NIHSS Top Predicted Questions and Correct Answers

How many areas are tested and scored in the NIHSS? - 11 What are the 11 areas tested in the NIHSS in order? - 1) Level of Consciousness 2) Best Gaze 3) Visual Fields 4) Facial Palsy 5) Motor Arm 6) Motor Leg 7) Limb Ataxia 8) Sensory 9) Language 10) Dysarthria 11) Extinction/Inattention What are the 3 parts of assessing the LOC? - 1a) Alertness 1b) Orientation (Month and Age) 1c) Blink eyes and Squeeze Hands If a person scores less than a 3 in assessing alertness (1a) but is nearly comatose, what implication does it have? - All other areas of NIHSS must be assessed, but will likely fall back on defaulted scores. How would you score orientation (1b) on a patient who is unable to communicate due to being intubated/dysarthric/facial trauma/language barrier? - 1 How would you score orientation (1b) on a patient who is comatose, stuporous, aphasic, or scores a 3 on part 1a? - 2 When assessing a persons orientation (1b), what if the patient states the wrong answer then changes it to a correct answer? - Score the initial wrong answer How do you score ability to follow commands if a patient makes an attempt but is unable to do so due to weakness? - Give credit for the attempt How do you assess gaze in a comatose patient? - Use occulocephalic maneuver (Doll's eyes) How to test gaze in a patient who is unable to follow finger due to confusion or aphasia? - Make eye contact and move from side to side