STROKESCA
411-STROKE
SCALE
ANSWERS,
LATEST
UPDATED
2022/23
, AttemptHHistory
Hernandez,HDelmy
01HNIHSSEnglishHGroupHAV3H 1stHCertification
Date Result
3/3/2018H4:12:38HAM Passed 89HofH90H (98.89H%) ViewH Responses
PatientH 1
Topic Question Answer Grade
LevelHofHConsc 1a.HLevelHofHConsciousn 0H=HAlert;HkeenlyHresponsive Correct
iousness ess:HTheHinvestigatorH
mustHchooseHaHresponse
,HevenHifHaHfullHevaluatio
nHisHpreventedHbyHsuchH
obstaclesHasHanHendotr
achealHtube,HlanguageH
barrier,HorotrachealHtra
uma/bandages.HAH3HisHsc
oredHonlyHifHtheHpatient
HmakesHnoHmovementH(
otherHthanHreflexiveHpo
sturing)HinHresponseHtoH
noxiousHstimulation.
LOCHQuestions 1b.HLOCH Questions:HThe 0H=HAnswersHbothHquestion Correct
patientHisHaskedHtheHm sHcorrectly
onthHandHhis/herHage.HT
heHanswerHmustHbeHcor
rectHthereHisHnoHpartialH
creditHforHbeingHclose.H
AphasicHandHstuporousH
patientsHwhoHdoHnotHco
mprehendHtheHquestion
sHwillHscoreH2.HPatientsH
unableHtoHspeakHbecaus
eHofHendotrachealHintuba
tion,HorotrachealHtraum
a,HsevereHdysarthriaHfro
mHanyHcause,Hlanguage
HbarrierHorHanyHotherHpr
oblemHnotHsecondaryHt
oHaphasiaHareHgivenHaH1.
HItHisHimportantHthatHonl
yHtheHinitialHanswerHbeH
gradedHandHthatHtheHex
aminerHnotH"help"HtheHp
atientHwithHverbalHorHno
nverbalHcues.
LOCHCommands 1c.H LOCH Commands: 0H=HPerformsH bothHtasksHcorrectlyHCorrect
TheHpatientHisHaskedHto
HopenHandHcloseHtheHeye
sHandHthenHtoHgripHand
, releaseHtheHnonpareticH
hand.HSubstituteHanoth
erHoneHstepHcommandHi
fHtheHhandsHcannotHbeH
used.HCreditHisHgivenHifH
anHunequivocalHattempt
HisHmadeHbutHnotHcompl
etedHdueHtoHweakness.H
IfHtheHpatientHdoesHnotH
respondHtoHcommand,Ht
heHtaskHshouldHbeHdem
onstratedHtoHthemH(pan
tomime)HandHscoreHtheH
resultH(i.e.,HfollowsHnon
e,HoneHorHtwoHcomman
ds).HPatientsHwithHtrau
ma,Hamputation,HorHoth
erHphysicalHimpediment
sHshouldHbeHgivenHsuitab
leHonestepHcommands.
OnlyHtheHfirstH attemptH is
scored.
BestHGaze
2.HBestHGaze:HOn
lyHhorizontalHeyeHmove 0H=HNormal Correct
mentsHwillHbeHtested.V
oluntaryHorHreflexiveH(o
culocephalic)HeyeHmove
mentsHwillHbeHscoredHb
utHcaloricHtestingHisHnot
Hdone.HIfHtheHpatientHh
asHaHconjugateHdeviatio
nHofHtheHeyesHthatHcanH
beHovercomeHbyHvolunt
aryHorHreflexiveHactivity
,HtheHscoreHwillHbeH1.HIf
HaHpatientHhasHanHisolat
edHperipheralHnerveHpar
esisH(CNHIII,HIVHorHVI)Hs
coreHaH1.HGazeHisHtesta
bleHinHallHaphasicHpatie
nts.
PatientsHwithHocular
trauma,Hbandages,Hpre
HexistingHblindnessHorH
otherHdisorderHofHvisua
lHacuityHorHfieldsHshoul
dHbeHtestedHwithHreflexi
veHmovementsHandHaH
choiceHmadeHbyHtheHin
vestigator.
EstablishingHeyeHcontact
HandHthenHmovingHabou
tHtheHpatientHfromHsideH
toHsideHwillHoccasionall
y
, clarifyHtheHpresenceHofHa
HpartialHgazeHpalsy.
Visual 0H=HNoHvisualHloss Correct
3.HVisual:HVisualHf
ieldsH(upperHandHlowerH
quadrants)HareHtestedHb
yHconfrontation,HusingHfi
ngerHcountingHorHvisualH
threatHasHappropriate.
PatientHmustHbeHencour
aged,HbutHifHtheyHlookHa
tHtheHsideHofHtheHmovin
gHfingersHappropriately,
HthisHcanHbeHscoredHasH
normal.HIfHthereHisHunil
ateralHblindnessH orHenu
cleation,HvisualHfieldsHinH
theHremainingHeyeHareHs
cored.HScoreH1HonlyHifHaH
clearcutHasymmetry,Hin
cludingHquadrantanopia
HisHfound.HIfHpatientHisHb
lindHfromHanyHcauseHsco
reH3.HDoubleHsimultane
ousHstimulationHisHperfor
medHatHthisHpoint.HIfHth
ereHisHextinctionHpatien
tHreceivesHaH1,HandHtheH
resultsHareHusedHtoHans
werHquestionH11.
FacialHPalsy 0H=HNormalHsymmetrica Correct
4.HFacialHPalsy:HA lHmovement
sk,HorHuseHpantomimeHt
oHencourageHtheHpatient
HtoHshowHteethHorHraiseH
eyebrowsHandHcloseHey
es.HScoreHsymmetryHofH
grimaceHinHresponseHtoH
noxiousHstimuliHinHtheHp
oorlyHresponsiveHorHnon
comprehendingHpatient.
HIfHfacialHtrauma/banda
ges,HorotrachealHtube,Ht
apeHorHotherHphysicalHb
arriersHobscureHtheHfac
e,HtheseHshouldHbeHrem
ovedHtoHtheHextentHpos
sible.
MotorH Arms 5a.HMotorH ArmH Left:H The 0H=HNoHdrift,HlimbHholdsH90H(o Incorrect
limbHisHplacedHinHtheHap rH45)HdegreesHforHfullH10Hsecon
propriateHposition:Hexte ds
ndHtheHarmsH(palmsHdo
wn)H90HdegreesH(ifHsitti
ng)HorH45HdegreesH(ifHsu
pine).HDriftH isHscoredHif
411-STROKE
SCALE
ANSWERS,
LATEST
UPDATED
2022/23
, AttemptHHistory
Hernandez,HDelmy
01HNIHSSEnglishHGroupHAV3H 1stHCertification
Date Result
3/3/2018H4:12:38HAM Passed 89HofH90H (98.89H%) ViewH Responses
PatientH 1
Topic Question Answer Grade
LevelHofHConsc 1a.HLevelHofHConsciousn 0H=HAlert;HkeenlyHresponsive Correct
iousness ess:HTheHinvestigatorH
mustHchooseHaHresponse
,HevenHifHaHfullHevaluatio
nHisHpreventedHbyHsuchH
obstaclesHasHanHendotr
achealHtube,HlanguageH
barrier,HorotrachealHtra
uma/bandages.HAH3HisHsc
oredHonlyHifHtheHpatient
HmakesHnoHmovementH(
otherHthanHreflexiveHpo
sturing)HinHresponseHtoH
noxiousHstimulation.
LOCHQuestions 1b.HLOCH Questions:HThe 0H=HAnswersHbothHquestion Correct
patientHisHaskedHtheHm sHcorrectly
onthHandHhis/herHage.HT
heHanswerHmustHbeHcor
rectHthereHisHnoHpartialH
creditHforHbeingHclose.H
AphasicHandHstuporousH
patientsHwhoHdoHnotHco
mprehendHtheHquestion
sHwillHscoreH2.HPatientsH
unableHtoHspeakHbecaus
eHofHendotrachealHintuba
tion,HorotrachealHtraum
a,HsevereHdysarthriaHfro
mHanyHcause,Hlanguage
HbarrierHorHanyHotherHpr
oblemHnotHsecondaryHt
oHaphasiaHareHgivenHaH1.
HItHisHimportantHthatHonl
yHtheHinitialHanswerHbeH
gradedHandHthatHtheHex
aminerHnotH"help"HtheHp
atientHwithHverbalHorHno
nverbalHcues.
LOCHCommands 1c.H LOCH Commands: 0H=HPerformsH bothHtasksHcorrectlyHCorrect
TheHpatientHisHaskedHto
HopenHandHcloseHtheHeye
sHandHthenHtoHgripHand
, releaseHtheHnonpareticH
hand.HSubstituteHanoth
erHoneHstepHcommandHi
fHtheHhandsHcannotHbeH
used.HCreditHisHgivenHifH
anHunequivocalHattempt
HisHmadeHbutHnotHcompl
etedHdueHtoHweakness.H
IfHtheHpatientHdoesHnotH
respondHtoHcommand,Ht
heHtaskHshouldHbeHdem
onstratedHtoHthemH(pan
tomime)HandHscoreHtheH
resultH(i.e.,HfollowsHnon
e,HoneHorHtwoHcomman
ds).HPatientsHwithHtrau
ma,Hamputation,HorHoth
erHphysicalHimpediment
sHshouldHbeHgivenHsuitab
leHonestepHcommands.
OnlyHtheHfirstH attemptH is
scored.
BestHGaze
2.HBestHGaze:HOn
lyHhorizontalHeyeHmove 0H=HNormal Correct
mentsHwillHbeHtested.V
oluntaryHorHreflexiveH(o
culocephalic)HeyeHmove
mentsHwillHbeHscoredHb
utHcaloricHtestingHisHnot
Hdone.HIfHtheHpatientHh
asHaHconjugateHdeviatio
nHofHtheHeyesHthatHcanH
beHovercomeHbyHvolunt
aryHorHreflexiveHactivity
,HtheHscoreHwillHbeH1.HIf
HaHpatientHhasHanHisolat
edHperipheralHnerveHpar
esisH(CNHIII,HIVHorHVI)Hs
coreHaH1.HGazeHisHtesta
bleHinHallHaphasicHpatie
nts.
PatientsHwithHocular
trauma,Hbandages,Hpre
HexistingHblindnessHorH
otherHdisorderHofHvisua
lHacuityHorHfieldsHshoul
dHbeHtestedHwithHreflexi
veHmovementsHandHaH
choiceHmadeHbyHtheHin
vestigator.
EstablishingHeyeHcontact
HandHthenHmovingHabou
tHtheHpatientHfromHsideH
toHsideHwillHoccasionall
y
, clarifyHtheHpresenceHofHa
HpartialHgazeHpalsy.
Visual 0H=HNoHvisualHloss Correct
3.HVisual:HVisualHf
ieldsH(upperHandHlowerH
quadrants)HareHtestedHb
yHconfrontation,HusingHfi
ngerHcountingHorHvisualH
threatHasHappropriate.
PatientHmustHbeHencour
aged,HbutHifHtheyHlookHa
tHtheHsideHofHtheHmovin
gHfingersHappropriately,
HthisHcanHbeHscoredHasH
normal.HIfHthereHisHunil
ateralHblindnessH orHenu
cleation,HvisualHfieldsHinH
theHremainingHeyeHareHs
cored.HScoreH1HonlyHifHaH
clearcutHasymmetry,Hin
cludingHquadrantanopia
HisHfound.HIfHpatientHisHb
lindHfromHanyHcauseHsco
reH3.HDoubleHsimultane
ousHstimulationHisHperfor
medHatHthisHpoint.HIfHth
ereHisHextinctionHpatien
tHreceivesHaH1,HandHtheH
resultsHareHusedHtoHans
werHquestionH11.
FacialHPalsy 0H=HNormalHsymmetrica Correct
4.HFacialHPalsy:HA lHmovement
sk,HorHuseHpantomimeHt
oHencourageHtheHpatient
HtoHshowHteethHorHraiseH
eyebrowsHandHcloseHey
es.HScoreHsymmetryHofH
grimaceHinHresponseHtoH
noxiousHstimuliHinHtheHp
oorlyHresponsiveHorHnon
comprehendingHpatient.
HIfHfacialHtrauma/banda
ges,HorotrachealHtube,Ht
apeHorHotherHphysicalHb
arriersHobscureHtheHfac
e,HtheseHshouldHbeHrem
ovedHtoHtheHextentHpos
sible.
MotorH Arms 5a.HMotorH ArmH Left:H The 0H=HNoHdrift,HlimbHholdsH90H(o Incorrect
limbHisHplacedHinHtheHap rH45)HdegreesHforHfullH10Hsecon
propriateHposition:Hexte ds
ndHtheHarmsH(palmsHdo
wn)H90HdegreesH(ifHsitti
ng)HorH45HdegreesH(ifHsu
pine).HDriftH isHscoredHif
