NIHSS - Level 1 Question and answers
correctly solved 2025
The patient is asked the month and his/her age. The answer must be correct -
there is no partial credit for being close. Aphasic and stuporous patients who
do not comprehend the questions will score 2. Patients unable to speak
because of endotracheal intubation, orotracheal trauma, severe dysarthria
from any cause, language barrier or any other problem not secondary to
aphasia are given a 1. It is important that only the initial answer be graded and
that the examiner not help the patient with verbal or non-verbal cues. - correct
answer ✔1b. LOC Questions
1-Answers One Question Correctly
The patient is asked to open and close the eyes and then to grip and release
the non-paretic hand. Substitute another one step command if the hands
cannot be used. Credit is given if an unequivocal attempt is made but not
completed due to weakness. If the patient does not respond to command, the
task should be demonstrated to them (pantomime) and score the result (i.e.,
follows none, one or two commands). Patients with trauma, amputation, or
other physical impediments should be given suitable one-step commands.
Only the first attempt is scored. - correct answer ✔1c. LOC Commands
0- Performs both Tasks Correctly
Only horizontal eye movements will be tested.Voluntary or reflexive
(oculocephalic) eye movements will be scored but caloric testing is not done.
If the patient has a conjugate deviation of the eyes that can be overcome by
voluntary or reflexive activity, the score will be 1. If a patient has an isolated
peripheral nerve paresis (CN III, IV or VI) score a 1. Gaze is testable in all
aphasic patients. Patients with ocular trauma, bandages, pre-existing
blindness or other disorder of visual acuity or fields should be tested with
reflexive movements and a choice made by the investigator. Establishing eye
contact and then moving about the patient from side to side will occasionally
clarify the presence of a partial gaze palsy. - correct answer ✔2. best Gaze
, 0-Normal
Visual fields (upper and lower quadrants) are tested by confrontation, using
finger counting or visual threat as appropriate. Patient must be encouraged,
but if they look at the side of the moving fingers appropriately, this can be
scored as normal. If there is unilateral blindness or enucleation, visual fields in
the remaining eye are scored. Score 1 only if a clear-cut asymmetry, including
quadrantanopia is found. If patient is blind from any cause score 3. Double
simultaneous stimulation is performed at this point. If there is extinction patient
receives a 1, and the results are used to answer question 11. - correct
answer ✔3. Visual
0-No Visual Loss
Ask, or use pantomime to encourage the patient to show teeth or raise
eyebrows and close eyes. Score symmetry of grimace in response to noxious
stimuli in the poorly responsive or non-comprehending patient. If facial
trauma/bandages, orotracheal tube, tape or other physical barriers obscure
the face, these should be removed to the extent possible. - correct answer
✔4. Facial Palsy
1-Minor Paralysis (Flattened nasolabial fold, asymmetry on smiling).
The limb is placed in the appropriate position: extend the arms (palms down)
90 degrees (if sitting) or 45 degrees (if supine). Drift is scored if the arm falls
before 10 seconds. The aphasic patient is encouraged using urgency in the
voice and pantomime, but not noxious stimulation. Each limb is tested in turn,
beginning with the non-paretic arm. Only in the case of amputation or joint
fusion at the shoulder, the examiner should record the score as untestable
(UN). - correct answer ✔5a. Motor Arm Left
0- No drift, limb holds 90 (or 45) degrees for full 10 seconds.
The limb is placed in the appropriate position: extend the arms (palms down)
90 degrees (if sitting) or 45 degrees (if supine). Drift is scored if the arm falls
before 10 seconds. The aphasic patient is encouraged using urgency in the
correctly solved 2025
The patient is asked the month and his/her age. The answer must be correct -
there is no partial credit for being close. Aphasic and stuporous patients who
do not comprehend the questions will score 2. Patients unable to speak
because of endotracheal intubation, orotracheal trauma, severe dysarthria
from any cause, language barrier or any other problem not secondary to
aphasia are given a 1. It is important that only the initial answer be graded and
that the examiner not help the patient with verbal or non-verbal cues. - correct
answer ✔1b. LOC Questions
1-Answers One Question Correctly
The patient is asked to open and close the eyes and then to grip and release
the non-paretic hand. Substitute another one step command if the hands
cannot be used. Credit is given if an unequivocal attempt is made but not
completed due to weakness. If the patient does not respond to command, the
task should be demonstrated to them (pantomime) and score the result (i.e.,
follows none, one or two commands). Patients with trauma, amputation, or
other physical impediments should be given suitable one-step commands.
Only the first attempt is scored. - correct answer ✔1c. LOC Commands
0- Performs both Tasks Correctly
Only horizontal eye movements will be tested.Voluntary or reflexive
(oculocephalic) eye movements will be scored but caloric testing is not done.
If the patient has a conjugate deviation of the eyes that can be overcome by
voluntary or reflexive activity, the score will be 1. If a patient has an isolated
peripheral nerve paresis (CN III, IV or VI) score a 1. Gaze is testable in all
aphasic patients. Patients with ocular trauma, bandages, pre-existing
blindness or other disorder of visual acuity or fields should be tested with
reflexive movements and a choice made by the investigator. Establishing eye
contact and then moving about the patient from side to side will occasionally
clarify the presence of a partial gaze palsy. - correct answer ✔2. best Gaze
, 0-Normal
Visual fields (upper and lower quadrants) are tested by confrontation, using
finger counting or visual threat as appropriate. Patient must be encouraged,
but if they look at the side of the moving fingers appropriately, this can be
scored as normal. If there is unilateral blindness or enucleation, visual fields in
the remaining eye are scored. Score 1 only if a clear-cut asymmetry, including
quadrantanopia is found. If patient is blind from any cause score 3. Double
simultaneous stimulation is performed at this point. If there is extinction patient
receives a 1, and the results are used to answer question 11. - correct
answer ✔3. Visual
0-No Visual Loss
Ask, or use pantomime to encourage the patient to show teeth or raise
eyebrows and close eyes. Score symmetry of grimace in response to noxious
stimuli in the poorly responsive or non-comprehending patient. If facial
trauma/bandages, orotracheal tube, tape or other physical barriers obscure
the face, these should be removed to the extent possible. - correct answer
✔4. Facial Palsy
1-Minor Paralysis (Flattened nasolabial fold, asymmetry on smiling).
The limb is placed in the appropriate position: extend the arms (palms down)
90 degrees (if sitting) or 45 degrees (if supine). Drift is scored if the arm falls
before 10 seconds. The aphasic patient is encouraged using urgency in the
voice and pantomime, but not noxious stimulation. Each limb is tested in turn,
beginning with the non-paretic arm. Only in the case of amputation or joint
fusion at the shoulder, the examiner should record the score as untestable
(UN). - correct answer ✔5a. Motor Arm Left
0- No drift, limb holds 90 (or 45) degrees for full 10 seconds.
The limb is placed in the appropriate position: extend the arms (palms down)
90 degrees (if sitting) or 45 degrees (if supine). Drift is scored if the arm falls
before 10 seconds. The aphasic patient is encouraged using urgency in the
