NIH Stroke Scale Group E Test (Patients 1–6) 2026 | Practice
Questions & Answers | Complete Study
Prepare for the NIH Stroke Scale (NIHSS) Group E Test covering Patients 1–6 with this
comprehensive study guide featuring practice questions, verified answers, and detailed
rationales. This resource reviews NIHSS scoring principles, neurological assessment techniques,
level of consciousness, gaze, visual fields, facial palsy, motor function, limb ataxia, sensory
deficits, language, dysarthria, extinction, and inattention. Designed to strengthen stroke
assessment skills and improve certification readiness, this guide is ideal for nurses, physicians,
EMS professionals, and healthcare providers.
Question 1
Which assessment finding is most suggestive of an acute ischemic stroke?
A. Gradual onset of joint pain
B. Sudden unilateral arm weakness
C. Bilateral ankle swelling
D. Chronic back pain
Correct Answer: B. Sudden unilateral arm weakness
Rationale: Sudden weakness on one side of the body is a hallmark symptom of acute ischemic
stroke and requires immediate evaluation.
Question 2
During a neurological assessment, the nurse asks the patient to state their age and the current
month. Which function is primarily being assessed?
A. Sensory perception
B. Orientation
C. Motor coordination
D. Memory recall
Correct Answer: B. Orientation
,Rationale: Asking the patient's age and the current month helps evaluate orientation and level of
consciousness.
Question 3
Which cranial nerve primarily controls facial muscle movement?
A. Cranial Nerve II
B. Cranial Nerve V
C. Cranial Nerve VII
D. Cranial Nerve X
Correct Answer: C. Cranial Nerve VII
Rationale: Cranial Nerve VII (Facial nerve) controls muscles responsible for facial expression.
Question 4
A patient is unable to maintain the right arm elevated for 10 seconds. This finding most likely
indicates:
A. Normal muscle strength
B. Motor weakness
C. Hearing impairment
D. Visual neglect
Correct Answer: B. Motor weakness
Rationale: Arm drift or inability to maintain elevation suggests weakness caused by neurological
impairment.
,Question 5
Which symptom is most consistent with expressive aphasia?
A. Difficulty understanding spoken language
B. Inability to produce fluent speech
C. Double vision
D. Hearing loss
Correct Answer: B. Inability to produce fluent speech
Rationale: Expressive aphasia affects speech production while comprehension may remain
intact.
Question 6
A patient ignores objects on the left side of the room despite normal vision. This finding is most
consistent with:
A. Hemianopia
B. Extinction and neglect
C. Dysarthria
D. Ataxia
Correct Answer: B. Extinction and neglect
Rationale: Spatial neglect is characterized by inattention to one side of the body or environment.
Question 7
Which assessment evaluates coordination?
A. Best Gaze
B. Limb Ataxia
, C. Dysarthria
D. Sensory
Correct Answer: B. Limb Ataxia
Rationale: Finger-to-nose and heel-to-shin testing assess cerebellar coordination.
Question 8
A patient has slurred speech but answers questions appropriately. Which finding is most likely?
A. Aphasia
B. Dysarthria
C. Confusion
D. Memory impairment
Correct Answer: B. Dysarthria
Rationale: Dysarthria affects speech articulation without impairing language comprehension.
Question 9
The priority intervention for a patient with suspected stroke is:
A. Schedule physical therapy
B. Activate the stroke response system
C. Encourage oral fluids
D. Obtain a dietary history
Correct Answer: B. Activate the stroke response system
Rationale: Early recognition and rapid treatment improve neurological outcomes.
Questions & Answers | Complete Study
Prepare for the NIH Stroke Scale (NIHSS) Group E Test covering Patients 1–6 with this
comprehensive study guide featuring practice questions, verified answers, and detailed
rationales. This resource reviews NIHSS scoring principles, neurological assessment techniques,
level of consciousness, gaze, visual fields, facial palsy, motor function, limb ataxia, sensory
deficits, language, dysarthria, extinction, and inattention. Designed to strengthen stroke
assessment skills and improve certification readiness, this guide is ideal for nurses, physicians,
EMS professionals, and healthcare providers.
Question 1
Which assessment finding is most suggestive of an acute ischemic stroke?
A. Gradual onset of joint pain
B. Sudden unilateral arm weakness
C. Bilateral ankle swelling
D. Chronic back pain
Correct Answer: B. Sudden unilateral arm weakness
Rationale: Sudden weakness on one side of the body is a hallmark symptom of acute ischemic
stroke and requires immediate evaluation.
Question 2
During a neurological assessment, the nurse asks the patient to state their age and the current
month. Which function is primarily being assessed?
A. Sensory perception
B. Orientation
C. Motor coordination
D. Memory recall
Correct Answer: B. Orientation
,Rationale: Asking the patient's age and the current month helps evaluate orientation and level of
consciousness.
Question 3
Which cranial nerve primarily controls facial muscle movement?
A. Cranial Nerve II
B. Cranial Nerve V
C. Cranial Nerve VII
D. Cranial Nerve X
Correct Answer: C. Cranial Nerve VII
Rationale: Cranial Nerve VII (Facial nerve) controls muscles responsible for facial expression.
Question 4
A patient is unable to maintain the right arm elevated for 10 seconds. This finding most likely
indicates:
A. Normal muscle strength
B. Motor weakness
C. Hearing impairment
D. Visual neglect
Correct Answer: B. Motor weakness
Rationale: Arm drift or inability to maintain elevation suggests weakness caused by neurological
impairment.
,Question 5
Which symptom is most consistent with expressive aphasia?
A. Difficulty understanding spoken language
B. Inability to produce fluent speech
C. Double vision
D. Hearing loss
Correct Answer: B. Inability to produce fluent speech
Rationale: Expressive aphasia affects speech production while comprehension may remain
intact.
Question 6
A patient ignores objects on the left side of the room despite normal vision. This finding is most
consistent with:
A. Hemianopia
B. Extinction and neglect
C. Dysarthria
D. Ataxia
Correct Answer: B. Extinction and neglect
Rationale: Spatial neglect is characterized by inattention to one side of the body or environment.
Question 7
Which assessment evaluates coordination?
A. Best Gaze
B. Limb Ataxia
, C. Dysarthria
D. Sensory
Correct Answer: B. Limb Ataxia
Rationale: Finger-to-nose and heel-to-shin testing assess cerebellar coordination.
Question 8
A patient has slurred speech but answers questions appropriately. Which finding is most likely?
A. Aphasia
B. Dysarthria
C. Confusion
D. Memory impairment
Correct Answer: B. Dysarthria
Rationale: Dysarthria affects speech articulation without impairing language comprehension.
Question 9
The priority intervention for a patient with suspected stroke is:
A. Schedule physical therapy
B. Activate the stroke response system
C. Encourage oral fluids
D. Obtain a dietary history
Correct Answer: B. Activate the stroke response system
Rationale: Early recognition and rapid treatment improve neurological outcomes.
