ESTUDYR
NIH STROKE SCALE UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED
SUCCESS WITH DETAILED RATIONALES
1
How many items are on the NIH Stroke Scale (NIHSS)?
A. 9
B. 10
C. 11 ✅
D. 12
Rationale: NIHSS contains 11 numbered items (1a–1c count together as consciousness items).
2
The NIHSS is best described as:
A. A disability index for long-term functioning
B. An 11-item clinical evaluation instrument to assess neurologic outcome and stroke severity. ✅
C. A cognitive screening only
D. A rehabilitation goal tool
Rationale: NIHSS quantifies neurologic deficits (impairments) after stroke for acute assessment and
trials.
3
Which of the following domains are assessed by NIHSS? (Select the best single answer)
A. Memory, affect, coordination
B. Consciousness, vision, motor, cerebellar, sensation, language, extinction/inattention. ✅
C. Autonomic function and gait only
D. Only motor and language
Rationale: NIHSS covers those seven domains you listed.
4
When administering NIHSS, should you coach the patient to perform better?
A. Yes, encourage every attempt
B. No — do not coach; record first response only. ✅
, ESTUDYR
C. Only for language items
D. Only for motor items
Rationale: Score the patient's first genuine effort; coaching invalidates standardized scoring.
5
What is important to have available when doing an NIHSS assessment?
A. Extra staff to assist
B. Reference materials (NIHSS scoring sheet / cards). ✅
C. A family member to translate always
D. Calibrated dynamometer
Rationale: Use standard reference materials (cards, instructions) for consistent scoring.
6
You must rate what the patient actually does — NOT what you think they can do. This principle
means:
A. Use your clinical judgement to estimate missing responses
B. Score observable behavior only. ✅
C. Always award partial credit
D. Repeat tasks until ideal performance
Rationale: NIHSS is objective and based on observed performance.
7
For limb ataxia scoring (Item 7): if a limb is too weak to test, how should ataxia be scored?
A. As 2 if asymmetry present
B. As 0 (assume absent) if weakness explains incoordination. ✅
C. As 1 by default
D. As untestable (exclude from total)
Rationale: Score ataxia only if incoordination is out of proportion to weakness.
8
If a patient has preexisting peripheral neuropathy that causes sensory loss, how do you score the
sensory item?
A. Always score as sensory loss due to current exam
B. Score as 2 by default
NIH STROKE SCALE UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED
SUCCESS WITH DETAILED RATIONALES
1
How many items are on the NIH Stroke Scale (NIHSS)?
A. 9
B. 10
C. 11 ✅
D. 12
Rationale: NIHSS contains 11 numbered items (1a–1c count together as consciousness items).
2
The NIHSS is best described as:
A. A disability index for long-term functioning
B. An 11-item clinical evaluation instrument to assess neurologic outcome and stroke severity. ✅
C. A cognitive screening only
D. A rehabilitation goal tool
Rationale: NIHSS quantifies neurologic deficits (impairments) after stroke for acute assessment and
trials.
3
Which of the following domains are assessed by NIHSS? (Select the best single answer)
A. Memory, affect, coordination
B. Consciousness, vision, motor, cerebellar, sensation, language, extinction/inattention. ✅
C. Autonomic function and gait only
D. Only motor and language
Rationale: NIHSS covers those seven domains you listed.
4
When administering NIHSS, should you coach the patient to perform better?
A. Yes, encourage every attempt
B. No — do not coach; record first response only. ✅
, ESTUDYR
C. Only for language items
D. Only for motor items
Rationale: Score the patient's first genuine effort; coaching invalidates standardized scoring.
5
What is important to have available when doing an NIHSS assessment?
A. Extra staff to assist
B. Reference materials (NIHSS scoring sheet / cards). ✅
C. A family member to translate always
D. Calibrated dynamometer
Rationale: Use standard reference materials (cards, instructions) for consistent scoring.
6
You must rate what the patient actually does — NOT what you think they can do. This principle
means:
A. Use your clinical judgement to estimate missing responses
B. Score observable behavior only. ✅
C. Always award partial credit
D. Repeat tasks until ideal performance
Rationale: NIHSS is objective and based on observed performance.
7
For limb ataxia scoring (Item 7): if a limb is too weak to test, how should ataxia be scored?
A. As 2 if asymmetry present
B. As 0 (assume absent) if weakness explains incoordination. ✅
C. As 1 by default
D. As untestable (exclude from total)
Rationale: Score ataxia only if incoordination is out of proportion to weakness.
8
If a patient has preexisting peripheral neuropathy that causes sensory loss, how do you score the
sensory item?
A. Always score as sensory loss due to current exam
B. Score as 2 by default
