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NIH Stroke Scale (NIHSS) Certification Exam | Practice Questions & Verified Answers, Study Guide & Exam Prep PDF

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Prepare effectively for the NIH Stroke Scale (NIHSS) Certification Exam with focused practice questions and verified answers covering neurological assessment, stroke severity evaluation, level of consciousness, visual fields, facial palsy, motor function, limb ataxia, sensory findings, language, dysarthria, and extinction/inattention. The American Heart Association's NIH Stroke Scale training program is designed to help healthcare professionals consistently administer and score the NIHSS through assessment scenarios, while its current training materials indicate a redesigned course launching in late summer/early fall 2026. This resource is designed for nurses, physicians, advanced practice providers, emergency and stroke-care professionals, and other healthcare learners seeking targeted NIHSS certification review, practice testing, and convenient PDF-based preparation for the period.

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NIH Stroke Scale (NIHSS) Certification Exam | Practice Questions & Verified Answer


How many items on the NIH stroke scale? 11




NIH Stroke scale is an 11-item clinical evaluation instrument widely used in clinical trials and practice to
assess neurologic outcome and degree of recovery from stroke.



NIH Stroke Scale is used to quantify the effects of acute levels of:
cerebral ischemia on levels of ... (7 items) consciousness
vision
motor function (facial and extremities)
cerebellar function
sensation
language
extinction or inattention


NIH SS is used to measure patient's status after a stroke treatment
and to assess the outcome after



Should the patient be coached? Should you go back and NO
rethink a particular assessment?



Having what when using NIH scale is important? reference materials




DO NOT RATE what you think the patient wants to do or rate only what they actually do
what you think they can do, RATE ONLY



use patient"s first response? YES - DO NOT USE SUMMARY OF RESPONSES




re ataxia score 1) 0
1-if real weak, assume ataxia score is... 2) ataxia
2-if they can hold leg or arm up w/ minimal drift but are all 3) 1 or 2
over place when trying finger to nose test, that's probably... 4) 0
3) Important to know if ataxia is present or not and if
present in _____ or _______ limbs
4) if patient very weak or paralyzed, the ataxia score is...


You should only score loss of sensation if you can really that they have loss of sensation
demonstrate...



if patient has sensory loss from neuropathy, do you count no, but you do if there's loss on top of the neuropathy
thatt?



aphasia is difficult because it can take a while to go mild, mod, severe
through the battery and it can be subjective as to whether
it is one of which classification?


start to recognise aphasia when you meet them and start what happened
talking and you don't get a history of...




Stuvia 2026-2027

, NIH Stroke Scale (NIHSS) Certification Exam | Practice Questions & Verified Answer


dysarthria is interesting because there are many cultural speech.
things about slurred ________?



Score is associated with prognosis? YES




Is NIH scale a measure of disability? NO. The NIH scale is a measure of impairments.




The NIH scale creates a common currency so that deficit, by giving a number that communicates to other professionals how sick the
everybody understands the patient's level of... patient is



how much time to budget to perorm NIH scale 7-10 mins




What effort should be recorded? Do not do what? The patient's first effort. Don't go back and change scores.




IMPORTANT CONVENTIONS IN ADMINISTRATION: -order
Administer scale items in their exact ______ -coaching
-Avoid ______ing patient -first
-Accept patient's _______ effort -does
-Score only what the patient _______ -Be consistent
-Be consistent -previous strokes
-Include all _________s into scoring, including those that
may be from _________s ______s


ITEM 1a and how to get it -examiner's overall impression of patient alertness
-ask 2-3 questions about circumstances of admission, stimuate patient by patting or
tapping, occasionally pinching


NIH Item 1a Scoring: -Alert
0 -Not alert, aroused w/ minor verbal stim
1 -Not alert, requires strong or painful stim
2 -Only reflexive movements or totally unresponsive
3


ITEM 1a - patient w/ 3 on this item is generally considered a coma
to be in... reflexive posturing in response to noxious stimulation
3 is scored ONLY if patient makes no movement other
than....


If difficult to determine 1 vs 2 in item 1a, continue with... medical hx qs until confident in assigning a score - THIS IS ONLY TIME IN NIH
scale where you can go back



EVEN IF PRESENTED WITH OBSTACLES OR SCORE
BARRIERS, YOU MUST CHOOSE A



NIH Item 1B -month of year
based on responses to two items: -patient's age
When?
-What about patient




Stuvia 2026-2027

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