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NIH STROKE SCALE (NIHSS) CERTIFICATION EXAM
ALL 300 RANDOMIZED PRACTICE QUESTIONS WITH
ANSWERS & RATIONALES LATEST VERSION THIS
YEAR
NIH STROKE SCALE (NIHSS) CERTIFICATION EXAM – 300 RANDOMIZED QUESTIONS
1. A patient is awake, alert, and answers all questions correctly. What is the correct score for Item 1a
(Level of Consciousness)?
A) 0
B) 1
C) 2
D) 3
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Answer: A Item 1a scores 0 for alert and fully responsive, 1 for drowsy but arousable, 2 for obtunded, and
3 for unresponsive. An alert patient receives a score of 0.
2. A patient is drowsy but awakens to minor stimulation and answers questions appropriately. What is the
score for Item 1a?
A) 0
B) 1
C) 2
D) 3
Answer: B Item 1a scores 1 when the patient is not fully alert but can be aroused by minor stimulation to
obey, answer, or respond. The patient is not lethargic or obtunded, so a score of 1 is correct.
3. A patient is unresponsive to all stimuli. What score is assigned to Item 1a?
A) 0
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B) 1
C) 2
D) 3
Answer: D Item 1a scores 3 for unresponsive patients who do not respond to any stimuli. This indicates a
comatose state and severe neurological impairment.
4. A patient is asked their age and the current month. They answer their age correctly but cannot state
the month. What is the score for Item 1b (LOC Questions)?
A) 0
B) 1
C) 2
D) 3
Answer: B Item 1b scores 0 if both questions are correct, 1 if one is correct, and 2 if neither is correct.
Since the patient answers age correctly but not the month, the score is 1.
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5. A patient is asked their age and the current month. They answer both questions correctly. What is the
score for Item 1b?
A) 0
B) 1
C) 2
D) 3
Answer: A Item 1b scores 0 when both questions are answered correctly. This indicates the patient is
oriented to basic personal and temporal information.
6. A patient is asked their age and the current month. They answer neither question correctly. What is
the score for Item 1b?
A) 0
B) 1
NIH STROKE SCALE (NIHSS) CERTIFICATION EXAM
ALL 300 RANDOMIZED PRACTICE QUESTIONS WITH
ANSWERS & RATIONALES LATEST VERSION THIS
YEAR
NIH STROKE SCALE (NIHSS) CERTIFICATION EXAM – 300 RANDOMIZED QUESTIONS
1. A patient is awake, alert, and answers all questions correctly. What is the correct score for Item 1a
(Level of Consciousness)?
A) 0
B) 1
C) 2
D) 3
, Page 2 of 196
Answer: A Item 1a scores 0 for alert and fully responsive, 1 for drowsy but arousable, 2 for obtunded, and
3 for unresponsive. An alert patient receives a score of 0.
2. A patient is drowsy but awakens to minor stimulation and answers questions appropriately. What is the
score for Item 1a?
A) 0
B) 1
C) 2
D) 3
Answer: B Item 1a scores 1 when the patient is not fully alert but can be aroused by minor stimulation to
obey, answer, or respond. The patient is not lethargic or obtunded, so a score of 1 is correct.
3. A patient is unresponsive to all stimuli. What score is assigned to Item 1a?
A) 0
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B) 1
C) 2
D) 3
Answer: D Item 1a scores 3 for unresponsive patients who do not respond to any stimuli. This indicates a
comatose state and severe neurological impairment.
4. A patient is asked their age and the current month. They answer their age correctly but cannot state
the month. What is the score for Item 1b (LOC Questions)?
A) 0
B) 1
C) 2
D) 3
Answer: B Item 1b scores 0 if both questions are correct, 1 if one is correct, and 2 if neither is correct.
Since the patient answers age correctly but not the month, the score is 1.
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5. A patient is asked their age and the current month. They answer both questions correctly. What is the
score for Item 1b?
A) 0
B) 1
C) 2
D) 3
Answer: A Item 1b scores 0 when both questions are answered correctly. This indicates the patient is
oriented to basic personal and temporal information.
6. A patient is asked their age and the current month. They answer neither question correctly. What is
the score for Item 1b?
A) 0
B) 1
