NIHSS Group C Patients 1-6 Exam
Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style
Questions | Pass Guaranteed – A+
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TABLE OF CONTENTS
Section 1: Patient 1 (Level of Consciousness & Orientation) - Questions 1-8
Section 2: Patient 2 (Best Gaze & Visual Fields) - Questions 9-16
Section 3: Patient 3 (Facial Palsy & Motor Arm) - Questions 17-24
Section 4: Patient 4 (Motor Leg & Limb Ataxia) - Questions 25-31
Section 5: Patient 5 (Sensory & Best Language) - Questions 32-38
Section 6: Patient 6 (Dysarthria & Extinction/Inattention) - Questions 39-45
Section 1: Patient 1 - Level of Consciousness & Orientation (Questions
1-8)
Q1: A 72-year-old female is evaluated for acute stroke symptoms. She is drowsy but opens
her eyes and responds appropriately to verbal questions. When asked her name, she
answers correctly but cannot state the current month or year. What is the NIHSS score for
Item 1a (Level of Consciousness)?
,A. 0 (Alert)
B. 1 (Drowsy, responds to verbal stimuli)
C. 2 (Stuporous, responds to pain)
D. 3 (Coma)
Correct Answer: B
Rationale: The patient is drowsy but responds to verbal stimuli, which corresponds to
NIHSS Item 1a score of 1. Option A is incorrect because she is not fully alert. Option C is
incorrect as she does not require pain to arouse. Option D is incorrect as she is not
comatose. This aligns with NIHSS guidelines where drowsiness with verbal response is
scored as 1, reflecting impaired consciousness without coma.
Q2: A 65-year-old male with sudden left-sided weakness is assessed. He is alert and
oriented to person, place, and time but becomes confused when asked to repeat the
month and year. What is the NIHSS score for Item 1b (Orientation)?
A. 0 (Oriented to both)
B. 1 (Oriented to person only)
C. 2 (Disoriented to both)
D. 3 (Unresponsive)
Correct Answer: B
Rationale: The patient is oriented to person but not to time (month/year), scoring 1 for Item
1b. Option A is incorrect as he is not fully oriented. Option C is incorrect because he is not
completely disoriented. Option D is irrelevant. NIHSS guidelines specify that partial
orientation (person only) scores 1, reflecting mild cognitive impairment.
Q3: During NIHSS assessment, a patient fails to respond to verbal commands but
withdraws from painful stimuli. What is the score for Item 1a?
A. 0
B. 1
, C. 2
D. 3
Correct Answer: C
Rationale: Withdrawal from pain indicates stupor, scoring 2 for Item 1a. Option A/B are
incorrect as the patient does not respond to verbal stimuli. Option D is incorrect as the
patient responds to pain, not coma. This follows NIHSS criteria where pain response
without verbal interaction scores 2.
Q4: A patient is alert but cannot state their age or current location. What is the Item 1b
score?
A. 0
B. 1
C. 2
D. 3
Correct Answer: C
Rationale: Disorientation to both person (age) and place (location) scores 2 for Item 1b.
Option A/B are incorrect as the patient is not oriented. Option D is irrelevant. NIHSS
guidelines specify complete disorientation scores 2, indicating significant cognitive deficit.
Q5: A stroke patient is comatose and does not respond to any stimuli. What is the Item 1a
score?
A. 0
B. 1
C. 2
D. 3
Correct Answer: D
Rationale: Coma with no response to any stimuli scores 3 for Item 1a. Options A-C are
Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style
Questions | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1: Patient 1 (Level of Consciousness & Orientation) - Questions 1-8
Section 2: Patient 2 (Best Gaze & Visual Fields) - Questions 9-16
Section 3: Patient 3 (Facial Palsy & Motor Arm) - Questions 17-24
Section 4: Patient 4 (Motor Leg & Limb Ataxia) - Questions 25-31
Section 5: Patient 5 (Sensory & Best Language) - Questions 32-38
Section 6: Patient 6 (Dysarthria & Extinction/Inattention) - Questions 39-45
Section 1: Patient 1 - Level of Consciousness & Orientation (Questions
1-8)
Q1: A 72-year-old female is evaluated for acute stroke symptoms. She is drowsy but opens
her eyes and responds appropriately to verbal questions. When asked her name, she
answers correctly but cannot state the current month or year. What is the NIHSS score for
Item 1a (Level of Consciousness)?
,A. 0 (Alert)
B. 1 (Drowsy, responds to verbal stimuli)
C. 2 (Stuporous, responds to pain)
D. 3 (Coma)
Correct Answer: B
Rationale: The patient is drowsy but responds to verbal stimuli, which corresponds to
NIHSS Item 1a score of 1. Option A is incorrect because she is not fully alert. Option C is
incorrect as she does not require pain to arouse. Option D is incorrect as she is not
comatose. This aligns with NIHSS guidelines where drowsiness with verbal response is
scored as 1, reflecting impaired consciousness without coma.
Q2: A 65-year-old male with sudden left-sided weakness is assessed. He is alert and
oriented to person, place, and time but becomes confused when asked to repeat the
month and year. What is the NIHSS score for Item 1b (Orientation)?
A. 0 (Oriented to both)
B. 1 (Oriented to person only)
C. 2 (Disoriented to both)
D. 3 (Unresponsive)
Correct Answer: B
Rationale: The patient is oriented to person but not to time (month/year), scoring 1 for Item
1b. Option A is incorrect as he is not fully oriented. Option C is incorrect because he is not
completely disoriented. Option D is irrelevant. NIHSS guidelines specify that partial
orientation (person only) scores 1, reflecting mild cognitive impairment.
Q3: During NIHSS assessment, a patient fails to respond to verbal commands but
withdraws from painful stimuli. What is the score for Item 1a?
A. 0
B. 1
, C. 2
D. 3
Correct Answer: C
Rationale: Withdrawal from pain indicates stupor, scoring 2 for Item 1a. Option A/B are
incorrect as the patient does not respond to verbal stimuli. Option D is incorrect as the
patient responds to pain, not coma. This follows NIHSS criteria where pain response
without verbal interaction scores 2.
Q4: A patient is alert but cannot state their age or current location. What is the Item 1b
score?
A. 0
B. 1
C. 2
D. 3
Correct Answer: C
Rationale: Disorientation to both person (age) and place (location) scores 2 for Item 1b.
Option A/B are incorrect as the patient is not oriented. Option D is irrelevant. NIHSS
guidelines specify complete disorientation scores 2, indicating significant cognitive deficit.
Q5: A stroke patient is comatose and does not respond to any stimuli. What is the Item 1a
score?
A. 0
B. 1
C. 2
D. 3
Correct Answer: D
Rationale: Coma with no response to any stimuli scores 3 for Item 1a. Options A-C are
