Guide — Step-by-Step NIHSS
Learning Manual
Q&A (Correct answers marked with )
1. What is the primary purpose of the NIH Stroke Scale (NIHSS)?
A. To diagnose diabetes
B. To determine stroke severity
C. To assess heart function
D. To measure blood glucose
2. The NIHSS score range is:
A. 0–31
B. 0–50
C. 0–42
D. 0–100
3. A score of 0 on the NIHSS usually indicates:
A. Severe stroke
B. Moderate stroke
C. No measurable neurological deficit
D. Brain death
4. What is the first item assessed on the NIHSS?
A. Visual fields
B. LOC (Level of Consciousness)
,C. Motor strength
D. Language
5. The NIHSS is usually performed during which phase of stroke care?
A. Only during discharge
B. Initial assessment and repeated at intervals
C. Only in rehabilitation
D. Only in ICU
6. LOC Questions assess the patient’s ability to:
A. Move limbs
B. Follow commands
C. State month and their age
D. Recognize pictures
7. LOC Commands include:
A. Naming body parts
B. Repeating phrases
C. Closing eyes and gripping hand
D. Drawing a figure
8. Best Gaze evaluates:
A. Finger-to-nose coordination
B. Horizontal eye movements
C. Pupillary reaction
D. Vertical gaze only
9. Visual Field testing checks for:
A. Hemianopsia
B. nystagmus
,C. diplopia
D. glaucoma
10. A score of “2” on motor arm means:
A. No drift
B. Drift before 10 seconds
C. Arm falls immediately
D. Amputation
11. How long must the arm remain elevated to score “no drift”?
A. 2 seconds
B. 5 seconds
C. 10 seconds
D. 15 seconds
12. For the leg motor test, how long must the leg stay up?
A. 2 seconds
B. 5 seconds
C. 10 seconds
D. 20 seconds
13. Ataxia testing is performed on which limbs?
A. Only upper limbs
B. Only lower limbs
C. Limbs with weakness
D. Limbs WITHOUT weakness
14. Sensory assessment uses:
A. Soft touch
B. Pinprick
, C. Heat/cold packs
D. Deep pressure
15. Extinction/Inattention is also called:
A. Aphasia
B. Neglect
C. Dysarthria
D. Apraxia
16. A patient who ignores one visual field likely has:
A. Hemineglect
B. Peripheral neuropathy
C. Ataxia
D. Coma
17. Dysarthria assesses:
A. Eye movement
B. Motor articulation of speech
C. Memory
D. Vision
18. Aphasia is assessed in which NIHSS section?
A. 4
B. 7
C. 9
D. 11
19. Which stroke type is most associated with global aphasia?
A. Cerebellar stroke
B. Brainstem stroke