NIH STROKE SCALE GROUP E EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND PASS |
LATEST EXAM UPDATE
Core Domains
Neurological Assessment and the NIHSS
Level of Consciousness and Arousal
Cranial Nerve Function (Visual, Motor, Sensory)
Motor Function and Coordination
Sensory Function and Inattention
Language and Speech (Aphasia, Dysarthria)
Extinction and Inattention (Neglect)
Clinical Decision-Making and Patient Management
Ethical and Legal Considerations in Acute Stroke Care
Introduction
This comprehensive examination is designed to rigorously assess the foundational
and applied knowledge necessary for the proficient administration and
interpretation of the National Institutes of Health Stroke Scale (NIHSS). The
assessment covers the theoretical underpinnings of the scale, the specific
neurological functions evaluated by each item, and the critical clinical reasoning
required to apply the scale accurately in a variety of patient scenarios. Through a
combination of multiple-choice questions and scenario-based items, this exam
evaluates your ability to make sound clinical decisions, recognize subtle but critical
neurological changes, and adhere to professional and ethical standards in the care
,of acute stroke patients. Mastery of this content is essential for healthcare
professionals who contribute to the timely and effective management of
cerebrovascular events.
SECTION ONE: QUESTIONS 1 – 50
Question 1
A patient is asked to state their name, the current month, and their location. They
are able to correctly answer all questions but are slow to respond and appear
drowsy. What is the most appropriate score for Level of Consciousness (LOC) -
Questions (Item 1a)?
A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: A. 0
🔴 Explanation: A score of 0 is given if the patient answers both questions
correctly, even if they are slow to respond. The time to answer is not a factor as
long as the answer is accurate and not due to aphasia or stupor.
Question 2
A patient is able to follow a two-step command to "close your eyes and then
open your mouth" but is unable to follow a more complex command. How should
this be scored on Item 1b (LOC - Commands)?
,A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: A. 0
🔴 Explanation: A score of 0 for commands is awarded if the patient performs
both tasks correctly on the first attempt. The command must be two-step. The
scale does not test for more complex commands, and only the first attempt is
scored.
Question 3
The patient is awake and alert but has severe expressive aphasia and is unable to
say the correct words when asked to name a pencil and a watch. What is the
correct score for Item 2 (Best Gaze)?
A. 0
B. 1
C. 2
D. Untestable
🟢 Correct Answer: A. 0
🔴 Explanation: Best Gaze (Item 2) is a test of conjugate eye movements, not
language. Even with aphasia, if the patient can track the examiner's finger or a
visual target, they can receive a score of 0. The inability to name is assessed on a
different item.
, Question 4
During the visual fields test (Item 3), the patient is able to detect the examiner's
fingers in all four quadrants of both eyes when using a double simultaneous
stimulation technique. What score should be assigned?
A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: A. 0
🔴 Explanation: A score of 0 is given for no visual field loss. The patient's ability
to see the fingers in all quadrants, even when presented simultaneously, confirms
an intact visual field.
Question 5
A patient has a left-sided facial droop that is noticeable when they smile, but their
forehead muscles are spared. What is the correct score for Item 4 (Facial Palsy)?
A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: B. 1
🔴 Explanation: A score of 1 (Minor paralysis) is given for an asymmetric smile or
flattened nasolabial fold, but with full forehead strength. This is indicative of a
central (upper motor neuron) facial nerve palsy, which typically spares the
forehead.
AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND PASS |
LATEST EXAM UPDATE
Core Domains
Neurological Assessment and the NIHSS
Level of Consciousness and Arousal
Cranial Nerve Function (Visual, Motor, Sensory)
Motor Function and Coordination
Sensory Function and Inattention
Language and Speech (Aphasia, Dysarthria)
Extinction and Inattention (Neglect)
Clinical Decision-Making and Patient Management
Ethical and Legal Considerations in Acute Stroke Care
Introduction
This comprehensive examination is designed to rigorously assess the foundational
and applied knowledge necessary for the proficient administration and
interpretation of the National Institutes of Health Stroke Scale (NIHSS). The
assessment covers the theoretical underpinnings of the scale, the specific
neurological functions evaluated by each item, and the critical clinical reasoning
required to apply the scale accurately in a variety of patient scenarios. Through a
combination of multiple-choice questions and scenario-based items, this exam
evaluates your ability to make sound clinical decisions, recognize subtle but critical
neurological changes, and adhere to professional and ethical standards in the care
,of acute stroke patients. Mastery of this content is essential for healthcare
professionals who contribute to the timely and effective management of
cerebrovascular events.
SECTION ONE: QUESTIONS 1 – 50
Question 1
A patient is asked to state their name, the current month, and their location. They
are able to correctly answer all questions but are slow to respond and appear
drowsy. What is the most appropriate score for Level of Consciousness (LOC) -
Questions (Item 1a)?
A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: A. 0
🔴 Explanation: A score of 0 is given if the patient answers both questions
correctly, even if they are slow to respond. The time to answer is not a factor as
long as the answer is accurate and not due to aphasia or stupor.
Question 2
A patient is able to follow a two-step command to "close your eyes and then
open your mouth" but is unable to follow a more complex command. How should
this be scored on Item 1b (LOC - Commands)?
,A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: A. 0
🔴 Explanation: A score of 0 for commands is awarded if the patient performs
both tasks correctly on the first attempt. The command must be two-step. The
scale does not test for more complex commands, and only the first attempt is
scored.
Question 3
The patient is awake and alert but has severe expressive aphasia and is unable to
say the correct words when asked to name a pencil and a watch. What is the
correct score for Item 2 (Best Gaze)?
A. 0
B. 1
C. 2
D. Untestable
🟢 Correct Answer: A. 0
🔴 Explanation: Best Gaze (Item 2) is a test of conjugate eye movements, not
language. Even with aphasia, if the patient can track the examiner's finger or a
visual target, they can receive a score of 0. The inability to name is assessed on a
different item.
, Question 4
During the visual fields test (Item 3), the patient is able to detect the examiner's
fingers in all four quadrants of both eyes when using a double simultaneous
stimulation technique. What score should be assigned?
A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: A. 0
🔴 Explanation: A score of 0 is given for no visual field loss. The patient's ability
to see the fingers in all quadrants, even when presented simultaneously, confirms
an intact visual field.
Question 5
A patient has a left-sided facial droop that is noticeable when they smile, but their
forehead muscles are spared. What is the correct score for Item 4 (Facial Palsy)?
A. 0
B. 1
C. 2
D. 3
🟢 Correct Answer: B. 1
🔴 Explanation: A score of 1 (Minor paralysis) is given for an asymmetric smile or
flattened nasolabial fold, but with full forehead strength. This is indicative of a
central (upper motor neuron) facial nerve palsy, which typically spares the
forehead.
