APEX NIH STROKE SCALE – GROUP A PATIENTS
1–6 PRACTICE EXAM (2026) QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES
1. Patient 1 opens eyes only after repeated painful stimulus. How is
| | | | | | | | | |
|Level of Consciousness (LOC) scored?
| | | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: C |
Rationale: Eye opening only to repeated or painful stimulation is
| | | | | | | | |
|scored as LOC 2. | | |
2. Patient 1 correctly states their age but gives the wrong month.
| | | | | | | | | |
|LOC Questions score is:
| | |
A. 0
B. 1
C. 2
D. Not testable|
Answer: B |
Rationale: One correct answer equals a score of 1.
| | | | | | | |
,3. Patient 1 follows one command but not the second. LOC
| | | | | | | | |
|Commands score is: | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: B |
Rationale: Following only one command scores 1.
| | | | | |
4. Patient 2 has a normal gaze with full voluntary eye movements.
| | | | | | | | | |
|Best gaze score is:
| | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: A |
Rationale: Normal horizontal eye movements score 0.
| | | | | |
5. Patient 2 has forced deviation of eyes to the left that cannot be
| | | | | | | | | | | |
|overcome. Best gaze score is: | | | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: C |
Rationale: Forced deviation scores 2.
| | | |
6. Patient 3 has complete hemianopia on the right side. Visual fields
| | | | | | | | | |
|score is: |
A. 0
|
, B. 1|
C. 2|
D. 3|
Answer: C |
Rationale: Complete hemianopia equals a score of 2.
| | | | | | |
7. Patient 3 ignores visual stimuli on both sides. Visual score is:
| | | | | | | | | |
A. 1|
B. 2|
C. 3|
D. 0|
Answer: C |
Rationale: Bilateral blindness scores 3.
| | | |
8. Patient 4 shows minor facial asymmetry when smiling. Facial palsy
| | | | | | | | |
score is:
| |
A. 0|
B. 1|
C. 2|
D. 3|
Answer: B |
Rationale: Minor paralysis scores 1.
| | | |
9. Patient 4 has complete paralysis of one side of the face. Facial
| | | | | | | | | | |
palsy score is:
| | |
A. 1|
B. 2|
C. 3|
D. 0|
, Answer: C |
Rationale: Complete facial paralysis scores 3.
| | | | |
10. Patient 5’s left arm drifts down but does not hit the bed.
| | | | | | | | | | |
Motor arm score is:
| | | |
A. 0|
B. 1|
C. 2|
D. 3|
Answer: B |
Rationale: Drift without hitting the bed scores 1.
| | | | | | |
11. Patient 5’s right arm falls rapidly and hits the bed. Motor arm
| | | | | | | | | | |
score is:
| |
A. 1|
B. 2|
C. 3|
D. 4|
Answer: C |
Rationale: Some effort against gravity but falls scores 3.
| | | | | | | |
12. Patient 6 shows no movement in the left arm. Motor arm
| | | | | | | | | |
score is:
| |
A. 3|
B. 4|
C. 2|
D. 1|
Answer: B |
Rationale: No movement scores 4.
| | | |
1–6 PRACTICE EXAM (2026) QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES
1. Patient 1 opens eyes only after repeated painful stimulus. How is
| | | | | | | | | |
|Level of Consciousness (LOC) scored?
| | | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: C |
Rationale: Eye opening only to repeated or painful stimulation is
| | | | | | | | |
|scored as LOC 2. | | |
2. Patient 1 correctly states their age but gives the wrong month.
| | | | | | | | | |
|LOC Questions score is:
| | |
A. 0
B. 1
C. 2
D. Not testable|
Answer: B |
Rationale: One correct answer equals a score of 1.
| | | | | | | |
,3. Patient 1 follows one command but not the second. LOC
| | | | | | | | |
|Commands score is: | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: B |
Rationale: Following only one command scores 1.
| | | | | |
4. Patient 2 has a normal gaze with full voluntary eye movements.
| | | | | | | | | |
|Best gaze score is:
| | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: A |
Rationale: Normal horizontal eye movements score 0.
| | | | | |
5. Patient 2 has forced deviation of eyes to the left that cannot be
| | | | | | | | | | | |
|overcome. Best gaze score is: | | | |
A. 0
|
B. 1
|
C. 2
|
D. 3
|
Answer: C |
Rationale: Forced deviation scores 2.
| | | |
6. Patient 3 has complete hemianopia on the right side. Visual fields
| | | | | | | | | |
|score is: |
A. 0
|
, B. 1|
C. 2|
D. 3|
Answer: C |
Rationale: Complete hemianopia equals a score of 2.
| | | | | | |
7. Patient 3 ignores visual stimuli on both sides. Visual score is:
| | | | | | | | | |
A. 1|
B. 2|
C. 3|
D. 0|
Answer: C |
Rationale: Bilateral blindness scores 3.
| | | |
8. Patient 4 shows minor facial asymmetry when smiling. Facial palsy
| | | | | | | | |
score is:
| |
A. 0|
B. 1|
C. 2|
D. 3|
Answer: B |
Rationale: Minor paralysis scores 1.
| | | |
9. Patient 4 has complete paralysis of one side of the face. Facial
| | | | | | | | | | |
palsy score is:
| | |
A. 1|
B. 2|
C. 3|
D. 0|
, Answer: C |
Rationale: Complete facial paralysis scores 3.
| | | | |
10. Patient 5’s left arm drifts down but does not hit the bed.
| | | | | | | | | | |
Motor arm score is:
| | | |
A. 0|
B. 1|
C. 2|
D. 3|
Answer: B |
Rationale: Drift without hitting the bed scores 1.
| | | | | | |
11. Patient 5’s right arm falls rapidly and hits the bed. Motor arm
| | | | | | | | | | |
score is:
| |
A. 1|
B. 2|
C. 3|
D. 4|
Answer: C |
Rationale: Some effort against gravity but falls scores 3.
| | | | | | | |
12. Patient 6 shows no movement in the left arm. Motor arm
| | | | | | | | | |
score is:
| |
A. 3|
B. 4|
C. 2|
D. 1|
Answer: B |
Rationale: No movement scores 4.
| | | |
