CE direct: The NIH Stroke Scale Exam Questions With Accurate Solutions

When should the NIHSS be administered? - ANSWER-C. As soon as possible and if there is a sudden change in status What is one way that the NIHSS is reproducible? - ANSWER-C. Use by certified professionals Correct Worsening scores in which of the following NIHSS categories is associated with neurological deterioration when observed within 120 minutes after TPA administration? - ANSWER-A. Level of consciousness When administering the NIHSS to a non-English speaking patient, what additional resources should the nurse plan to have for the assessment? - ANSWER-B. Language services or an interpreter What is the NIHSS category score for 1c (LOC-Commands) when the patient attempts to follow instructions but is too weak? - ANSWER-A. 0 - Performs both tasks correctly For which category of the NIHSS would the nurse ask the patient to "follow my finger" as the nurse moves a finger horizontally to the left and right? - ANSWER-B. Best gaze When assessing Motor Arm function for a patient sitting in a wheelchair, should the palm be up or down? And, at what angle should the arms be? - ANSWER-D. Down, 90 The nurse is evaluating the Motor Arm function, right arm. The provider positions the arm in the correct position and then releases the arm. The arm slightly dips, returns to normal position, and the position is held. What is the appropriate score? - ANSWER-A. 0 - No drift