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NIHSS English Group G-V3 (7th Edition) – Certification Exam Questions and Answers (2025)

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This verified 2025 NIHSS (National Institutes of Health Stroke Scale) English Group G-V3 certification guide includes all seven patient case studies with accurate scores and detailed observations for each NIHSS item. Covers all 11 categories, including level of consciousness, gaze, facial palsy, limb strength, ataxia, sensory loss, language, and neglect. Ideal for medical professionals preparing for NIHSS recertification or clinical reference.

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NIHSS-English Group G-V3 - 7th.
Certification questions and answers
| Patient Description | NIHSS Item | Score |

|---------------------|------------|-------|

| **Certification Patient 1** (Dr. Lyden-San Diego, California) <br>Purple flowers in background, drip
bag hanging from IV pole, yellow book on table. Male Caucasian patient. | 1a. Level of Consciousness | 0
|

| | 1b. LOC Questions | 0 |

| | 1c. LOC Commands | 0 |

| | 2. Best Gaze | 0 |

| | 3. Visual | 0 |

| | 4. Facial Palsy | 1 = Minor paralysis |

| | 5a. Motor Arm Left | 3 = No effort against gravity, limb falls. |

| | 5b. Motor Arm Right | 0 = No drift |

| | 6a. Left Leg | 1 = Drift, leg falls by the end of the 5 second period, but does not hit bed |

| | 6b. Right Leg | 0 = No drift |

| | 7. Limb Ataxia | 1 = Present in one limb |

| | 8. Sensory | 2 = Severe or total sensory loss |

| | 9. Best Language | 0 = No aphasia, normal |

| | 10. Dysarthria | 0 = Normal |

| | 11. Extinction and Inattention (formerly Neglect) | 0 = No abnormality |



---



| Patient Description | NIHSS Item | Score |

|---------------------|------------|-------|

| **Certification Patient 2** (Karen Rapp, RN Nurse coordinator, San Diego, CA)<br>Karen in red
blazer/pink long sleeve shirt and black trousers, patient laying in bed, appears to have cataract right eye;
purple flowers, card upright on desk. Male Caucasian patient. | 1a. Level of Consciousness | 0 = Alert;
keenly responsive |

, | | 1b. LOC Questions | 2 = Answers neither question correctly |

| | 1c. LOC Commands | 0 = Performs both tasks correctly |

| | 2. Best Gaze | 1 = Partial gaze palsy. (THIS ANSWER IS WRONG) |

| | 3. Visual | 0 = No visual loss |

| | 4. Facial Palsy | 0 = Normal symmetrical movement |

| | 5a. Motor Arm Left | 0 = No drift |

| | 5b. Motor Arm Right | 0 = No drift |

| | 6a. Left Leg | 0 = No drift |

| | 6b. Right Leg | 0 = No drift |

| | 7. Limb Ataxia | 0 = Absent |

| | 8. Sensory | 1 = Mild-to-moderate sensory loss |

| | 9. Best Language | 2 = Severe aphasia |

| | 10. Dysarthria | 2 = Severe dysarthria |

| | 11. Extinction and Inattention (formerly Neglect) | 0 = No abnormality |



---



| Patient Description | NIHSS Item | Score |

|---------------------|------------|-------|

| **Certification Patient 3** (Dr. Lyden-San Diego, California)<br>Whiteboard: Nurses, Ted and Amy,
February 26, Monday-Have a great day, cat pictures on the wall. Patient is 81 year old Caucasian female
on O2 and ID on right hand (your left), has IV in Left AC area. | 1a. Level of Consciousness | 0 = Alert;
keenly responsive |

| | 1b. LOC Questions | 0 = Answers both questions correctly |

| | 1c. LOC Commands | 0 = Performs both tasks correctly |

| | 2. Best Gaze | 0 = Normal |

| | 3. Visual | 0 = No visual loss |

| | 4. Facial Palsy | 1 = Minor paralysis |

| | 5a. Motor Arm Left | 0 = No drift |

| | 5b. Motor Arm Right | 0 = No drift |
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