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National Institute of Health Stroke Scale (NIHSS) Test | Complete Study Guide, Practice Questions & Stroke Assessment Prep

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Prepare for the National Institute of Health Stroke Scale (NIHSS) Test with this complete study guide designed to help healthcare professionals review essential neurological assessment and stroke evaluation concepts. This resource covers NIHSS components, stroke severity assessment, neurological examination principles, patient evaluation techniques, and key stroke care topics. Featuring organized study material and exam-style practice questions, this guide supports effective preparation for NIHSS training, clinical competency assessments, nursing education, and stroke care certification review.

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NEURO_ National
Institute of Health
Stroke Scale (NIHSS)
Test

(2025-2026)
(Final Exam Questions With 100% Correct
Answers | Verified Answer Guaranteed
Pass | Latest Update (2026-2027) | Already
Graded A+)FIBA Agent Test

, NIH Stroke Scale 11 item neurological exam used to quantify the effects of acute cerebral ischemia on
levels of
-consciousness
-vision
-motor function (facial and extremities)
-cerebellar function
-sensation
-language
-extinction or inattention


NIHSS exam rules -administer scale items in their exact order
-avoid coaching the patient
-accept patient's first effort
-score only what the patient does
-be consistent
-include all deficits in scoring, including what might have been from previous stroke


itme 1a level of consciousness
0 - alert
1 - not alert; aroused with minor verbal stimulation
2 - not alert; requires strong or painful stimulation
3 - reflex movements only or totally unresponsive
(pt scoring a 3 is generally considered to be in a coma)


how to score 1a -ask the patient 2 or 3 questions about the circumstances of the admission
-stimulate the patient by padding or tapping on patient
-or a more noxious stimuli such as pinching


scoring a 3 on item 1a -pr soaring a 3 is generally considered to be in a coma
-a 3 is scored only if the patient makes no movement other than reflexive posturing
in response to noxious stimulation
-score of 3 has an impact on scoring other items


item 1b level of consciousness: questions
-based on patient's answers on 2 specific questions:
-the month of the year
-pt's age

-by definition, pt unable to communicate bc of endotracheal intubation, oral tracheal
trauma, severe dysarthria from any cause, a language barrier, or any other problem
not secondary to aphasia are scored a 1
-pt who scores a 3 on item 1a must be scored a 2
-aphasic and stuporous pt who do not comprehend the questions will score a 2
-comatous pt will score a 2


scoring item 1b 0 - answers both questions correctly
1 - answers 1 question correctly
2 - answers neither question correctly


tips on item 1b -a pt who can not speak may be able to write the answer
-pt who gives an incorrect answer and corrects himself is an incorrect answer
-giving date of birth when asked for age is a wrong answer


item 1c level of consciousness: commands
-be sure to position eyes and hands in testable position before asking 2 questions
-"close your eyes for me, now open them"
-"now make a fist with your hand, now open them"

-may repeat the command once, but do not coach or encourage
-may use visual cues


scoring item 1c 0 - performs both tasks correctly
1 - performs 1 task correctly
2 - performs neither task correctly

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