NIHSS-English Group E-V3 - 5th Certification Questions and Answers

NIHSS-English Group E-V3 - 5th Certification Questions and
Answers

Question 1
A patient presents with a stroke. The nurse assesses the patient and
determines a score of '0' for item 1a (Level of Consciousness), '0' for 1b (LOC
Questions), and '0' for 1c (LOC Commands). This indicates the patient is:
A) Comatose and unresponsive.
B) Lethargic and requires repeated stimulation.
C) Arousable only with painful stimulation.
D) Fully alert and responsive to all stimuli.
E) Unresponsive to verbal commands.
Correct Answer: D) Fully alert and responsive to all stimuli.
Rationale: A score of 0 for NIHSS items 1a, 1b, and 1c (as indicated in
Patient 1's score) signifies that the patient is fully alert, conversant,
and able to respond appropriately to all commands and questions,
without any signs of impaired consciousness.

Question 2
For the same patient (Patient 1), the Motor Arm Right (5b) score is '0'. This
suggests the patient:
A) Has mild weakness in the right arm.
B) Is unable to move the right arm at all.
C) Has no drift in the right arm.
D) Has severe weakness in the right arm.
E) Has some resistance to gravity in the right arm.
Correct Answer: C) Has no drift in the right arm.
Rationale: A score of 0 for Motor Arm Right (5b) (as indicated in
Patient 1's score) means the patient's arm holds the commanded
position for the full 10 seconds without any drift, indicating no
motor weakness.

Question 3
Patient 1's Left Leg (6a) score is '0' and Right Leg (6b) score is '1'. This

,specific finding implies:
A) Complete paralysis in both legs.
B) No motor weakness in either leg.
C) Slight weakness or drift in the right leg, but normal strength in the left leg.
D) Complete paralysis in the left leg and slight weakness in the right.
E) Severe weakness in both legs.
Correct Answer: C) Slight weakness or drift in the right leg, but normal
strength in the left leg.
Rationale: A score of 0 for Left Leg (6a) means no drift in the left leg,
while a score of 1 for Right Leg (6b) (as indicated in Patient 1's
score) signifies drift but the leg not hitting the bed, indicating slight
weakness in the right leg.

Question 4
Patient 1 has a Sensory score (8) of '1'. This suggests the patient has:
A) Normal sensation.
B) Mild-to-moderate sensory loss.
C) Severe sensory loss.
D) Complete sensory loss.
E) Asymmetrical sensory loss.
Correct Answer: B) Mild-to-moderate sensory loss.
Rationale: A Sensory score of 1 (as indicated in Patient 1's score)
indicates mild-to-moderate sensory loss (e.g., dull to pinprick or
loss of superficial pain sensation).

Question 5
Considering Patient 1's overall NIHSS score, with mostly '0's and a '1' in Right
Leg (6b) and Sensory (8), the patient likely has:
A) A severe stroke.
B) A moderate stroke.
C) A mild stroke.
D) No stroke.

,E) A rapidly worsening stroke.
Correct Answer: C) A mild stroke.
Rationale: An NIHSS score with predominantly 0s and a few 1s (as
seen in Patient 1's score) generally indicates a mild stroke,
characterized by minimal neurological deficits.

Question 6
For Patient 2, the LOC Questions (1b) score is '1'. This indicates the patient:
A) Answers all questions correctly.
B) Answers one question incorrectly.
C) Answers both questions incorrectly.
D) Is aphasic.
E) Is unresponsive.
Correct Answer: B) Answers one question incorrectly.
Rationale: A score of 1 for LOC Questions (1b) (as indicated in Patient
2's score) means the patient answers one of the two orientation
questions (month, age) incorrectly.

Question 7
Patient 2's Facial Palsy (4) score is '1'. This suggests the patient has:
A) No facial weakness.
B) Minor facial weakness (e.g., asymmetry with smiling).
C) Partial facial weakness.
D) Complete paralysis of one side of the face.
E) Bilateral facial weakness.
Correct Answer: B) Minor facial weakness (e.g., asymmetry with
smiling).
Rationale: A score of 1 for Facial Palsy (4) (as indicated in Patient 2's
score) signifies minor facial weakness (e.g., asymmetry present with
smiling, but full movement otherwise).

Question 8
For Patient 2, the Motor Arm Right (5b) score is '4'. This means the patient:

, A) Has no drift in the right arm.
B) Has drift in the right arm, but it does not hit the bed.
C) Has some movement against gravity in the right arm.
D) Is unable to move the right arm.
E) Has no movement in the right arm.
Correct Answer: D) Is unable to move the right arm.
Rationale: A score of 4 for Motor Arm Right (5b) (as indicated in
Patient 2's score) means the patient is unable to move the right arm
at all (no movement).

Question 9
Patient 2's Right Leg (6b) score is '3'. This implies the patient has:
A) No drift in the right leg.
B) Some movement in the right leg, but not against gravity.
C) Drift in the right leg, hitting the bed.
D) No movement in the right leg.
E) Only slight movement against gravity in the right leg.
Correct Answer: B) Some movement in the right leg, but not against
gravity.
Rationale: A score of 3 for Right Leg (6b) (as indicated in Patient 2's
score) indicates some movement against gravity, but the leg does
not sustain the position for the full 5 seconds.

Question 10
Patient 2 has a Sensory score (8) of '1' and an Extinction and Inattention (11)
score of '1'. These combined findings suggest:
A) Normal sensation and no neglect.
B) Mild sensory loss and some inattention to one side.
C) Severe sensory loss and complete neglect.
D) No sensory loss but severe neglect.
E) Unilateral sensory loss with normal attention.
Correct Answer: B) Mild sensory loss and some inattention to one side.