NIH STROKE SCALE ALL TEST GROUPS A-F
PATIENTS 1-6 EXAMINATION TEST 2026
COMPLETE ANSWER KEY UPDATED
SOLUTIONS GRADED A+
⩥ NIH 4: for aphasic, poorly responsive or noncomprehending patient,
use what kind of stimulus?
If using this stimulus, what is the basis for the scoring? Answer: noxious
-the symmetry of the grimace
⩥ NIH Item #4 Scoring
0
1
2
3. Answer: 0 - normal symmetrical movement
1 - minor paralysis such as a flattened nasolabial fold or mild asymmetry
while smiling - proper score if function is less than clearly normal
2-paralysis of the lower face - appropriate for clear cut upper motor
neuron facial palsy
3- complete paralysis of the upper and lower face - appropriate score for
obtunded or comatose patient or one with unilateral-lower motor neuron
facial weakness
,⩥ decreased spontaneous and forced facial movements are most
prominent at what location. Answer: the mouth
⩥ if there is a clear cut asymmetry of the smile, the score is.... Answer:
two, all other subtle asymmetries are scored as a one
⩥ score of 3 re: face is reserved for unusual complete paralysis seen
with some strokes of what kind. Answer: some brain stem strokes
⩥ NIH scale item 5 is.... Answer: Item 5 - Motor Arm
⩥ what is proper positioning for item 5 motor arm movement?. Answer:
extend arms 90 deg if sitting OR 45 deg if supine
⩥ item 5 leg test always in what position and how many deg. Answer:
leg motor test supine and extended 30 deg
⩥ for item 5 motor arm, score a drift if arm does when and when?.
Answer: if arm falls before 10 seconds as you count down out loud
⩥ for motor leg, score a drift if leg does what and when. Answer: if leg
falls before 5 seconds
, ⩥ motor items: begin counting when?. Answer: immediately at the
release of the limb
⩥ how should the examiner be counting down?
why?. Answer: verbally and with fingers in full view of the patient, so
the patient receives verbal and visual input
⩥ watch for what upon release of the limb? what to consider about this?.
Answer: watch for an initial dip after release of the limb, only score
abnormal if there is a downward drift after the dip
⩥ each arm is tested in turn beginning with the.... Answer: non-paretic
arm
⩥ when testing arms, what position for palms?. Answer: down
⩥ can limbs be tested simultaneously?. Answer: NO
⩥ in what cases are the motor items not scored?. Answer: only in the
case of amputation or joint fusion of the shoulder or hip, BUT A
WRITTEN NOTE OF THIS MUST BE NOTED - IF advised to score 9,
do not use in calculating score
PATIENTS 1-6 EXAMINATION TEST 2026
COMPLETE ANSWER KEY UPDATED
SOLUTIONS GRADED A+
⩥ NIH 4: for aphasic, poorly responsive or noncomprehending patient,
use what kind of stimulus?
If using this stimulus, what is the basis for the scoring? Answer: noxious
-the symmetry of the grimace
⩥ NIH Item #4 Scoring
0
1
2
3. Answer: 0 - normal symmetrical movement
1 - minor paralysis such as a flattened nasolabial fold or mild asymmetry
while smiling - proper score if function is less than clearly normal
2-paralysis of the lower face - appropriate for clear cut upper motor
neuron facial palsy
3- complete paralysis of the upper and lower face - appropriate score for
obtunded or comatose patient or one with unilateral-lower motor neuron
facial weakness
,⩥ decreased spontaneous and forced facial movements are most
prominent at what location. Answer: the mouth
⩥ if there is a clear cut asymmetry of the smile, the score is.... Answer:
two, all other subtle asymmetries are scored as a one
⩥ score of 3 re: face is reserved for unusual complete paralysis seen
with some strokes of what kind. Answer: some brain stem strokes
⩥ NIH scale item 5 is.... Answer: Item 5 - Motor Arm
⩥ what is proper positioning for item 5 motor arm movement?. Answer:
extend arms 90 deg if sitting OR 45 deg if supine
⩥ item 5 leg test always in what position and how many deg. Answer:
leg motor test supine and extended 30 deg
⩥ for item 5 motor arm, score a drift if arm does when and when?.
Answer: if arm falls before 10 seconds as you count down out loud
⩥ for motor leg, score a drift if leg does what and when. Answer: if leg
falls before 5 seconds
, ⩥ motor items: begin counting when?. Answer: immediately at the
release of the limb
⩥ how should the examiner be counting down?
why?. Answer: verbally and with fingers in full view of the patient, so
the patient receives verbal and visual input
⩥ watch for what upon release of the limb? what to consider about this?.
Answer: watch for an initial dip after release of the limb, only score
abnormal if there is a downward drift after the dip
⩥ each arm is tested in turn beginning with the.... Answer: non-paretic
arm
⩥ when testing arms, what position for palms?. Answer: down
⩥ can limbs be tested simultaneously?. Answer: NO
⩥ in what cases are the motor items not scored?. Answer: only in the
case of amputation or joint fusion of the shoulder or hip, BUT A
WRITTEN NOTE OF THIS MUST BE NOTED - IF advised to score 9,
do not use in calculating score
