APEX NIH STROKE SCALE GROUP B PATIENT 1-6
(ADVENTHEALTH 2025/2026) PASSED!!
Question 1
During the Level of Consciousness (LOC) Questions item, the patient --answer--s
"September" for the month and "New York" for their location, but is unable to
state their age. What is the correct score?
A) 0
B) 1
C) 2
D) 3
--answer--: B) 1
Explanation: A score of 1 is given if the patient --answer--s one question correctly.
They correctly --answer--ed two questions (month, location) but failed one (age).
The score is based on number of correct --answer--s: 2 correct = 1, not the
number incorrect.
Question 2
When testing LOC Commands, you ask the patient to "close your eyes" and then
"make a fist." The patient closes their eyes but only makes a weak, partial effort
to form a fist with the right hand. The left hand does not move. Score?
A) 0
B) 1
C) 2
D) 3
,--answer--: B) 1
Explanation: A score of 1 is for partial or fragmentary performance (obeys one
command fully and attempts another). Here, one command (close eyes) is fully
obeyed, and an attempt is made at the second, despite hemiparesis.
Question 3
You are assessing Best Gaze. The patient's eyes are closed due to a dense left
hemiplegia. How should you proceed?
A) Score a 3 for forced deviation.
B) Score a 2 for complete gaze palsy.
C) Score a 0, as you cannot test it.
D) Manually open the eyelids and observe eye position at rest, then test voluntary
saccades.
--answer--: D) Manually open the eyelids and observe eye position at rest, then
test voluntary saccades.
Explanation: Eyelid closure does not preclude testing. You must open the lids and
first observe the resting position, then ask the patient to look at your face and
follow your finger. Scoring is based on the movement of the eyes, not the lids.
Question 4
In Visual Fields, you use confrontation testing with finger counting. The patient
accurately identifies fingers in the entire right visual field but misses all stimuli
presented in the left superior and left inferior quadrants. Both eyes are open.
Score?
A) 1 (Partial hemianopia)
B) 2 (Complete hemianopia)
C) 3 (Bilateral hemianopia)
D) 0 (No visual loss)
--answer--: B) 2 (Complete hemianopia)
Explanation: Missing all stimuli in both the superior and inferior quadrants of the
left side constitutes a complete left homonymous hemianopia. This is scored a 2,
even if the right field is intact.
Question 5
, Facial Palsy: The patient has complete drooping of the lower face on the right
side, but when asked to raise eyebrows, both sides raise symmetrically and fully.
Score?
A) 1 (Minor paralysis)
B) 2 (Partial paralysis)
C) 3 (Complete paralysis)
D) 0 (Normal)
--answer--: B) 2 (Partial paralysis)
Explanation: The upper face (forehead) has bilateral cortical innervation, so it may
be spared in a central (UMN) lesion. Significant, obvious lower facial weakness
with normal upper face function is scored as a 2 (partial).
Question 6
Motor Arm - Left: You place the left arm in the 90-degree (sitting) or 45-degree
(supine) position. The arm drifts down within 5 seconds but does not hit the bed.
Score?
A) 0 (No drift)
B) 1 (Drift)
C) 2 (Some effort against gravity)
D) 3 (No effort against gravity)
--answer--: B) 1 (Drift)
Explanation: A "drift" is defined as the limb falling relative to the starting position
before 10 seconds have elapsed, but not hitting the bed or other support. This is a
classic score of 1.
Question 7
Motor Leg - Right: You test the right leg in the 30-degree position (always supine).
The leg falls immediately to the bed with no effort to hold position. Score?
A) 1 (Drift)
B) 2 (Some effort against gravity)
C) 3 (No effort against gravity)
D) 4 (No movement)
--answer--: C) 3 (No effort against gravity)
Explanation: If the limb falls immediately to the bed (or has a barely flicker of
(ADVENTHEALTH 2025/2026) PASSED!!
Question 1
During the Level of Consciousness (LOC) Questions item, the patient --answer--s
"September" for the month and "New York" for their location, but is unable to
state their age. What is the correct score?
A) 0
B) 1
C) 2
D) 3
--answer--: B) 1
Explanation: A score of 1 is given if the patient --answer--s one question correctly.
They correctly --answer--ed two questions (month, location) but failed one (age).
The score is based on number of correct --answer--s: 2 correct = 1, not the
number incorrect.
Question 2
When testing LOC Commands, you ask the patient to "close your eyes" and then
"make a fist." The patient closes their eyes but only makes a weak, partial effort
to form a fist with the right hand. The left hand does not move. Score?
A) 0
B) 1
C) 2
D) 3
,--answer--: B) 1
Explanation: A score of 1 is for partial or fragmentary performance (obeys one
command fully and attempts another). Here, one command (close eyes) is fully
obeyed, and an attempt is made at the second, despite hemiparesis.
Question 3
You are assessing Best Gaze. The patient's eyes are closed due to a dense left
hemiplegia. How should you proceed?
A) Score a 3 for forced deviation.
B) Score a 2 for complete gaze palsy.
C) Score a 0, as you cannot test it.
D) Manually open the eyelids and observe eye position at rest, then test voluntary
saccades.
--answer--: D) Manually open the eyelids and observe eye position at rest, then
test voluntary saccades.
Explanation: Eyelid closure does not preclude testing. You must open the lids and
first observe the resting position, then ask the patient to look at your face and
follow your finger. Scoring is based on the movement of the eyes, not the lids.
Question 4
In Visual Fields, you use confrontation testing with finger counting. The patient
accurately identifies fingers in the entire right visual field but misses all stimuli
presented in the left superior and left inferior quadrants. Both eyes are open.
Score?
A) 1 (Partial hemianopia)
B) 2 (Complete hemianopia)
C) 3 (Bilateral hemianopia)
D) 0 (No visual loss)
--answer--: B) 2 (Complete hemianopia)
Explanation: Missing all stimuli in both the superior and inferior quadrants of the
left side constitutes a complete left homonymous hemianopia. This is scored a 2,
even if the right field is intact.
Question 5
, Facial Palsy: The patient has complete drooping of the lower face on the right
side, but when asked to raise eyebrows, both sides raise symmetrically and fully.
Score?
A) 1 (Minor paralysis)
B) 2 (Partial paralysis)
C) 3 (Complete paralysis)
D) 0 (Normal)
--answer--: B) 2 (Partial paralysis)
Explanation: The upper face (forehead) has bilateral cortical innervation, so it may
be spared in a central (UMN) lesion. Significant, obvious lower facial weakness
with normal upper face function is scored as a 2 (partial).
Question 6
Motor Arm - Left: You place the left arm in the 90-degree (sitting) or 45-degree
(supine) position. The arm drifts down within 5 seconds but does not hit the bed.
Score?
A) 0 (No drift)
B) 1 (Drift)
C) 2 (Some effort against gravity)
D) 3 (No effort against gravity)
--answer--: B) 1 (Drift)
Explanation: A "drift" is defined as the limb falling relative to the starting position
before 10 seconds have elapsed, but not hitting the bed or other support. This is a
classic score of 1.
Question 7
Motor Leg - Right: You test the right leg in the 30-degree position (always supine).
The leg falls immediately to the bed with no effort to hold position. Score?
A) 1 (Drift)
B) 2 (Some effort against gravity)
C) 3 (No effort against gravity)
D) 4 (No movement)
--answer--: C) 3 (No effort against gravity)
Explanation: If the limb falls immediately to the bed (or has a barely flicker of
