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NIHSS CERTIFICATION ACTUAL EXAM 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS |ALREADY A GRADED |NEW AND REVISED
1. 11 components of NIHSS: 1. LOC (Question & Command)
2. Gaze
3. Visual field
4. Facial palsy
5. Upper extremity
6. Lower extremity
7. Limb ataxia
8. Sensory
9. Best language
10. Dysarthria
11. Extinction & inattention
2. 1A - LOC: 0 = Alert
1 = Not alert; aroused with minor verbal stimulation
2 = Not alert; requires strong or painful stimulation
3 = Reflex movements only or totally unresponsive (COMA ~ try rub on chest)
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1a. Level of Consciousness: The investigator must choose a response, even if a full evaluation is prevented by such obstacles as
an endotracheal tube, language barrier, orotracheal trauma/bandages. A 3 is scored only if the patient makes no movement (other
than reflexive posturing) in response to noxious stimulation.*
3. 1B - LOC Questions (2): Month of year
Patient age
0 = Answers both questions correctly
1 = Answers one question correctly
2 = Answers neither question correctly
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1b. LOC Questions: The patient is asked the month and his/her age. The answer must be correct - there is no partial credit for being
close. Aphasic and stuporous patients who do not comprehend the questions will score 2. Patients
2/
13
NIHSS CERTIFICATION ACTUAL EXAM 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS |ALREADY A GRADED |NEW AND REVISED
1. 11 components of NIHSS: 1. LOC (Question & Command)
2. Gaze
3. Visual field
4. Facial palsy
5. Upper extremity
6. Lower extremity
7. Limb ataxia
8. Sensory
9. Best language
10. Dysarthria
11. Extinction & inattention
2. 1A - LOC: 0 = Alert
1 = Not alert; aroused with minor verbal stimulation
2 = Not alert; requires strong or painful stimulation
3 = Reflex movements only or totally unresponsive (COMA ~ try rub on chest)
---
1a. Level of Consciousness: The investigator must choose a response, even if a full evaluation is prevented by such obstacles as
an endotracheal tube, language barrier, orotracheal trauma/bandages. A 3 is scored only if the patient makes no movement (other
than reflexive posturing) in response to noxious stimulation.*
3. 1B - LOC Questions (2): Month of year
Patient age
0 = Answers both questions correctly
1 = Answers one question correctly
2 = Answers neither question correctly
1/
13
,2|Page
---
1b. LOC Questions: The patient is asked the month and his/her age. The answer must be correct - there is no partial credit for being
close. Aphasic and stuporous patients who do not comprehend the questions will score 2. Patients
2/
13
