NIH STROKE SCALE EXAM 300 QUESTIONS
AND CORRECT ANSWERS WITH
RATIONALES LATEST UPDATES ASSURED
PASS!!!!!!!!!!!!!!!!!!!
SECTION A: LEVEL OF CONSCIOUSNESS (Item 1a)
Question 1
A patient opens their eyes and follows commands appropriately when you enter the
room. They are fully oriented and responsive. What is the correct LOC score?
A) 0
B) 1
C) 2
D) 3
Answer: A) 0
Rationale: A score of 0 is assigned when the patient is fully alert and responsive.
The NIHSS defines this as being able to interact appropriately with the examiner
without any stimulation needed to maintain arousal .
---
Question 2
,A patient is drowsy but awakens easily when you call their name softly. They
respond appropriately to questions but drift back to sleep between assessments.
What LOC score should be assigned?
A) 0
B) 1
C) 2
D) 3
Answer: B) 1
Rationale: A score of 1 indicates the patient is not fully alert but is arousable with
minor stimulation (such as verbal cues). They can maintain attention but require
prompting to stay engaged .
---
Question 3
A patient requires repeated, vigorous painful stimulation to elicit any response.
They do not maintain awareness between stimuli. What is the LOC score?
A) 0
B) 1
C) 2
D) 3
Answer: C) 2
,Rationale: A score of 2 is given when the patient requires repeated or strong
stimulation to attend. They are obtunded and cannot sustain alertness without
continuous prompting .
---
Question 4
A comatose patient shows only reflexive posturing in response to painful stimuli
and has no purposeful movement. What LOC score is appropriate?
A) 0
B) 1
C) 2
D) 3
Answer: D) 3
Rationale: A score of 3 is reserved for patients who are unresponsive or respond
only with reflex motor activity. This includes coma and states with no purposeful
response to any stimulus .
Question 5
Which statement about scoring Level of Consciousness (1a) is correct?
A) The score can be changed after moving to the next item
B) This is the only item where you may go back and change the score
C) The score must be based solely on the patient's response to pain
, D) Family report can be used to determine the score
Answer: B) This is the only item where you may go back and change the score
Rationale: Item 1a is unique in that examiners are permitted to return and adjust
the score if further interaction with the patient during the exam provides better
information about their level of arousal .
---
Question 6
A patient is lethargic but opens their eyes when you speak loudly. They can answer
questions but seem confused and disoriented. What is the most appropriate LOC
score?
A) 0
B) 1
C) 2
D) 3
Answer: B) 1
Rationale: The patient demonstrates arousal with minor verbal stimulation and can
respond, meeting criteria for a score of 1. The content of responses is assessed
separately in items 1b and 1c .
---
Question 7
AND CORRECT ANSWERS WITH
RATIONALES LATEST UPDATES ASSURED
PASS!!!!!!!!!!!!!!!!!!!
SECTION A: LEVEL OF CONSCIOUSNESS (Item 1a)
Question 1
A patient opens their eyes and follows commands appropriately when you enter the
room. They are fully oriented and responsive. What is the correct LOC score?
A) 0
B) 1
C) 2
D) 3
Answer: A) 0
Rationale: A score of 0 is assigned when the patient is fully alert and responsive.
The NIHSS defines this as being able to interact appropriately with the examiner
without any stimulation needed to maintain arousal .
---
Question 2
,A patient is drowsy but awakens easily when you call their name softly. They
respond appropriately to questions but drift back to sleep between assessments.
What LOC score should be assigned?
A) 0
B) 1
C) 2
D) 3
Answer: B) 1
Rationale: A score of 1 indicates the patient is not fully alert but is arousable with
minor stimulation (such as verbal cues). They can maintain attention but require
prompting to stay engaged .
---
Question 3
A patient requires repeated, vigorous painful stimulation to elicit any response.
They do not maintain awareness between stimuli. What is the LOC score?
A) 0
B) 1
C) 2
D) 3
Answer: C) 2
,Rationale: A score of 2 is given when the patient requires repeated or strong
stimulation to attend. They are obtunded and cannot sustain alertness without
continuous prompting .
---
Question 4
A comatose patient shows only reflexive posturing in response to painful stimuli
and has no purposeful movement. What LOC score is appropriate?
A) 0
B) 1
C) 2
D) 3
Answer: D) 3
Rationale: A score of 3 is reserved for patients who are unresponsive or respond
only with reflex motor activity. This includes coma and states with no purposeful
response to any stimulus .
Question 5
Which statement about scoring Level of Consciousness (1a) is correct?
A) The score can be changed after moving to the next item
B) This is the only item where you may go back and change the score
C) The score must be based solely on the patient's response to pain
, D) Family report can be used to determine the score
Answer: B) This is the only item where you may go back and change the score
Rationale: Item 1a is unique in that examiners are permitted to return and adjust
the score if further interaction with the patient during the exam provides better
information about their level of arousal .
---
Question 6
A patient is lethargic but opens their eyes when you speak loudly. They can answer
questions but seem confused and disoriented. What is the most appropriate LOC
score?
A) 0
B) 1
C) 2
D) 3
Answer: B) 1
Rationale: The patient demonstrates arousal with minor verbal stimulation and can
respond, meeting criteria for a score of 1. The content of responses is assessed
separately in items 1b and 1c .
---
Question 7
