NIH Stroke Scale Group B
1. Level of Consciousness (1a):
The patient is alert and responsive.
A. 3 - Responds only with reflexes
B. 2 - Requires repeated stimulation
C. 1 - Not alert but arousable
D. 0 - Alert, keenly responsive
✅Correct Answer: D (0)
Rationale: The patient shows normal alertness and responsiveness, corresponding to an NIHSS
score of 0.
2. Orientation (1b):
The patient correctly answers only one of two questions (month and age).
A. 0 - Both correct
B. 1 - One correct
C. 2 - None correct
D. 3 - No response
✅Correct Answer: B (1)
Rationale: One correct answer indicates mild disorientation; NIHSS assigns a score of 1.
3. Commands (1c):
The patient follows both commands: “Blink eyes” and “Squeeze hands.”
A. 0 - Performs both correctly
B. 1 - Performs one correctly
C. 2 - Performs none correctly
D. 3 - Unresponsive
✅Correct Answer: A (0)
Rationale: Full compliance with both commands scores 0 for normal performance.
4. Gaze (2):
The patient has full horizontal gaze movement.
A. 0 - Normal
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B. 1 - Partial gaze palsy
C. 2 - Total gaze palsy
D. 3 - Forced deviation
✅Correct Answer: A (0)
Rationale: Normal conjugate gaze yields a score of 0.
5. Visual Fields (3):
The patient sees all quadrants normally.
A. 0 - No visual loss
B. 1 - Partial hemianopia
C. 2 - Complete hemianopia
D. 3 - Bilateral hemianopia
✅Correct Answer: A (0)
Rationale: No visual field defect = NIHSS score of 0.
6. Facial Palsy (4):
Minor droop noted on the left side of the face.
A. 0 - Normal
B. 1 - Minor facial weakness
C. 2 - Partial paralysis
D. 3 - Complete paralysis
✅Correct Answer: B (1)
Rationale: Slight asymmetry indicates mild facial weakness, scoring 1.
7. Left Arm Motor (5a):
The arm stays up for 10 seconds without drift.
A. 0 - No drift
B. 1 - Drift before 10 sec
C. 2 - Falls before 10 sec
D. 3 - No movement
✅Correct Answer: A (0)
Rationale: Maintaining full elevation = normal motor function (0).