APEX NIH Stroke Scale Group A Patients 1–6
(Complete) Verified Answers – 2025/2026 Edition |
Comprehensive NIH Stroke Scale Certification
Practice Examination
The content is organized into domains covering all 11 components of the NIHSS:
Level of Consciousness, Best Gaze, Visual Fields, Facial Palsy, Motor Arm, Motor
Leg, Limb Ataxia, Sensory, Best Language, Dysarthria, and Extinction/Inattention.
Each domain covers distinct sub-topics, ensuring every question tests a unique
body of knowledge with no duplication across the examination. All answers are
verified to current stroke assessment guidelines and training protocols, designed
for accurate reference in clinical or test environments.
Domain 1: Level of Consciousness (LOC)
(Questions 1–12)
Question 1
A patient is fully awake and responsive. What is the correct Level of
Consciousness (LOC) score?
A. 1 - Arouses to minor stimulation
B. 2 - Requires repeated stimulation
C. 0 - Alert
D. 3 - Unresponsive
Correct Answer: C
Rationale: A score of 0 on the LOC item indicates the patient is alert and fully
responsive. This is the baseline for a normal neurologic examination. Any score
above 0 indicates some level of impaired consciousness.
,Question 2
A patient arouses only to vigorous and repeated stimulation. What is the correct
LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
Correct Answer: C
Rationale: A score of 2 indicates the patient requires repeated or vigorous
stimulation to arouse. This represents significant impairment of consciousness and
may indicate serious neurologic injury.
Question 3
A patient is unresponsive to all stimuli. What is the correct LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
Correct Answer: D
Rationale: A score of 3 on the LOC item indicates the patient is completely
unresponsive to all stimuli. This is the most severe impairment of consciousness
and suggests profound brain injury.
Question 4
A patient arouses to minor stimulation such as gentle touch or voice. What is the
correct LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
,Correct Answer: B
Rationale: A score of 1 indicates the patient arouses to minor stimulation. This
represents mild to moderate impairment of consciousness.
Question 5
When assessing LOC, which question is asked to evaluate orientation?
A. "What is today's date?"
B. "What month is it?" and "How old are you?"
C. "What is your address?"
D. "What is your favorite color?"
Correct Answer: B
Rationale: The NIHSS assesses orientation by asking the patient the current month
and their age. These two questions evaluate orientation to time and person. Both
must be answered correctly for a score of 0.
Question 6
A patient answers the month correctly but gives an incorrect age. What is the
correct score for the orientation questions?
A. 0 - Both correct
B. 1 - One correct
C. 2 - Neither correct
D. 3 - Intubated or other barrier
Correct Answer: B
Rationale: The orientation questions ask the month and age. If only one answer is
correct, the score is 1. Both must be correct for a score of 0. If the patient is
intubated or has a barrier, the score is documented as 3.
Question 7
A patient is intubated and cannot speak. How should the LOC orientation questions
be scored?
A. 0 - Both correct
B. 1 - One correct
, C. 2 - Neither correct
D. 3 - Intubated or other barrier
Correct Answer: D
Rationale: If the patient is intubated, has a tracheostomy, or cannot speak due to
other barriers, the orientation questions are scored as 3 (untestable). The examiner
should document the reason for the untestable score.
Question 8
A patient opens their eyes to pain but does not follow commands. What is the
appropriate LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
Correct Answer: C
Rationale: Opening eyes only to pain indicates the patient requires repeated or
vigorous stimulation to arouse, which corresponds to a score of 2. This level of
consciousness impairment is significant and requires close monitoring.
Question 9
Which LOC score indicates the patient is fully awake, alert, and oriented?
A. 0
B. 1
C. 2
D. 3
Correct Answer: A
Rationale: A score of 0 on the LOC item indicates the patient is fully awake, alert,
and oriented. This is considered normal and indicates intact consciousness.
Question 10
A patient is drowsy but answers questions appropriately when stimulated. What is
the correct LOC score?
(Complete) Verified Answers – 2025/2026 Edition |
Comprehensive NIH Stroke Scale Certification
Practice Examination
The content is organized into domains covering all 11 components of the NIHSS:
Level of Consciousness, Best Gaze, Visual Fields, Facial Palsy, Motor Arm, Motor
Leg, Limb Ataxia, Sensory, Best Language, Dysarthria, and Extinction/Inattention.
Each domain covers distinct sub-topics, ensuring every question tests a unique
body of knowledge with no duplication across the examination. All answers are
verified to current stroke assessment guidelines and training protocols, designed
for accurate reference in clinical or test environments.
Domain 1: Level of Consciousness (LOC)
(Questions 1–12)
Question 1
A patient is fully awake and responsive. What is the correct Level of
Consciousness (LOC) score?
A. 1 - Arouses to minor stimulation
B. 2 - Requires repeated stimulation
C. 0 - Alert
D. 3 - Unresponsive
Correct Answer: C
Rationale: A score of 0 on the LOC item indicates the patient is alert and fully
responsive. This is the baseline for a normal neurologic examination. Any score
above 0 indicates some level of impaired consciousness.
,Question 2
A patient arouses only to vigorous and repeated stimulation. What is the correct
LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
Correct Answer: C
Rationale: A score of 2 indicates the patient requires repeated or vigorous
stimulation to arouse. This represents significant impairment of consciousness and
may indicate serious neurologic injury.
Question 3
A patient is unresponsive to all stimuli. What is the correct LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
Correct Answer: D
Rationale: A score of 3 on the LOC item indicates the patient is completely
unresponsive to all stimuli. This is the most severe impairment of consciousness
and suggests profound brain injury.
Question 4
A patient arouses to minor stimulation such as gentle touch or voice. What is the
correct LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
,Correct Answer: B
Rationale: A score of 1 indicates the patient arouses to minor stimulation. This
represents mild to moderate impairment of consciousness.
Question 5
When assessing LOC, which question is asked to evaluate orientation?
A. "What is today's date?"
B. "What month is it?" and "How old are you?"
C. "What is your address?"
D. "What is your favorite color?"
Correct Answer: B
Rationale: The NIHSS assesses orientation by asking the patient the current month
and their age. These two questions evaluate orientation to time and person. Both
must be answered correctly for a score of 0.
Question 6
A patient answers the month correctly but gives an incorrect age. What is the
correct score for the orientation questions?
A. 0 - Both correct
B. 1 - One correct
C. 2 - Neither correct
D. 3 - Intubated or other barrier
Correct Answer: B
Rationale: The orientation questions ask the month and age. If only one answer is
correct, the score is 1. Both must be correct for a score of 0. If the patient is
intubated or has a barrier, the score is documented as 3.
Question 7
A patient is intubated and cannot speak. How should the LOC orientation questions
be scored?
A. 0 - Both correct
B. 1 - One correct
, C. 2 - Neither correct
D. 3 - Intubated or other barrier
Correct Answer: D
Rationale: If the patient is intubated, has a tracheostomy, or cannot speak due to
other barriers, the orientation questions are scored as 3 (untestable). The examiner
should document the reason for the untestable score.
Question 8
A patient opens their eyes to pain but does not follow commands. What is the
appropriate LOC score?
A. 0 - Alert
B. 1 - Arouses to minor stimulation
C. 2 - Requires repeated stimulation
D. 3 - Unresponsive
Correct Answer: C
Rationale: Opening eyes only to pain indicates the patient requires repeated or
vigorous stimulation to arouse, which corresponds to a score of 2. This level of
consciousness impairment is significant and requires close monitoring.
Question 9
Which LOC score indicates the patient is fully awake, alert, and oriented?
A. 0
B. 1
C. 2
D. 3
Correct Answer: A
Rationale: A score of 0 on the LOC item indicates the patient is fully awake, alert,
and oriented. This is considered normal and indicates intact consciousness.
Question 10
A patient is drowsy but answers questions appropriately when stimulated. What is
the correct LOC score?
