APEX NIH STROKE SCALE GROUP A
ACTUAL EXAM 2026/2027 | PATIENTS 1–6
STUDY GUIDE & PRACTICE REVIEW |
VERIFIED ANSWERS | PASS
GUARANTEED - A+ GRADED
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
• Level of Consciousness (LOC)
• Best Gaze
• Visual Fields
• Facial Palsy
• Motor Function – Arms
• Motor Function – Legs
• Limb Ataxia
• Sensory Function
• Best Language
• Dysarthria
• Extinction and Inattention (Neglect)
,Introduction
The APEX NIH Stroke Scale Group A certification examination assesses the
healthcare professional's ability to accurately administer and score the
National Institutes of Health Stroke Scale across six standardized patient
scenarios. This comprehensive assessment evaluates foundational knowledge
of all eleven NIHSS items, applied clinical scoring judgment, regulatory
compliance with NINDS certification standards, and ethical decision-making
in acute stroke evaluation. Through multiple-choice and scenario-based
questions, candidates must demonstrate competency in real-world stroke
assessment, accurate scoring determination, and appropriate clinical decision-
making based on patient presentation.
SECTION ONE: QUESTIONS 1–100
Question 1
Patient 1 opens eyes only after repeated painful stimulus. How is Level of
Consciousness (LOC) scored?
A. 0
B. 1
C. 2
D. 3
C
RATIONALE: Eye opening only to repeated or painful stimulation is
scored as LOC 2. A score of 0 indicates alertness, 1 indicates drowsiness but
arousal with minimal stimulation, and 3 indicates no response even with
painful stimulation.
Question 2
,Patient 1 correctly states their age but gives the wrong month. What is the
LOC Questions score?
A. 0
B. 1
C. 2
D. Not testable
B
RATIONALE: For item 1b (LOC Questions), each of the two questions is
scored separately. One correct answer out of two scores 1, indicating partial
impairment. A score of 0 requires both answers correct, and 2 is assigned
when both are incorrect.
Question 3
Patient 1 follows one command but not the second. What is the LOC
Commands score?
A. 0
B. 1
C. 2
D. 3
B
RATIONALE: For item 1c (LOC Commands), the patient is asked to
perform two tasks. One task performed correctly scores 1 (partial
impairment). Score 0 is assigned if both tasks are performed correctly, and 2
if neither is performed.
Question 4
, Patient 1 has a left gaze preference that is not forced; he can cross the midline
with slow saccades. According to NIHSS item 2 (Best Gaze), what is the score?
A. 0
B. 1
C. 2
D. 3
B
RATIONALE: Item 2 scores: 0 = normal, 1 = partial gaze palsy (abnormal
gaze but can cross midline), 2 = forced deviation or total gaze paresis (cannot
cross midline). The patient has partial gaze palsy, so the score is 1.
Question 5
Patient 1 has normal visual fields to confrontation in both eyes. What is the
score for item 3 (Visual Fields)?
A. 0
B. 1
C. 2
D. 3
A
RATIONALE: Score 0 is assigned for no visual loss. Score 1 indicates
partial hemianopia, 2 indicates complete hemianopia, and 3 indicates
bilateral blindness. This patient has normal visual fields.
Question 6
Patient 1 is asked to show his teeth. The left nasolabial fold is flattened and
the left side of the mouth does not move. The right side moves well. What is
the score for item 4 (Facial Palsy)?
ACTUAL EXAM 2026/2027 | PATIENTS 1–6
STUDY GUIDE & PRACTICE REVIEW |
VERIFIED ANSWERS | PASS
GUARANTEED - A+ GRADED
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
• Level of Consciousness (LOC)
• Best Gaze
• Visual Fields
• Facial Palsy
• Motor Function – Arms
• Motor Function – Legs
• Limb Ataxia
• Sensory Function
• Best Language
• Dysarthria
• Extinction and Inattention (Neglect)
,Introduction
The APEX NIH Stroke Scale Group A certification examination assesses the
healthcare professional's ability to accurately administer and score the
National Institutes of Health Stroke Scale across six standardized patient
scenarios. This comprehensive assessment evaluates foundational knowledge
of all eleven NIHSS items, applied clinical scoring judgment, regulatory
compliance with NINDS certification standards, and ethical decision-making
in acute stroke evaluation. Through multiple-choice and scenario-based
questions, candidates must demonstrate competency in real-world stroke
assessment, accurate scoring determination, and appropriate clinical decision-
making based on patient presentation.
SECTION ONE: QUESTIONS 1–100
Question 1
Patient 1 opens eyes only after repeated painful stimulus. How is Level of
Consciousness (LOC) scored?
A. 0
B. 1
C. 2
D. 3
C
RATIONALE: Eye opening only to repeated or painful stimulation is
scored as LOC 2. A score of 0 indicates alertness, 1 indicates drowsiness but
arousal with minimal stimulation, and 3 indicates no response even with
painful stimulation.
Question 2
,Patient 1 correctly states their age but gives the wrong month. What is the
LOC Questions score?
A. 0
B. 1
C. 2
D. Not testable
B
RATIONALE: For item 1b (LOC Questions), each of the two questions is
scored separately. One correct answer out of two scores 1, indicating partial
impairment. A score of 0 requires both answers correct, and 2 is assigned
when both are incorrect.
Question 3
Patient 1 follows one command but not the second. What is the LOC
Commands score?
A. 0
B. 1
C. 2
D. 3
B
RATIONALE: For item 1c (LOC Commands), the patient is asked to
perform two tasks. One task performed correctly scores 1 (partial
impairment). Score 0 is assigned if both tasks are performed correctly, and 2
if neither is performed.
Question 4
, Patient 1 has a left gaze preference that is not forced; he can cross the midline
with slow saccades. According to NIHSS item 2 (Best Gaze), what is the score?
A. 0
B. 1
C. 2
D. 3
B
RATIONALE: Item 2 scores: 0 = normal, 1 = partial gaze palsy (abnormal
gaze but can cross midline), 2 = forced deviation or total gaze paresis (cannot
cross midline). The patient has partial gaze palsy, so the score is 1.
Question 5
Patient 1 has normal visual fields to confrontation in both eyes. What is the
score for item 3 (Visual Fields)?
A. 0
B. 1
C. 2
D. 3
A
RATIONALE: Score 0 is assigned for no visual loss. Score 1 indicates
partial hemianopia, 2 indicates complete hemianopia, and 3 indicates
bilateral blindness. This patient has normal visual fields.
Question 6
Patient 1 is asked to show his teeth. The left nasolabial fold is flattened and
the left side of the mouth does not move. The right side moves well. What is
the score for item 4 (Facial Palsy)?
