NIH Stroke Scale (NIHSS) Exam – Test Group C (Patients
1–6) Comprehensive Assessment for Stroke Severity
Patient 1 – Level of Consciousness (LOC) Questions
Q1. You ask Patient 1 to state their age and the current month. They respond
correctly to both questions.
How should you score LOC Questions (1b)?
A) 0
B) 1
C) 2
✅ Answer: A) 0
Rationale: Both questions were answered correctly = normal.
Patient 2 – Best Gaze
Q2. Patient 2 cannot follow your finger past midline in either direction.
How should you score Best Gaze (Item 2)?
A) 0
B) 1
C) 2
✅ Answer: C) 2
Rationale: Total gaze paresis; patient cannot look to one side = 2.
Patient 3 – Visual Field Testing
Q3. Patient 3 ignores stimuli in the left visual field in both eyes.
How should you score Visual Fields (Item 3)?
A) 0
, B) 1
C) 2
D) 3
✅ Answer: C) 2
Rationale: Complete hemianopia = 2.
Patient 4 – Facial Palsy
Q4. Patient 4 shows asymmetrical smile but full eye closure and no forehead
involvement.
How should you score Facial Palsy (Item 4)?
A) 0
B) 1
C) 2
D) 3
✅ Answer: B) 1
Rationale: Minor facial weakness (flattened nasolabial fold) = 1.
Patient 5 – Motor Arm Left
Q5. Left arm drifts to the bed within 5 seconds but does not hit the bed.
How should you score Motor Arm – Left (Item 5a)?
A) 0
B) 1
C) 2
D) 3
E) 4
✅ Answer: B) 1
Rationale: Drift before 10 seconds without hitting bed = 1.
Patient 6 – Motor Leg Right
1–6) Comprehensive Assessment for Stroke Severity
Patient 1 – Level of Consciousness (LOC) Questions
Q1. You ask Patient 1 to state their age and the current month. They respond
correctly to both questions.
How should you score LOC Questions (1b)?
A) 0
B) 1
C) 2
✅ Answer: A) 0
Rationale: Both questions were answered correctly = normal.
Patient 2 – Best Gaze
Q2. Patient 2 cannot follow your finger past midline in either direction.
How should you score Best Gaze (Item 2)?
A) 0
B) 1
C) 2
✅ Answer: C) 2
Rationale: Total gaze paresis; patient cannot look to one side = 2.
Patient 3 – Visual Field Testing
Q3. Patient 3 ignores stimuli in the left visual field in both eyes.
How should you score Visual Fields (Item 3)?
A) 0
, B) 1
C) 2
D) 3
✅ Answer: C) 2
Rationale: Complete hemianopia = 2.
Patient 4 – Facial Palsy
Q4. Patient 4 shows asymmetrical smile but full eye closure and no forehead
involvement.
How should you score Facial Palsy (Item 4)?
A) 0
B) 1
C) 2
D) 3
✅ Answer: B) 1
Rationale: Minor facial weakness (flattened nasolabial fold) = 1.
Patient 5 – Motor Arm Left
Q5. Left arm drifts to the bed within 5 seconds but does not hit the bed.
How should you score Motor Arm – Left (Item 5a)?
A) 0
B) 1
C) 2
D) 3
E) 4
✅ Answer: B) 1
Rationale: Drift before 10 seconds without hitting bed = 1.
Patient 6 – Motor Leg Right
