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NIH STROKE SCALE GROUP D PATIENT 1-6 COMPLETE
2026/2027 | 100% Verified Answers | All 6 Patients | Pass
Guaranteed - A+ Graded
Section 1: NIHSS Item 1a-1c (LOC, LOC Questions, LOC Commands) (Q1-12)
Q1. A 67-year-old patient with acute ischemic stroke opens his eyes spontaneously
before the examiner enters the room, tracks the examiner's face, and responds
immediately to all questions. What is the correct Item 1a (Level of Consciousness)
score?
A. Score of 1 (Not alert; arousable by minor stimulation)
B. Score of 2 (Not alert; requires repeated stimulation)
C. Score of 0 (Alert; keenly responsive) [CORRECT]
D. Score of 3 (Responds only with reflex motor or autonomic effects)
Rationale: The patient is alert and keenly responsive with spontaneous eye opening
and immediate tracking, meeting the criteria for Item 1a = 0; scores 1–3 describe
progressively depressed levels of arousal.
Correct Answer: C
Q2. A patient opens her eyes when the examiner speaks loudly but immediately drifts
back to sleep when stimulation ceases. She can be aroused again with minor verbal
stimulation. What is the correct Item 1a score?
A. Score of 0
B. Score of 2 (Not alert; requires repeated stimulation to attend)
C. Score of 1 (Not alert; but arousable by minor stimulation to obey, answer, or
respond) [CORRECT]
D. Score of 3 (Totally unresponsive, flaccid, areflexic)
Rationale: The patient is not fully alert but can be aroused by minor stimulation and
responds appropriately when awake, which defines Item 1a = 1; a score of 2 would
require painful or repeated stimulation.
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Correct Answer: C
Q3. A patient with a large right hemisphere infarct requires repeated sternal rubs to
open his eyes and only mumbles without forming words before lapsing back into
unresponsiveness. What is the correct Item 1a score?
A. Score of 1
B. Score of 3
C. Score of 2 (Not alert; requires repeated stimulation to attend, or is obtunded and
needs strong/painful stimulation to make movements) [CORRECT]
D. Score of 0
Rationale: The patient is obtunded and requires strong, painful stimulation to arouse
transiently without coherent verbal response, meeting criteria for stupor (Item 1a =
2); score 3 would require only reflex movements or total unresponsiveness.
Correct Answer: C
Q4. A patient brought in by EMS is unresponsive to verbal or painful stimuli. She
exhibits decerebrate posturing to deep nail bed pressure but no purposeful
movement or verbalization. What is the correct Item 1a score?
A. Score of 0
B. Score of 1
C. Score of 2
D. Score of 3 (Responds only with reflex motor or autonomic effects or totally
unresponsive, flaccid, areflexic) [CORRECT]
Rationale: Decerebrate posturing is a reflex motor response without awareness or
purposeful movement, meeting criteria for coma (Item 1a = 3); the patient does not
arouse to repeated or painful stimulation in a meaningful way.
Correct Answer: D
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Q5. During Item 1b (LOC Questions), an alert patient correctly states the current
month and her exact age. What is the correct Item 1b score?
A. Score of 1 (Answers one correctly)
B. Score of UN (Untestable)
C. Score of 2 (Answers neither correctly)
D. Score of 0 (Answers both correctly) [CORRECT]
Rationale: Correct responses to both orientation questions (month and age) establish
normal cognitive responsiveness and score 0 on Item 1b.
Correct Answer: D
Q6. A patient correctly states the month but provides an age that is 10 years off and
does not self-correct when offered a second attempt. What is the correct Item 1b
score?
A. Score of 0
B. Score of 2 (Answers neither correctly)
C. Score of UN (Untestable)
D. Score of 1 (Answers one correctly) [CORRECT]
Rationale: Only one of the two orientation questions is answered correctly, which
meets the explicit criteria for Item 1b = 1 regardless of whether the incorrect answer
is close to the actual value.
Correct Answer: D
Q7. A 58-year-old patient is intubated and receiving propofol sedation in the ICU
after a massive stroke. The nurse attempts to score Item 1b (LOC Questions). What is
the correct score?
A. Score of 0
B. Score of 1
NIH STROKE SCALE GROUP D PATIENT 1-6 COMPLETE
2026/2027 | 100% Verified Answers | All 6 Patients | Pass
Guaranteed - A+ Graded
Section 1: NIHSS Item 1a-1c (LOC, LOC Questions, LOC Commands) (Q1-12)
Q1. A 67-year-old patient with acute ischemic stroke opens his eyes spontaneously
before the examiner enters the room, tracks the examiner's face, and responds
immediately to all questions. What is the correct Item 1a (Level of Consciousness)
score?
A. Score of 1 (Not alert; arousable by minor stimulation)
B. Score of 2 (Not alert; requires repeated stimulation)
C. Score of 0 (Alert; keenly responsive) [CORRECT]
D. Score of 3 (Responds only with reflex motor or autonomic effects)
Rationale: The patient is alert and keenly responsive with spontaneous eye opening
and immediate tracking, meeting the criteria for Item 1a = 0; scores 1–3 describe
progressively depressed levels of arousal.
Correct Answer: C
Q2. A patient opens her eyes when the examiner speaks loudly but immediately drifts
back to sleep when stimulation ceases. She can be aroused again with minor verbal
stimulation. What is the correct Item 1a score?
A. Score of 0
B. Score of 2 (Not alert; requires repeated stimulation to attend)
C. Score of 1 (Not alert; but arousable by minor stimulation to obey, answer, or
respond) [CORRECT]
D. Score of 3 (Totally unresponsive, flaccid, areflexic)
Rationale: The patient is not fully alert but can be aroused by minor stimulation and
responds appropriately when awake, which defines Item 1a = 1; a score of 2 would
require painful or repeated stimulation.
,2
Correct Answer: C
Q3. A patient with a large right hemisphere infarct requires repeated sternal rubs to
open his eyes and only mumbles without forming words before lapsing back into
unresponsiveness. What is the correct Item 1a score?
A. Score of 1
B. Score of 3
C. Score of 2 (Not alert; requires repeated stimulation to attend, or is obtunded and
needs strong/painful stimulation to make movements) [CORRECT]
D. Score of 0
Rationale: The patient is obtunded and requires strong, painful stimulation to arouse
transiently without coherent verbal response, meeting criteria for stupor (Item 1a =
2); score 3 would require only reflex movements or total unresponsiveness.
Correct Answer: C
Q4. A patient brought in by EMS is unresponsive to verbal or painful stimuli. She
exhibits decerebrate posturing to deep nail bed pressure but no purposeful
movement or verbalization. What is the correct Item 1a score?
A. Score of 0
B. Score of 1
C. Score of 2
D. Score of 3 (Responds only with reflex motor or autonomic effects or totally
unresponsive, flaccid, areflexic) [CORRECT]
Rationale: Decerebrate posturing is a reflex motor response without awareness or
purposeful movement, meeting criteria for coma (Item 1a = 3); the patient does not
arouse to repeated or painful stimulation in a meaningful way.
Correct Answer: D
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Q5. During Item 1b (LOC Questions), an alert patient correctly states the current
month and her exact age. What is the correct Item 1b score?
A. Score of 1 (Answers one correctly)
B. Score of UN (Untestable)
C. Score of 2 (Answers neither correctly)
D. Score of 0 (Answers both correctly) [CORRECT]
Rationale: Correct responses to both orientation questions (month and age) establish
normal cognitive responsiveness and score 0 on Item 1b.
Correct Answer: D
Q6. A patient correctly states the month but provides an age that is 10 years off and
does not self-correct when offered a second attempt. What is the correct Item 1b
score?
A. Score of 0
B. Score of 2 (Answers neither correctly)
C. Score of UN (Untestable)
D. Score of 1 (Answers one correctly) [CORRECT]
Rationale: Only one of the two orientation questions is answered correctly, which
meets the explicit criteria for Item 1b = 1 regardless of whether the incorrect answer
is close to the actual value.
Correct Answer: D
Q7. A 58-year-old patient is intubated and receiving propofol sedation in the ICU
after a massive stroke. The nurse attempts to score Item 1b (LOC Questions). What is
the correct score?
A. Score of 0
B. Score of 1
