NIH STROKE SCALE (NIHSS) CERTIFICATION EXAM 2026–2027 PRACTICE QUESTIONS WITH ANSWER KEYS & RATIONALES – ALL TEST GROUPS A–F (PATIENTS 1–6) – 100% PASS GUARANTEE

NIH STROKE SCALE (NIHSS) CERTIFICATION
EXAM 2026–2027 PRACTICE QUESTIONS WITH
ANSWER KEYS & RATIONALES – ALL TEST
GROUPS A–F (PATIENTS 1–6) – 100% PASS
GUARANTEE


This comprehensive question NIH Stroke Scale (NIHSS)
practice exam covers all six certification test groups (A–F)
with detailed answer keys and bold-italic rationales for every
question. Each question mirrors the format of the official
NIHSS certification videos, including patient scoring, clinical
correlation, and advanced practice scenarios. Ideal for
nurses, physicians, and allied health professionals preparing
for initial certification or renewal, this study guide ensures
100% exam readiness with evidence-based explanations.


Question 1: What is the correct score for 1a (Level of Consciousness) for
Patient 1?
A) 0
B) 1
C) 2
D) 3
Answer: A
Rationale: Patient 1 is fully alert and keenly responsive. A score of 0
indicates the patient is alert and keenly responsive to stimulation, which is
the expected finding for this patient.

,Question 2: What is the correct score for 1b (LOC Questions) for Patient
1?
A) 0
B) 1
C) 2
D) Not tested
Answer: A
Rationale: The patient answers both questions correctly (current month
and age). A score of 0 is assigned when the patient correctly answers both
LOC questions.


Question 3: What is the correct score for 1c (LOC Commands) for Patient
1?
A) 0
B) 1
C) 2
D) Cannot be determined
Answer: A
Rationale: The patient performs both tasks correctly (opens/closes eyes
and grips/releases non-paretic hand). Score 0 indicates both commands
are performed correctly.


Question 4: What is the correct score for Item 2 (Best Gaze) for Patient 1?
A) 0
B) 1
C) 2
D) Not applicable
Answer: A

,Rationale: Patient 1 demonstrates normal horizontal eye movements with
no gaze palsy. A score of 0 is assigned for normal gaze.


Question 5: What is the correct score for Item 3 (Visual Fields) for Patient
1?
A) 0
B) 1
C) 2
D) 3
Answer: A
Rationale: No visual loss is detected during confrontation testing. Score 0
indicates no visual field deficit.


Question 6: What is the correct score for Item 4 (Facial Palsy) for Patient
1?
A) 0
B) 1
C) 2
D) 3
Answer: B
Rationale: Patient 1 exhibits minor paralysis with a flattened nasolabial
fold. Score 1 is assigned for minor paralysis (flattened nasolabial fold,
asymmetry on smiling).


Question 7: What is the correct score for 5a (Motor Arm - Left) for Patient
1?
A) 0
B) 1

, C) 2
D) 3
Answer: D
Rationale: The left arm shows no movement against gravity. Score 3
indicates no effort against gravity; the limb falls. This finding is consistent
with significant left-sided weakness.


Question 8: What is the correct score for 6a (Motor Leg - Left) for Patient
1?
A) 0
B) 1
C) 2
D) 3
Answer: B
Rationale: The left leg drifts but does not hit the bed within 10 seconds.
Score 1 indicates drift that does not hit the bed or other support.


Question 9: What is the correct score for Item 11 (Extinction/Inattention)
for Patient 1?
A) 0
B) 1
C) 2
D) Cannot be assessed
Answer: B
Rationale: The patient demonstrates inattention to one side. Score 1
indicates inattention or extinction to bilateral simultaneous stimulation in
one sensory modality.