1
Comprehensive NIHSS 2026-2027 Exam Prep:
200 Questions with Rationales for Certification
Success
Section 1: General Principles & Scoring Criteria
(Questions 1-30)
Q1. According to the NIHSS, a total score of 0
indicates:
• A) A mild stroke
• B) No stroke symptoms
• C) The patient is in a coma
• D) The test was not completed
Correct ☑VERIFIED ANSWER: B) No stroke
symptoms
Rationale: A score of 0 on the NIHSS
indicates no stroke symptoms. The scale
,2
ranges from 0-42, with higher scores
indicating greater severity.
Q2. For item 1A (Level of Consciousness), a
patient who is not alert but arouses to minor
stimulation (e.g., speaking) to obey commands
is scored as:
• A) 0
• B) 1
• C) 2
• D) 3
Correct ☑VERIFIED ANSWER: B) 1
Rationale: Item 1A scoring: 0 = Alert; 1 =
Not alert, but arousable by minor
stimulation; 2 = Requires repeated
stimulation; 3 = Reflex movements only or
unresponsive.
,3
Q3. The two standardized questions for item
1B (LOC Questions) are:
• A) "What is your name?" and "Where are
you?"
• B) "What month is it?" and "How old are
you?"
• C) "What day of the week is it?" and "What
year is it?"
• D) "Who is the President?" and "Where is
the hospital?"
Correct ☑VERIFIED ANSWER: B) "What
month is it?" and "How old are you?"
Rationale: The standardized questions are
the current month and the patient's age.
This tests orientation, not general
knowledge.
, 4
Q4. For item 1C (LOC Commands), you ask the
patient to perform two tasks. If the patient is
aphasic, you should:
• A) Score a 2 automatically
• B) Use a noxious stimulus to get a response
• C) Demonstrate the task (pantomime) and
then score the result
• D) Skip the item and mark it as "untestable"
Correct ☑VERIFIED ANSWER: C)
Demonstrate the task (pantomime) and
then score the result
Rationale: If the patient does not respond to
command, the task should be demonstrated
to them (pantomime), and the result scored
based on whether they follow none, one, or
two commands.
Comprehensive NIHSS 2026-2027 Exam Prep:
200 Questions with Rationales for Certification
Success
Section 1: General Principles & Scoring Criteria
(Questions 1-30)
Q1. According to the NIHSS, a total score of 0
indicates:
• A) A mild stroke
• B) No stroke symptoms
• C) The patient is in a coma
• D) The test was not completed
Correct ☑VERIFIED ANSWER: B) No stroke
symptoms
Rationale: A score of 0 on the NIHSS
indicates no stroke symptoms. The scale
,2
ranges from 0-42, with higher scores
indicating greater severity.
Q2. For item 1A (Level of Consciousness), a
patient who is not alert but arouses to minor
stimulation (e.g., speaking) to obey commands
is scored as:
• A) 0
• B) 1
• C) 2
• D) 3
Correct ☑VERIFIED ANSWER: B) 1
Rationale: Item 1A scoring: 0 = Alert; 1 =
Not alert, but arousable by minor
stimulation; 2 = Requires repeated
stimulation; 3 = Reflex movements only or
unresponsive.
,3
Q3. The two standardized questions for item
1B (LOC Questions) are:
• A) "What is your name?" and "Where are
you?"
• B) "What month is it?" and "How old are
you?"
• C) "What day of the week is it?" and "What
year is it?"
• D) "Who is the President?" and "Where is
the hospital?"
Correct ☑VERIFIED ANSWER: B) "What
month is it?" and "How old are you?"
Rationale: The standardized questions are
the current month and the patient's age.
This tests orientation, not general
knowledge.
, 4
Q4. For item 1C (LOC Commands), you ask the
patient to perform two tasks. If the patient is
aphasic, you should:
• A) Score a 2 automatically
• B) Use a noxious stimulus to get a response
• C) Demonstrate the task (pantomime) and
then score the result
• D) Skip the item and mark it as "untestable"
Correct ☑VERIFIED ANSWER: C)
Demonstrate the task (pantomime) and
then score the result
Rationale: If the patient does not respond to
command, the task should be demonstrated
to them (pantomime), and the result scored
based on whether they follow none, one, or
two commands.
