NIH STROKE SCALE (NIHSS) EXAM LATEST
UPDATED QUESTIONS AND ANSWERS 2026-2027
1. What is the primary purpose of the NIH Stroke Scale (NIHSS)? Answer - To
quantitatively measure neurological impairment and stroke severity.
2. What does NIHSS item 1a (Level of Consciousness) assess? Answer - The patient's
level of alertness and arousal.
3. How is NIHSS item 1b (LOC Questions) tested? Answer - By asking the patient their current
month and age.
4. How is NIHSS item 1c (LOC Commands) tested? Answer - By asking the patient to open
and close their eyes and grip and release their hand.
5. What is the scoring range for NIHSS item 1a (Level of Consciousness)? Answer -
0 (alert) to 3 (unresponsive).
6. What does NIHSS item 2 (Best Gaze) measure? Answer - Horizontal eye movements.
7. What is the highest score possible on the NIHSS Best Gaze item? Answer - 2,
indicating forced deviation or total gaze paresis.
8. How are visual fields tested in NIHSS item 3? Answer - By confrontation or visual threat in
upper and lower quadrants.
9. What does NIHSS item 4 (Facial Palsy) evaluate? Answer - The symmetry of facial movements
such as smiling or showing teeth.
10. How is the motor arm test conducted for the left arm (item 5a)? Answer - By
holding the arm at 90 degrees (sitting) or 45 degrees (supine) for 10 seconds.
11. What is the scoring range for Motor Arm items (5a and 5b)? Answer - 0 (no
drift) to 4 (no movement).
12. Why are the arms tested separately in the NIHSS? Answer - To independently isolate left
(5a) and right (5b) motor function.
13. How is the motor leg test conducted for the left leg (item 6a)? Answer - By
holding the leg at 30 degrees for 5 seconds.
14. What is the scoring range for Motor Leg items (6a and 6b)? Answer - 0 (no drift)
to 4 (no movement).
15. What does NIHSS item 7 (Limb Ataxia) assess? Answer - Unilateral cerebellar ataxia
using fin-ger-nose-finger and heel-shin tests.
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UPDATED QUESTIONS AND ANSWERS 2026-2027
1. What is the primary purpose of the NIH Stroke Scale (NIHSS)? Answer - To
quantitatively measure neurological impairment and stroke severity.
2. What does NIHSS item 1a (Level of Consciousness) assess? Answer - The patient's
level of alertness and arousal.
3. How is NIHSS item 1b (LOC Questions) tested? Answer - By asking the patient their current
month and age.
4. How is NIHSS item 1c (LOC Commands) tested? Answer - By asking the patient to open
and close their eyes and grip and release their hand.
5. What is the scoring range for NIHSS item 1a (Level of Consciousness)? Answer -
0 (alert) to 3 (unresponsive).
6. What does NIHSS item 2 (Best Gaze) measure? Answer - Horizontal eye movements.
7. What is the highest score possible on the NIHSS Best Gaze item? Answer - 2,
indicating forced deviation or total gaze paresis.
8. How are visual fields tested in NIHSS item 3? Answer - By confrontation or visual threat in
upper and lower quadrants.
9. What does NIHSS item 4 (Facial Palsy) evaluate? Answer - The symmetry of facial movements
such as smiling or showing teeth.
10. How is the motor arm test conducted for the left arm (item 5a)? Answer - By
holding the arm at 90 degrees (sitting) or 45 degrees (supine) for 10 seconds.
11. What is the scoring range for Motor Arm items (5a and 5b)? Answer - 0 (no
drift) to 4 (no movement).
12. Why are the arms tested separately in the NIHSS? Answer - To independently isolate left
(5a) and right (5b) motor function.
13. How is the motor leg test conducted for the left leg (item 6a)? Answer - By
holding the leg at 30 degrees for 5 seconds.
14. What is the scoring range for Motor Leg items (6a and 6b)? Answer - 0 (no drift)
to 4 (no movement).
15. What does NIHSS item 7 (Limb Ataxia) assess? Answer - Unilateral cerebellar ataxia
using fin-ger-nose-finger and heel-shin tests.
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