NIH Stroke Scale Practice Exam – Group A (Patients 1–6) (Original content for study purposes; mimics NIHSS format)

NIH Stroke Scale Practice Exam – Group A
(Patients 1–6)
(Original content for study purposes; mimics NIHSS format)




Instructions:
 Score each patient according to the NIH Stroke Scale (0–42).
 Note deficits in level of consciousness, gaze, visual fields, facial palsy, motor function,
ataxia, sensory, language, dysarthria, neglect.
 Each patient scenario is independent.




Patient 1
History: 68-year-old man with sudden right arm weakness and slurred speech for 1 hour.

Exam:

 Alert, oriented ×3.
 Best gaze: normal.
 Visual fields: full.
 Facial palsy: right lower facial droop.
 Motor: right arm 2/5, right leg 4/5, left side normal.
 Limb ataxia: absent.
 Sensory: decreased sensation right arm and leg.
 Language: mild expressive aphasia.
 Dysarthria: mild.
 Extinction/inattention: none.

NIHSS Scoring (Original Example):

 LOC: 0
 Best gaze: 0
 Visual: 0
 Facial palsy: 1
 Motor arm R: 4 (0–4 scale)
 Motor leg R: 1

,  Motor left side: 0
 Limb ataxia: 0
 Sensory: 1
 Language: 1
 Dysarthria: 1
 Extinction/inattention: 0

Total NIHSS Score: 9

Explanation: Right hemiparesis, mild facial droop, expressive aphasia, sensory loss → moderate
stroke.




Patient 2
History: 75-year-old woman with left-sided weakness and neglect, onset 2 hours ago.

Exam:

 Alert, follows commands.
 Best gaze: right gaze preference.
 Visual fields: left hemianopia.
 Facial palsy: left upper and lower face weak.
 Motor: left arm 0/5, left leg 0/5, right side normal.
 Limb ataxia: none.
 Sensory: decreased on left.
 Language: normal.
 Dysarthria: moderate.
 Extinction/inattention: left neglect present.

NIHSS Score (Example):

 LOC: 0
 Best gaze: 2
 Visual: 2
 Facial: 2
 Motor left arm: 4
 Motor left leg: 4
 Motor right side: 0
 Ataxia: 0
 Sensory: 1
 Language: 0
 Dysarthria: 2
 Extinction: 2