ESTUDYR
MODIFIED NIH STROKE SCALE MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. Item 1B — LOC / Orientation: Which two questions are asked for 1B?
A. “What is your name?” and “Where are you?”
B. “What day of the week?” and “What year is it?”
C. “What month is it?” and “How old are you?” ✅
D. “What is your birthdate?” and “Who is the president?”
Rationale: NIHSS 1B specifically asks month and age to test orientation.
2. Scoring for 1B (LOC questions): What does a score of 0 mean?
A. One question correct
B. Both questions correct ✅
C. No questions asked
D. Neither question correct
Rationale: 0 = fully oriented for the two standardized items.
3. Scoring for 1B: What does a score of 1 mean?
A. Both incorrect
B. One question correct ✅
C. Patient is mute only
D. Patient is comatose
Rationale: 1 = partial orientation (one of two answers correct).
4. Scoring for 1B: What does a score of 2 mean?
A. Both correct
B. One correct
C. Zero questions correct ✅
D. Not testable
Rationale: 2 = disorientation on both items (or unable to respond for reasons not due to
aphasia).
5. Item 1C — LOC Commands: Which two commands are standard for NIHSS 1C?
A. “Stick out your tongue” and “blink twice”
B. “Close your eyes,” “Open your eyes,” and “Make a fist” ✅
, ESTUDYR
C. “Raise both legs” and “tap your knee”
D. “Smile” and “say your name”
Rationale: 1C actually uses three simple actions (close eyes, open eyes, make a fist) — scored
across them.
6. Scoring for 1C (Commands): What does 0 mean?
A. One task correct
B. Both/all tasks performed correctly ✅
C. No commands given
D. Two tasks incorrect
Rationale: 0 = patient executes the required commands (full performance).
7. Scoring for 1C: What does 1 mean?
A. All tasks wrong
B. One task correct ✅
C. Patient untestable
D. Patient mute for other reasons
Rationale: 1 = partial command performance (one of the required commands done).
8. Scoring for 1C: What does 2 mean?
A. Both tasks correct
B. One task correct
C. Zero tasks performed correctly ✅
D. Patient too weak but tried
Rationale: 2 = failure to follow any commands on first attempt (no correct task).
9. Item 2 — Best Gaze tests which function?
A. Vertical eye movements only
B. Horizontal extraocular movements (voluntary gaze). ✅
C. Pupillary light reflex
D. Convergence only
Rationale: NIHSS item 2 examines horizontal gaze control and forced deviation.
10. Scoring for Item 2 (Best Gaze): What does 0 indicate?
A. Forced eye deviation
MODIFIED NIH STROKE SCALE MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. Item 1B — LOC / Orientation: Which two questions are asked for 1B?
A. “What is your name?” and “Where are you?”
B. “What day of the week?” and “What year is it?”
C. “What month is it?” and “How old are you?” ✅
D. “What is your birthdate?” and “Who is the president?”
Rationale: NIHSS 1B specifically asks month and age to test orientation.
2. Scoring for 1B (LOC questions): What does a score of 0 mean?
A. One question correct
B. Both questions correct ✅
C. No questions asked
D. Neither question correct
Rationale: 0 = fully oriented for the two standardized items.
3. Scoring for 1B: What does a score of 1 mean?
A. Both incorrect
B. One question correct ✅
C. Patient is mute only
D. Patient is comatose
Rationale: 1 = partial orientation (one of two answers correct).
4. Scoring for 1B: What does a score of 2 mean?
A. Both correct
B. One correct
C. Zero questions correct ✅
D. Not testable
Rationale: 2 = disorientation on both items (or unable to respond for reasons not due to
aphasia).
5. Item 1C — LOC Commands: Which two commands are standard for NIHSS 1C?
A. “Stick out your tongue” and “blink twice”
B. “Close your eyes,” “Open your eyes,” and “Make a fist” ✅
, ESTUDYR
C. “Raise both legs” and “tap your knee”
D. “Smile” and “say your name”
Rationale: 1C actually uses three simple actions (close eyes, open eyes, make a fist) — scored
across them.
6. Scoring for 1C (Commands): What does 0 mean?
A. One task correct
B. Both/all tasks performed correctly ✅
C. No commands given
D. Two tasks incorrect
Rationale: 0 = patient executes the required commands (full performance).
7. Scoring for 1C: What does 1 mean?
A. All tasks wrong
B. One task correct ✅
C. Patient untestable
D. Patient mute for other reasons
Rationale: 1 = partial command performance (one of the required commands done).
8. Scoring for 1C: What does 2 mean?
A. Both tasks correct
B. One task correct
C. Zero tasks performed correctly ✅
D. Patient too weak but tried
Rationale: 2 = failure to follow any commands on first attempt (no correct task).
9. Item 2 — Best Gaze tests which function?
A. Vertical eye movements only
B. Horizontal extraocular movements (voluntary gaze). ✅
C. Pupillary light reflex
D. Convergence only
Rationale: NIHSS item 2 examines horizontal gaze control and forced deviation.
10. Scoring for Item 2 (Best Gaze): What does 0 indicate?
A. Forced eye deviation
