NIHSS GROUP C CERTIFICATION EXAM
WITH VERIFIED QUESTIONS AND ANSWERS ||
ALREADY GRADED A+
Section 1: Level of Consciousness (Items 1a, 1b, 1c)
Item 1a – Level of Consciousness
Q1. A patient is fully awake, answers questions appropriately, and follows
commands. What is the score for item 1a?
A) 0 B) 1 C) 2 D) 3
Answer: A) 0 – Alert and fully responsive = 0.
Q2. A patient is drowsy but awakens to verbal stimulation and answers
questions correctly before becoming lethargic again. What score should be
assigned?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Not alert but arousable by minor stimulation.
Q3. A patient is unresponsive to verbal commands but withdraws from painful
stimulation. What score is given?
A) 0 B) 1 C) 2 D) 3
Answer: C) 2 – Requires repeated or strong painful stimulation.
Q4. A patient demonstrates no motor response to painful stimulation and has no
vocalization. What score should be assigned?
A) 0 B) 1 C) 2 D) 3
Answer: D) 3 – Comatose, unresponsive.
Q5. A patient is lethargic but can be awakened briefly with repeated verbal
stimulation and can then answer questions. Which LOC score is appropriate?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Not fully alert but arousable by minor stimulation.
Q6. During the LOC assessment, a patient is completely unresponsive despite
repeated verbal and physical stimulation. What score should be assigned for
item 1a?
,A) 0 B) 1 C) 2 D) 3
Answer: D) 3 – Completely unresponsive.
Item 1b – LOC Questions
Q7. A patient correctly identifies the month but gives an incorrect age. How
should item 1b be scored?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – One of two questions answered correctly.
Q8. A patient knows his age and the current month. What is the score for item
1b?
A) 0 B) 1 C) 2
Answer: A) 0 – Answers both correctly.
Q9. Patient 1 is asked the month and their age. They cannot answer either
correctly. What is the score?
A) 0 B) 1 C) 2 D) 3
Answer: C) 2 – Answers neither correctly.
Q10. A patient is aphasic and cannot comprehend the questions. What score
should be assigned for item 1b?
A) 0 B) 1 C) 2
Answer: C) 2 – Aphasic or stuporous patients who cannot comprehend score 2.
Q11. A patient answers both LOC questions correctly. What is the score?
A) 0 B) 1 C) 2
Answer: A) 0 – Both correct.
Item 1c – LOC Commands
Q12. A patient is asked to open and close the eyes and then grip and release the
non-paretic hand. The patient performs both tasks correctly. What is the
appropriate score?
A) 0 B) 1 C) 2 D) 3
Answer: A) 0 – Both commands completed correctly.
Q13. The patient is asked to open/close eyes and grip/release the non-paretic
hand. They perform only the eye task correctly. What is the score?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Performs one task correctly.
Q14. Which finding represents the most severe abnormality for item 1c?
A) Performs both commands correctly B) Performs one command correctly C)
Performs neither command correctly D) Performs commands only after
, encouragement
Answer: C) Performs neither command correctly – Score 2.
Q15. A patient has severe aphasia and cannot understand the commands but
makes purposeful movements spontaneously. What score should be assigned for
item 1c?
A) 0 B) 1 C) 2 D) Untestable
Answer: C) 2 – Cannot perform either command due to comprehension
deficits.
Q16. Patient 1 is asked to open/close eyes and grip/release the non-paretic hand.
They perform only the eye task correctly. What is the score?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Performs one task correctly.
Q17. A patient performs both LOC commands correctly. What is the score?
A) 0 B) 1 C) 2
Answer: A) 0 – Both tasks performed correctly.
Q18. A patient performs neither LOC command correctly. What is the score?
A) 0 B) 1 C) 2
Answer: C) 2 – Neither task performed correctly.
Section 2: Best Gaze (Item 2)
Q19. When assessing horizontal gaze, the patient's eyes are deviated toward the
right and cannot be voluntarily moved past midline toward the left. What
finding should be recognized?
A) Normal gaze B) Partial gaze palsy C) Forced gaze deviation D) Isolated
visual field loss
Answer: C) Forced gaze deviation – Score 2.
Q20. A patient has an abnormal horizontal gaze but can overcome the deficit
with voluntary or reflexive eye movements. What gaze score is appropriate?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Partial gaze palsy.
Q21. The patient's eye movements are conjugate without deviation. What is the
score for item 2?
A) 0 B) 1 C) 2 D) 3
Answer: A) 0 – Normal.
WITH VERIFIED QUESTIONS AND ANSWERS ||
ALREADY GRADED A+
Section 1: Level of Consciousness (Items 1a, 1b, 1c)
Item 1a – Level of Consciousness
Q1. A patient is fully awake, answers questions appropriately, and follows
commands. What is the score for item 1a?
A) 0 B) 1 C) 2 D) 3
Answer: A) 0 – Alert and fully responsive = 0.
Q2. A patient is drowsy but awakens to verbal stimulation and answers
questions correctly before becoming lethargic again. What score should be
assigned?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Not alert but arousable by minor stimulation.
Q3. A patient is unresponsive to verbal commands but withdraws from painful
stimulation. What score is given?
A) 0 B) 1 C) 2 D) 3
Answer: C) 2 – Requires repeated or strong painful stimulation.
Q4. A patient demonstrates no motor response to painful stimulation and has no
vocalization. What score should be assigned?
A) 0 B) 1 C) 2 D) 3
Answer: D) 3 – Comatose, unresponsive.
Q5. A patient is lethargic but can be awakened briefly with repeated verbal
stimulation and can then answer questions. Which LOC score is appropriate?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Not fully alert but arousable by minor stimulation.
Q6. During the LOC assessment, a patient is completely unresponsive despite
repeated verbal and physical stimulation. What score should be assigned for
item 1a?
,A) 0 B) 1 C) 2 D) 3
Answer: D) 3 – Completely unresponsive.
Item 1b – LOC Questions
Q7. A patient correctly identifies the month but gives an incorrect age. How
should item 1b be scored?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – One of two questions answered correctly.
Q8. A patient knows his age and the current month. What is the score for item
1b?
A) 0 B) 1 C) 2
Answer: A) 0 – Answers both correctly.
Q9. Patient 1 is asked the month and their age. They cannot answer either
correctly. What is the score?
A) 0 B) 1 C) 2 D) 3
Answer: C) 2 – Answers neither correctly.
Q10. A patient is aphasic and cannot comprehend the questions. What score
should be assigned for item 1b?
A) 0 B) 1 C) 2
Answer: C) 2 – Aphasic or stuporous patients who cannot comprehend score 2.
Q11. A patient answers both LOC questions correctly. What is the score?
A) 0 B) 1 C) 2
Answer: A) 0 – Both correct.
Item 1c – LOC Commands
Q12. A patient is asked to open and close the eyes and then grip and release the
non-paretic hand. The patient performs both tasks correctly. What is the
appropriate score?
A) 0 B) 1 C) 2 D) 3
Answer: A) 0 – Both commands completed correctly.
Q13. The patient is asked to open/close eyes and grip/release the non-paretic
hand. They perform only the eye task correctly. What is the score?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Performs one task correctly.
Q14. Which finding represents the most severe abnormality for item 1c?
A) Performs both commands correctly B) Performs one command correctly C)
Performs neither command correctly D) Performs commands only after
, encouragement
Answer: C) Performs neither command correctly – Score 2.
Q15. A patient has severe aphasia and cannot understand the commands but
makes purposeful movements spontaneously. What score should be assigned for
item 1c?
A) 0 B) 1 C) 2 D) Untestable
Answer: C) 2 – Cannot perform either command due to comprehension
deficits.
Q16. Patient 1 is asked to open/close eyes and grip/release the non-paretic hand.
They perform only the eye task correctly. What is the score?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Performs one task correctly.
Q17. A patient performs both LOC commands correctly. What is the score?
A) 0 B) 1 C) 2
Answer: A) 0 – Both tasks performed correctly.
Q18. A patient performs neither LOC command correctly. What is the score?
A) 0 B) 1 C) 2
Answer: C) 2 – Neither task performed correctly.
Section 2: Best Gaze (Item 2)
Q19. When assessing horizontal gaze, the patient's eyes are deviated toward the
right and cannot be voluntarily moved past midline toward the left. What
finding should be recognized?
A) Normal gaze B) Partial gaze palsy C) Forced gaze deviation D) Isolated
visual field loss
Answer: C) Forced gaze deviation – Score 2.
Q20. A patient has an abnormal horizontal gaze but can overcome the deficit
with voluntary or reflexive eye movements. What gaze score is appropriate?
A) 0 B) 1 C) 2 D) 3
Answer: B) 1 – Partial gaze palsy.
Q21. The patient's eye movements are conjugate without deviation. What is the
score for item 2?
A) 0 B) 1 C) 2 D) 3
Answer: A) 0 – Normal.
