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Exam (elaborations)

APEX NIH Stroke Scale – Group A Patients 1–6 Practice Exam (2026) – Complete practice questions with correct answers

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This document provides an extensive practice exam for the APEX NIH Stroke Scale (NIHSS), focusing on Group A patients 1–6. It includes multiple-choice and applied short-answer questions with correct answers and rationales, covering all NIHSS items such as level of consciousness, motor function, language, sensory testing, neglect, and stroke severity interpretation. The material is designed for exam preparation and clinical skill reinforcement for stroke assessment in 2026.

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APEX NIH STROKE SCALE – GROUP A PATIENTS
1–6 PRACTICE EXAM (2026) QUESTIONS AND
CORRECT ANSWERS


1. Patient 1 opens eyes only after repeated painful stimulus. How is Level
of Consciousness (LOC) scored?
A. 0
B. 1
C. 2
D. 3
Answer: C
Rationale: Eye opening only to repeated or painful stimulation is scored
as LOC 2.

2. Patient 1 correctly states their age but gives the wrong month. LOC
Questions score is:
A. 0
B. 1
C. 2
D. Not testable
Answer: B
Rationale: One correct answer equals a score of 1.

3. Patient 1 follows one command but not the second. LOC
Commands score is:
A. 0
B. 1
C. 2
D. 3
Answer: B
Rationale: Following only one command scores 1.

4. Patient 2 has a normal gaze with full voluntary eye movements. Best

, gaze score is:
A. 0
B. 1
C. 2
D. 3
Answer: A
Rationale: Normal horizontal eye movements score 0.

5. Patient 2 has forced deviation of eyes to the left that cannot be
overcome. Best gaze score is:
A. 0
B. 1
C. 2
D. 3
Answer: C
Rationale: Forced deviation scores 2.

6. Patient 3 has complete hemianopia on the right side. Visual fields score
is:
A. 0
B. 1
C. 2
D. 3
Answer: C
Rationale: Complete hemianopia equals a score of 2.

7. Patient 3 ignores visual stimuli on both sides. Visual score is:
A. 1
B. 2
C. 3
D. 0
Answer: C
Rationale: Bilateral blindness scores 3.

8. Patient 4 shows minor facial asymmetry when smiling. Facial palsy
score is:

, A. 0
B. 1
C. 2
D. 3
Answer: B
Rationale: Minor paralysis scores 1.

9. Patient 4 has complete paralysis of one side of the face. Facial palsy
score is:
A. 1
B. 2
C. 3
D. 0
Answer: C
Rationale: Complete facial paralysis scores 3.

10. Patient 5’s left arm drifts down but does not hit the bed.
Motor arm score is:
A. 0
B. 1
C. 2
D. 3
Answer: B
Rationale: Drift without hitting the bed scores 1.

11. Patient 5’s right arm falls rapidly and hits the bed. Motor arm score
is:
A. 1
B. 2
C. 3
D. 4
Answer: C
Rationale: Some effort against gravity but falls scores 3.

12. Patient 6 shows no movement in the left arm. Motor arm score

Document information

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January 8, 2026
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