NIHSS Group C patIeNtS 1-6 exam aCtual exam 2026/2027
– Complete exam-Style QueStIoNS wItH DetaIleD
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GraDeD
Question 1
A patient is alert and responsive. When asked to state their age and the current month, they
answer both questions correctly. According to the NIHSS, what score do they receive for
"Level of Consciousness (LOC) Questions" (Item 1b)?
A) 0
B) 1
C) 2
D) 3
Answer: A) 0
Rationale: Item 1b specifically scores the patient's ability to answer two questions: their age
and the current month. A score of 0 is given when both answers are correct. A score of 1 is
given for one correct answer, and 2 for zero correct answers. This is based on the first
response, not the best effort .
Question 2
During the assessment for "Best Gaze" (Item 2), the patient is able to track the examiner's
finger to the right but cannot voluntarily move their eyes to the left. What is the correct score?
A) 0
B) 1
C) 2
, D) 3
Answer:B) 1
Rationale: A score of 1 (Partial Gaze Palsy) is assigned when there is gaze abnormality in one
or both eyes that is not total. This includes isolated weakness of horizontal gaze that can be
overcome with the oculocephalic maneuver. A score of 0 is normal, and 2 (Forced Deviation) is
for total gaze paresis that cannot be overcome .
Question 3
The patient reports seeing normally but fails to detect a visual stimulus presented to their left
side when both sides are stimulated simultaneously. On a standard NIHSS exam, this finding
would be documented under which item?
A) Item 3 - Visual Fields
B) Item 11 - Extinction and Inattention
C) Item 8 - Sensory
D) Item 9 - Best Language
Answer: B) Item 11 - Extinction and Inattention
Rationale: The inability to perceive a stimulus on one side when presented simultaneously
with a stimulus on the other side is called "extinction." This is a hallmark of neglect (usually
left-sided) and is scored specifically under Item 11, which assesses neglect, extinction, and
inattention. It is not a primary visual field cut .
Question 4
A patient who is otherwise alert and able to follow commands has significant facial
asymmetry. When asked to show their teeth and raise their eyebrows, the left side of their
face remains flat. What is the score for "Facial Palsy" (Item 4)?
A) 0 - Normal
B) 1 - Minor paralysis
– Complete exam-Style QueStIoNS wItH DetaIleD
ratIoNaleS | 100% VerIfIeD – paSS GuaraNteeD – a+
GraDeD
Question 1
A patient is alert and responsive. When asked to state their age and the current month, they
answer both questions correctly. According to the NIHSS, what score do they receive for
"Level of Consciousness (LOC) Questions" (Item 1b)?
A) 0
B) 1
C) 2
D) 3
Answer: A) 0
Rationale: Item 1b specifically scores the patient's ability to answer two questions: their age
and the current month. A score of 0 is given when both answers are correct. A score of 1 is
given for one correct answer, and 2 for zero correct answers. This is based on the first
response, not the best effort .
Question 2
During the assessment for "Best Gaze" (Item 2), the patient is able to track the examiner's
finger to the right but cannot voluntarily move their eyes to the left. What is the correct score?
A) 0
B) 1
C) 2
, D) 3
Answer:B) 1
Rationale: A score of 1 (Partial Gaze Palsy) is assigned when there is gaze abnormality in one
or both eyes that is not total. This includes isolated weakness of horizontal gaze that can be
overcome with the oculocephalic maneuver. A score of 0 is normal, and 2 (Forced Deviation) is
for total gaze paresis that cannot be overcome .
Question 3
The patient reports seeing normally but fails to detect a visual stimulus presented to their left
side when both sides are stimulated simultaneously. On a standard NIHSS exam, this finding
would be documented under which item?
A) Item 3 - Visual Fields
B) Item 11 - Extinction and Inattention
C) Item 8 - Sensory
D) Item 9 - Best Language
Answer: B) Item 11 - Extinction and Inattention
Rationale: The inability to perceive a stimulus on one side when presented simultaneously
with a stimulus on the other side is called "extinction." This is a hallmark of neglect (usually
left-sided) and is scored specifically under Item 11, which assesses neglect, extinction, and
inattention. It is not a primary visual field cut .
Question 4
A patient who is otherwise alert and able to follow commands has significant facial
asymmetry. When asked to show their teeth and raise their eyebrows, the left side of their
face remains flat. What is the score for "Facial Palsy" (Item 4)?
A) 0 - Normal
B) 1 - Minor paralysis
