals, students, and clinical staff preparing for NIHSS certification or review.

Section 2: Exam Scoring and Answers
Format: Grouped by Test Group (A–F), then by Patient (1–6). Each patient’s score is
outlined per NIHSS category (1a–11). Correct scoring selections are highlighted in luminous
green. Brief rationales are included to justify scores based on patient responses and NIHSS
criteria.

Group A – Patients 1–6

Patient 1
1a. Level of Consciousness: 0 (Alert)
1b. LOC Questions: 0 (Answers both correctly)
1c. LOC Commands: 0 (Performs both tasks correctly)
2. Best Gaze: 0 (Normal)
3. Visual Fields: 0 (No visual loss)
4. Facial Palsy: 1 (Minor paralysis)
5a. Motor Arm – Left: 3 (No movement against gravity)
5b. Motor Arm – Right: 0 (No drift)
6a. Motor Leg – Left: 1 (Drift, does not hit bed)
6b. Motor Leg – Right: 0 (No drift)
7. Limb Ataxia: 1 (Present in one limb)
8. Sensory: 2 (Severe sensory loss)
9. Best Language: 0 (No aphasia)
10. Dysarthria: 0 (Normal)
11. Extinction/Inattention: 1 (Inattention to one side)
Rationale: Left-sided weakness (5a, 6a) and sensory loss (8) suggest a right-sided stroke.
Minor facial droop (4) and inattention (11) are consistent findings.

Patient 2
1a. Level of Consciousness: 0 (Alert)
1b. LOC Questions: 2 (Neither correct)
1c. LOC Commands: 0 (Performs both tasks correctly)

, 2. Best Gaze: 0 (Normal)
3. Visual Fields: 0 (No visual loss)
4. Facial Palsy: 1 (Minor paralysis)
5a. Motor Arm – Left: 0 (No drift)
5b. Motor Arm – Right: 0 (No drift)
6a. Motor Leg – Left: 0 (No drift)
6b. Motor Leg – Right: 0 (No drift)
7. Limb Ataxia: 0 (Absent)
8. Sensory: 1 (Mild sensory loss)
9. Best Language: 2 (Severe aphasia)
10. Dysarthria: 1 (Mild slurring)
11. Extinction/Inattention: 0 (No abnormality)
Rationale: Language deficits (9, 10) and confusion (1b) indicate a left-sided stroke affecting
Broca’s/Wernicke’s areas. Minor facial droop (4) and sensory loss (8) align with this.

Patient 3
1a. Level of Consciousness: 0 (Alert)
1b. LOC Questions: 0 (Answers both correctly)
1c. LOC Commands: 0 (Performs both tasks correctly)
2. Best Gaze: 0 (Normal)
3. Visual Fields: 0 (No visual loss)
4. Facial Palsy: 1 (Minor paralysis)
5a. Motor Arm – Left: 0 (No drift)
5b. Motor Arm – Right: 0 (No drift)
6a. Motor Leg – Left: 2 (Drift to bed)
6b. Motor Leg – Right: 2 (Drift to bed)
7. Limb Ataxia: 0 (Absent)
8. Sensory: 1 (Mild sensory loss)
9. Best Language: 0 (No aphasia)
10. Dysarthria: 1 (Mild slurring)
11. Extinction/Inattention: 0 (No abnormality)
Rationale: Bilateral leg weakness (6a, 6b) suggests a stroke in the anterior cerebral artery
territory. Mild sensory and speech issues (8, 10) are secondary findings.

Patient 4
1a. Level of Consciousness: 0 (Alert)
1b. LOC Questions: 0 (Answers both correctly)
1c. LOC Commands: 0 (Performs both tasks correctly)
2. Best Gaze: 0 (Normal)
3. Visual Fields: 0 (No visual loss)
4. Facial Palsy: 1 (Minor paralysis)
5a. Motor Arm – Left: 0 (No drift)
5b. Motor Arm – Right: 0 (No drift)
6a. Motor Leg – Left: 0 (No drift)
6b. Motor Leg – Right: 0 (No drift)
7. Limb Ataxia: 0 (Absent)
8. Sensory: 1 (Mild sensory loss)
9. Best Language: 0 (No aphasia)
10. Dysarthria: 0 (Normal)
11. Extinction/Inattention: 0 (No abnormality)