NIHSS-ENGLISH GROUP E-V3 - 5TH CERTIFICATION
SOLVED 100% CORRECT 2023
CORE DOMAINS
Level of Consciousness (1a, 1b, 1c)
Best Gaze (2)
Visual Fields (3)
Facial Palsy (4)
Motor Arm and Leg (5a, 5b, 6a, 6b)
Limb Ataxia (7)
Sensory (8)
Best Language (9)
Dysarthria (10)
Extinction and Inattention (11)
INTRODUCTION
This document provides the complete, verified answer key for the NIHSS-
English Group E-V3, 5th Certification examination. It includes itemized
scoring solutions for Patients 1 through 6, covering all 11 assessment
parameters of the National Institutes of Health Stroke Scale. Each answer
is accompanied by a descriptive rationale based on the official NIHSS
scoring guidelines. This resource is designed for healthcare professionals
completing initial or renewal NIHSS certification and serves as a
comprehensive study and reference guide.
SECTION ONE: QUESTIONS AND ANSWERS
1. Patient 1 — What is the correct NIHSS score for each assessment
item?
Patient 1 presents as an older White man with a mustache and blue eyes
who exhibits normal baseline functionality across almost all metrics.
A. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 1, 7: 0, 8: 1, 9:
0, 10: 0, 11: 0
B. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 1, 7: 0, 8: 1, 9:
0, 10: 0, 11: 0
, C. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 0, 7: 0, 8: 0, 9:
0, 10: 0, 11: 0
D. 1a: 1, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 0, 7: 0, 8: 0, 9:
0, 10: 0, 11: 0
A. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 1, 7: 0, 8: 1,
9: 0, 10: 0, 11: 0
RATIONALE: Patient 1 demonstrates normal consciousness, gaze,
visual fields, facial symmetry, and motor function in the arms. The right leg
shows mild drift (score 1), and there is mild sensory loss (score 1) .
2. Patient 2 — What is the correct NIHSS score for each assessment
item?
Patient 2 presents with partial right-sided weakness and mild language
impairment.
A. 1a: 0, 1b: 1, 1c: 0, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
B. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
C. 1a: 0, 1b: 1, 1c: 0, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 3, 6a: 0, 6b: 2, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
D. 1a: 0, 1b: 1, 1c: 1, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
A. 1a: 0, 1b: 1, 1c: 0, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1,
9: 1, 10: 0, 11: 1
RATIONALE: Patient 2 answers one question incorrectly (1b: 1), has
minor facial paralysis (4: 1), no movement in the right arm (5b: 4), right leg
shows no movement against gravity (6b: 3), mild sensory loss (8: 1), mild
aphasia (9: 1), and inattention (11: 1) .
3. Patient 3 — What is the correct NIHSS score for each assessment
item?
Patient 3 presents with severe neurological deficits including impaired
consciousness and hemiplegia.
SOLVED 100% CORRECT 2023
CORE DOMAINS
Level of Consciousness (1a, 1b, 1c)
Best Gaze (2)
Visual Fields (3)
Facial Palsy (4)
Motor Arm and Leg (5a, 5b, 6a, 6b)
Limb Ataxia (7)
Sensory (8)
Best Language (9)
Dysarthria (10)
Extinction and Inattention (11)
INTRODUCTION
This document provides the complete, verified answer key for the NIHSS-
English Group E-V3, 5th Certification examination. It includes itemized
scoring solutions for Patients 1 through 6, covering all 11 assessment
parameters of the National Institutes of Health Stroke Scale. Each answer
is accompanied by a descriptive rationale based on the official NIHSS
scoring guidelines. This resource is designed for healthcare professionals
completing initial or renewal NIHSS certification and serves as a
comprehensive study and reference guide.
SECTION ONE: QUESTIONS AND ANSWERS
1. Patient 1 — What is the correct NIHSS score for each assessment
item?
Patient 1 presents as an older White man with a mustache and blue eyes
who exhibits normal baseline functionality across almost all metrics.
A. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 1, 7: 0, 8: 1, 9:
0, 10: 0, 11: 0
B. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 1, 7: 0, 8: 1, 9:
0, 10: 0, 11: 0
, C. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 0, 7: 0, 8: 0, 9:
0, 10: 0, 11: 0
D. 1a: 1, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 0, 7: 0, 8: 0, 9:
0, 10: 0, 11: 0
A. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 0, 6a: 0, 6b: 1, 7: 0, 8: 1,
9: 0, 10: 0, 11: 0
RATIONALE: Patient 1 demonstrates normal consciousness, gaze,
visual fields, facial symmetry, and motor function in the arms. The right leg
shows mild drift (score 1), and there is mild sensory loss (score 1) .
2. Patient 2 — What is the correct NIHSS score for each assessment
item?
Patient 2 presents with partial right-sided weakness and mild language
impairment.
A. 1a: 0, 1b: 1, 1c: 0, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
B. 1a: 0, 1b: 0, 1c: 0, 2: 0, 3: 0, 4: 0, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
C. 1a: 0, 1b: 1, 1c: 0, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 3, 6a: 0, 6b: 2, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
D. 1a: 0, 1b: 1, 1c: 1, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1, 9:
1, 10: 0, 11: 1
A. 1a: 0, 1b: 1, 1c: 0, 2: 0, 3: 0, 4: 1, 5a: 0, 5b: 4, 6a: 0, 6b: 3, 7: 0, 8: 1,
9: 1, 10: 0, 11: 1
RATIONALE: Patient 2 answers one question incorrectly (1b: 1), has
minor facial paralysis (4: 1), no movement in the right arm (5b: 4), right leg
shows no movement against gravity (6b: 3), mild sensory loss (8: 1), mild
aphasia (9: 1), and inattention (11: 1) .
3. Patient 3 — What is the correct NIHSS score for each assessment
item?
Patient 3 presents with severe neurological deficits including impaired
consciousness and hemiplegia.
