NIH Stroke Scale Group E Test
Answers (Patients 1-6) – Itemized &
Descriptive Key Practice Questions
And Correct Answers (Verified
Answers) Plus Rationale 2026 Q&A|
Instant Download Pdf
1. What is the primary purpose of Item 1a of the NIHSS?
A. Assess visual fields
B. Assess language
C. Assess level of consciousness
D. Assess limb ataxia
Rationale: Item 1a evaluates the patient's overall level of
consciousness and responsiveness.
2. A patient is awake, alert, and responds appropriately without
stimulation. What is the appropriate NIHSS Item 1a score?
A. 1
B. 2
C. 3
D. 0
Rationale: A score of 0 represents an alert patient who is fully
responsive.
3. A patient is not fully alert but can be awakened by minor
stimulation and then responds. Which Item 1a score is most
appropriate?
,A. 0
B. 1
C. 2
D. 3
Rationale: A score of 1 reflects mild impairment of consciousness,
such as requiring minor stimulation to respond.
4. A patient requires repeated or strong stimulation to produce a
response. Which LOC score is most appropriate?
A. 0
B. 1
C. 2
D. 3
Rationale: Item 1a score 2 indicates a patient who is not alert and
requires repeated or vigorous stimulation to respond.
5. A patient responds only with reflex motor or autonomic effects
and does not demonstrate meaningful interaction. Which Item 1a
score is appropriate?
A. 0
B. 1
C. 2
D. 3
Rationale: A score of 3 represents an unresponsive patient with no
meaningful response to stimulation.
6. Which finding most strongly supports an NIHSS LOC score of 0?
A. Opens eyes only after painful stimulation
B. Requires repeated verbal commands
C. Immediately responds to questions and commands
D. Produces only reflexive movements
,Rationale: Immediate, appropriate responsiveness indicates normal
consciousness.
7. Why should the examiner avoid unnecessarily painful stimulation
when assessing an alert patient?
A. It improves the NIHSS score
B. The patient should first be assessed using ordinary stimulation
and interaction
C. Painful stimulation is required for all patients
D. Painful stimulation determines language ability
Rationale: NIHSS examination proceeds from ordinary interaction to
stronger stimulation only when necessary.
8. A patient is drowsy but awakens to a normal verbal command
and answers appropriately. Which score is most likely?
A. 0
B. 1
C. 2
D. 3
Rationale: If the patient is fully responsive during the examination
without significant stimulation, Item 1a can remain 0.
9. Which NIHSS item specifically evaluates the patient's ability to
answer two standard orientation questions?
A. 1a
B. 1b
C. 1c
D. 2
Rationale: Item 1b evaluates LOC questions.
10. Standard NIHSS LOC questions assess orientation to:
A. Name and address
B. Age and occupation
, C. Month and age
D. City and hospital
Rationale: The standard NIHSS questions are the patient's current
month and age.
11. A patient answers both LOC questions correctly. What is the
Item 1b score?
A. 0
B. 1
C. 2
D. 3
Rationale: Correctly answering both questions receives a score of 0.
12. A patient answers one of the two LOC questions correctly. What
is the score?
A. 0
B. 1
C. 2
D. 3
Rationale: One correct answer corresponds to a score of 1.
13. A patient answers neither LOC question correctly. What is the
score?
A. 0
B. 1
C. 2
D. 3
Rationale: Neither question answered correctly produces an Item 1b
score of 2.
14. A patient knows the hospital but gives the wrong month and
age. How should Item 1b be scored?
Answers (Patients 1-6) – Itemized &
Descriptive Key Practice Questions
And Correct Answers (Verified
Answers) Plus Rationale 2026 Q&A|
Instant Download Pdf
1. What is the primary purpose of Item 1a of the NIHSS?
A. Assess visual fields
B. Assess language
C. Assess level of consciousness
D. Assess limb ataxia
Rationale: Item 1a evaluates the patient's overall level of
consciousness and responsiveness.
2. A patient is awake, alert, and responds appropriately without
stimulation. What is the appropriate NIHSS Item 1a score?
A. 1
B. 2
C. 3
D. 0
Rationale: A score of 0 represents an alert patient who is fully
responsive.
3. A patient is not fully alert but can be awakened by minor
stimulation and then responds. Which Item 1a score is most
appropriate?
,A. 0
B. 1
C. 2
D. 3
Rationale: A score of 1 reflects mild impairment of consciousness,
such as requiring minor stimulation to respond.
4. A patient requires repeated or strong stimulation to produce a
response. Which LOC score is most appropriate?
A. 0
B. 1
C. 2
D. 3
Rationale: Item 1a score 2 indicates a patient who is not alert and
requires repeated or vigorous stimulation to respond.
5. A patient responds only with reflex motor or autonomic effects
and does not demonstrate meaningful interaction. Which Item 1a
score is appropriate?
A. 0
B. 1
C. 2
D. 3
Rationale: A score of 3 represents an unresponsive patient with no
meaningful response to stimulation.
6. Which finding most strongly supports an NIHSS LOC score of 0?
A. Opens eyes only after painful stimulation
B. Requires repeated verbal commands
C. Immediately responds to questions and commands
D. Produces only reflexive movements
,Rationale: Immediate, appropriate responsiveness indicates normal
consciousness.
7. Why should the examiner avoid unnecessarily painful stimulation
when assessing an alert patient?
A. It improves the NIHSS score
B. The patient should first be assessed using ordinary stimulation
and interaction
C. Painful stimulation is required for all patients
D. Painful stimulation determines language ability
Rationale: NIHSS examination proceeds from ordinary interaction to
stronger stimulation only when necessary.
8. A patient is drowsy but awakens to a normal verbal command
and answers appropriately. Which score is most likely?
A. 0
B. 1
C. 2
D. 3
Rationale: If the patient is fully responsive during the examination
without significant stimulation, Item 1a can remain 0.
9. Which NIHSS item specifically evaluates the patient's ability to
answer two standard orientation questions?
A. 1a
B. 1b
C. 1c
D. 2
Rationale: Item 1b evaluates LOC questions.
10. Standard NIHSS LOC questions assess orientation to:
A. Name and address
B. Age and occupation
, C. Month and age
D. City and hospital
Rationale: The standard NIHSS questions are the patient's current
month and age.
11. A patient answers both LOC questions correctly. What is the
Item 1b score?
A. 0
B. 1
C. 2
D. 3
Rationale: Correctly answering both questions receives a score of 0.
12. A patient answers one of the two LOC questions correctly. What
is the score?
A. 0
B. 1
C. 2
D. 3
Rationale: One correct answer corresponds to a score of 1.
13. A patient answers neither LOC question correctly. What is the
score?
A. 0
B. 1
C. 2
D. 3
Rationale: Neither question answered correctly produces an Item 1b
score of 2.
14. A patient knows the hospital but gives the wrong month and
age. How should Item 1b be scored?
