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2026 APEX NIH Stroke Scale Group D Patients 1-6 (Complete) - Verified Answers

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This comprehensive study guide provides the verified, step-by-step scoring answers for the APEX NIH Stroke Scale (NIHSS) Group D certification exam covering Patients 1 through 6. Each entry breaks down the specific point allocations for critical neurological metrics, including motor deficits, level of consciousness, facial palsy, and language capabilities. Use this review sheet to verify your diagnostic accuracy, understand complex patient scoring rationales, and successfully pass your stroke scale certification.

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2026 APEX NIH Stroke Scale Group D
Patients 1-6 (Complete) - Verified
Answers

APEX NIH Stroke Scale (NIHSS)
Group D - Patients 1-6

NIHSS ITEMS (REFERENCE)
1. 1a. Level of Consciousness (LOC)
2. 1b. LOC Questions
3. 1c. LOC Commands
4. 2. Best Gaze
5. 3. Visual Fields
6. 4. Facial Palsy
7. 5. Motor Arm (L/R)
8. 6. Motor Leg (L/R)
9. 7. Limb Ataxia

, 10. 8. Sensory
11. 9. Best Language
12. 10. Dysarthria
13. 11. Extinction & Inattention (Neglect)




Patient 1 - Mild Right-Sided Weakness
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 1
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 1
Total NIHSS: [6-7]

,Rationale: This patient presents with mild right-sided weakness. A score
of 1 on Facial Palsy indicates minor paralysis, such as flattening of the
nasolabial fold. A score of 3 on the right arm suggests the limb falls with
no effort against gravity. The patient shows no aphasia or dysarthria but
has some sensory loss and mild neglect .


Patient 2 - Aphasia with Left-Sided Weakness
Scores
1a LOC: 0
1b LOC Questions: 2
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 1
9 Best Language: 2
10 Dysarthria: 1
11 Neglect: 0
Total NIHSS: [7]

, Rationale: This patient typically presents with left-sided weakness and
aphasia. A score of 2 on LOC Questions is common when a patient cannot
answer due to aphasia. A score of 2 on Best Language indicates moderate
aphasia where communication is fragmented. There is mild sensory loss
and dysarthria .


Patient 3 - Near-Normal / Minimal Deficit
Scores
1a LOC: 0
1b LOC Questions: 0
1c LOC Commands: 0
2 Best Gaze: 0
3 Visual Fields: 0
4 Facial Palsy: 1
5 Motor Arms (L/R):
6 Motor Legs (L/R):
7 Limb Ataxia: 0
8 Sensory: 0
9 Best Language: 0
10 Dysarthria: 0
11 Neglect: 0
Total NIHSS: [1]

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