1|P age
NIH STROKE SCALE (NIHSS)
CERTIFICATION EXAM ANSWER GUIDE
Groups A–F | Patients 1–6
Verified Questions & Accurate Answers
Fully Updated for the 2025–2026 Examination
◻ Patient 1 – Test Group A
1. Level of Consciousness (LOC)
Question: When asked the current month and their age, the patient responds
incorrectly to both. What LOC question score should be recorded?
a. 0 – Answers both correctly
b. 1 – Answers one correctly
c. 2 – Answers both incorrectly
d. 3 – Unresponsive
- ANSWER: c. 2 – Answers both incorrectly
◻ Patient 2 – Test Group B
2. Best Gaze
Question: The patient is unable to follow commands to look left or right and shows
spontaneous deviation of the eyes to the left. What is the correct score?
a. 0 – Normal
b. 1 – Partial gaze palsy
c. 2 – Forced deviation
d. 3 – Complete gaze paralysis
,2|P age
- ANSWER: c. 2 – Forced deviation
◻ Patient 3 – Test Group C
3. Visual Fields
Question: The patient reports not seeing fingers in the left visual field in both eyes.
What score should be recorded?
a. 0 – No visual loss
b. 1 – Partial hemianopia
c. 2 – Complete hemianopia
d. 3 – Bilateral blindness
- ANSWER: c. 2 – Complete hemianopia
◻ Patient 4 – Test Group D
4. Facial Palsy
Question: Patient has complete paralysis of the lower face on one side and partial
on the upper face. What is the correct score?
a. 0 – Normal
b. 1 – Minor paralysis
c. 2 – Partial paralysis
d. 3 – Complete paralysis on one or both sides
- ANSWER: d. 3 – Complete paralysis
, 3|P age
◻ Patient 5 – Test Group E
5. Motor Arm (Right)
Question: Arm drifts down but does not hit the bed and shows effort against
gravity. What is the score?
a. 0 – No drift
b. 1 – Drift
c. 2 – Some effort against gravity
d. 3 – No effort against gravity
- ANSWER: b. 1 – Drift
◻ Patient 6 – Test Group F
6. Language
Question: The patient has noticeable difficulty finding words but communicates
ideas clearly. What is the correct score?
a. 0 – No aphasia
b. 1 – Mild to moderate aphasia
c. 2 – Severe aphasia
d. 3 – Mute or global aphasia
- ANSWER: b. 1 – Mild to moderate aphasia
7. LOC Commands
NIH STROKE SCALE (NIHSS)
CERTIFICATION EXAM ANSWER GUIDE
Groups A–F | Patients 1–6
Verified Questions & Accurate Answers
Fully Updated for the 2025–2026 Examination
◻ Patient 1 – Test Group A
1. Level of Consciousness (LOC)
Question: When asked the current month and their age, the patient responds
incorrectly to both. What LOC question score should be recorded?
a. 0 – Answers both correctly
b. 1 – Answers one correctly
c. 2 – Answers both incorrectly
d. 3 – Unresponsive
- ANSWER: c. 2 – Answers both incorrectly
◻ Patient 2 – Test Group B
2. Best Gaze
Question: The patient is unable to follow commands to look left or right and shows
spontaneous deviation of the eyes to the left. What is the correct score?
a. 0 – Normal
b. 1 – Partial gaze palsy
c. 2 – Forced deviation
d. 3 – Complete gaze paralysis
,2|P age
- ANSWER: c. 2 – Forced deviation
◻ Patient 3 – Test Group C
3. Visual Fields
Question: The patient reports not seeing fingers in the left visual field in both eyes.
What score should be recorded?
a. 0 – No visual loss
b. 1 – Partial hemianopia
c. 2 – Complete hemianopia
d. 3 – Bilateral blindness
- ANSWER: c. 2 – Complete hemianopia
◻ Patient 4 – Test Group D
4. Facial Palsy
Question: Patient has complete paralysis of the lower face on one side and partial
on the upper face. What is the correct score?
a. 0 – Normal
b. 1 – Minor paralysis
c. 2 – Partial paralysis
d. 3 – Complete paralysis on one or both sides
- ANSWER: d. 3 – Complete paralysis
, 3|P age
◻ Patient 5 – Test Group E
5. Motor Arm (Right)
Question: Arm drifts down but does not hit the bed and shows effort against
gravity. What is the score?
a. 0 – No drift
b. 1 – Drift
c. 2 – Some effort against gravity
d. 3 – No effort against gravity
- ANSWER: b. 1 – Drift
◻ Patient 6 – Test Group F
6. Language
Question: The patient has noticeable difficulty finding words but communicates
ideas clearly. What is the correct score?
a. 0 – No aphasia
b. 1 – Mild to moderate aphasia
c. 2 – Severe aphasia
d. 3 – Mute or global aphasia
- ANSWER: b. 1 – Mild to moderate aphasia
7. LOC Commands
