STROKE ASSESSMENT · NIHSS CERTIFICATION
NIHSS GROUP C - PATIENTS 1-6 FOR ME (PASSING ANSWERS)
2026/2027!!
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Level of Consciousness (Items 1a, 1b, 1c)
Best Gaze, Visual Fields, and Facial Palsy
Motor Arm, Motor Leg, and Limb Ataxia
Sensory, Best Language, and Dysarthria
Extinction/Inattention, Total Scoring, and Certification Application
STUVIAACTUALEXAM
, SECTION 1: LEVEL OF CONSCIOUSNESS (ITEMS 1A, 1B, 1C)
Q1
A stroke patient is examined in the emergency department. The patient does not respond to voice but opens eyes and
withdraws to a deep nail-bed pressure stimulus. According to NIHSS item 1a (Level of Consciousness), which score is
assigned?
A. 1 – Not alert, but arousable by minor stimulation to obey, answer, or respond
B. 2 – Not alert, requires repeated stimulation or is obtunded and requires strong/painful stimulation to make movements
C. 3 – Responds only with reflex motor or autonomic effects, or totally unresponsive
D. 0 – Alert and responsive
Correct Answer: B
Rationale:
Item 1a score 2 is used when the patient requires strong or painful stimulation to elicit any response and remains obtunded. Score 1 is reserved
for patients who respond to minor stimulation; score 3 is for reflex-only or total unresponsiveness.
Q2
During NIHSS testing the examiner asks the patient the month and the patient’s age. The patient correctly states the month but
gives an age that is two years incorrect. How is item 1b (LOC Questions) scored?
A. 0 – Answers both questions correctly
B. 1 – Answers one question correctly
C. 2 – Answers neither question correctly
D. UN – Untestable because of intubation
Correct Answer: B
Rationale:
Item 1b awards 1 point when only one of the two questions is answered correctly. Exact correctness is required; approximate answers count as
incorrect.
Q3
A patient is asked to open and close the eyes and then to grip and release the non-paretic hand. The patient performs the eye
command correctly but does not attempt the hand grip despite comprehension of the request. What is the correct score for item
1c (LOC Commands)?
A. 0 – Performs both tasks correctly
B. 1 – Performs one task correctly
C. 2 – Performs neither task correctly
D. 3 – Not used for this item
Correct Answer: B
Rationale:
Item 1c is scored 1 when only one of the two commands is performed correctly. Credit is given only for actual performance, not for attempted
but incomplete movements.
NIHSS GROUP C - PATIENTS 1-6 FOR ME (PASSING ANSWERS)
2026/2027!!
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Level of Consciousness (Items 1a, 1b, 1c)
Best Gaze, Visual Fields, and Facial Palsy
Motor Arm, Motor Leg, and Limb Ataxia
Sensory, Best Language, and Dysarthria
Extinction/Inattention, Total Scoring, and Certification Application
STUVIAACTUALEXAM
, SECTION 1: LEVEL OF CONSCIOUSNESS (ITEMS 1A, 1B, 1C)
Q1
A stroke patient is examined in the emergency department. The patient does not respond to voice but opens eyes and
withdraws to a deep nail-bed pressure stimulus. According to NIHSS item 1a (Level of Consciousness), which score is
assigned?
A. 1 – Not alert, but arousable by minor stimulation to obey, answer, or respond
B. 2 – Not alert, requires repeated stimulation or is obtunded and requires strong/painful stimulation to make movements
C. 3 – Responds only with reflex motor or autonomic effects, or totally unresponsive
D. 0 – Alert and responsive
Correct Answer: B
Rationale:
Item 1a score 2 is used when the patient requires strong or painful stimulation to elicit any response and remains obtunded. Score 1 is reserved
for patients who respond to minor stimulation; score 3 is for reflex-only or total unresponsiveness.
Q2
During NIHSS testing the examiner asks the patient the month and the patient’s age. The patient correctly states the month but
gives an age that is two years incorrect. How is item 1b (LOC Questions) scored?
A. 0 – Answers both questions correctly
B. 1 – Answers one question correctly
C. 2 – Answers neither question correctly
D. UN – Untestable because of intubation
Correct Answer: B
Rationale:
Item 1b awards 1 point when only one of the two questions is answered correctly. Exact correctness is required; approximate answers count as
incorrect.
Q3
A patient is asked to open and close the eyes and then to grip and release the non-paretic hand. The patient performs the eye
command correctly but does not attempt the hand grip despite comprehension of the request. What is the correct score for item
1c (LOC Commands)?
A. 0 – Performs both tasks correctly
B. 1 – Performs one task correctly
C. 2 – Performs neither task correctly
D. 3 – Not used for this item
Correct Answer: B
Rationale:
Item 1c is scored 1 when only one of the two commands is performed correctly. Credit is given only for actual performance, not for attempted
but incomplete movements.
