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NIH Stroke Scale Group D Patient 1-6 Complete
Exam Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | 100%
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Patient 1 Case (Questions 1-10)
Scenario: Patient 1 is alert. When asked the current month, the patient answers "December"
correctly. When asked their age, the patient answers "68" correctly. The patient follows
commands to open and close eyes and grip/release the non-paretic hand correctly. Gaze is
normal. Visual fields are full to confrontation. There is mild facial asymmetry (smile is
asymmetric, nasolabial fold flattened). Right arm drifts down after 7 seconds but does not hit the
bed. Left arm is normal. Right leg holds 30° for 5 seconds. Left leg is normal. Limb ataxia is
absent. Sensation is intact. Patient has word-finding difficulties but can describe a picture.
Speech is slightly slurred. No neglect.
Q1: Based on the scenario, what is the score for Item 1a - Level of Consciousness?
A. 0
B. 1
C. 2
D. 3
Q2: Based on the scenario, what is the score for Item 1b - LOC Questions?
A. 0
B. 1
C. 2
D. 3
Q3: Based on the scenario, what is the score for Item 1c - LOC Commands?
A. 0
,2
B. 1
C. 2
D. 3
Q4: The patient is asked to look at the examiner's finger and follow it to the left and right. Both
eyes move fully and symmetrically. What is the score for Item 2 - Best Gaze?
A. 0 [CORRECT]
B. 1
C. 2
D. 3
Q5: Visual fields are tested by confrontation in all quadrants. The patient correctly counts fingers
in all fields. What is the score for Item 3 - Visual?
A. 0 [CORRECT]
B. 1
C. 2
D. 3
Q6: The patient is asked to show teeth or smile. There is flattening of the left nasolabial fold and
asymmetry in the smile, but the patient can close the eye tightly on command. What is the score
for Item 4 - Facial Palsy?
A. 0
B. 1 [CORRECT]
C. 2
D. 3
Q7: The patient holds their right arm at 90 degrees. After 7 seconds, the arm drifts downward but
does not hit the bed before 10 seconds elapse. What is the score for Item 5 - Motor Arm (Right)?
A. 0
, 3
B. 1 [CORRECT]
C. 2
D. 3
Q8: The patient holds their right leg at 30 degrees. It maintains the position for the full 5 seconds
without movement. What is the score for Item 6 - Motor Leg (Right)?
A. 0 [CORRECT]
B. 1
C. 2
D. 3
Q9: The patient has clear word-finding difficulty and paraphasic errors (substituting words), but
their comprehension of commands is intact. They can name objects and describe the picture
fragmentedly. What is the score for Item 9 - Best Language?
A. 0
B. 1 [CORRECT]
C. 2
D. 3
Q10: Calculate the Total NIHSS Score for Patient 1 based on the findings provided.
A. 2
B. 4
C. 6
D. 8
Correct Answer: A
Rationale: The patient is alert, keenly responsive (0). Answers both month and age correctly (0).
Performs both commands correctly (0). Gaze is normal (0). Visual fields are normal (0). Facial
palsy is minor (1). Right arm drifts (1). Motor legs are normal (0, 0). Limb ataxia absent (0).
NIH Stroke Scale Group D Patient 1-6 Complete
Exam Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Patient 1 Case (Questions 1-10)
Scenario: Patient 1 is alert. When asked the current month, the patient answers "December"
correctly. When asked their age, the patient answers "68" correctly. The patient follows
commands to open and close eyes and grip/release the non-paretic hand correctly. Gaze is
normal. Visual fields are full to confrontation. There is mild facial asymmetry (smile is
asymmetric, nasolabial fold flattened). Right arm drifts down after 7 seconds but does not hit the
bed. Left arm is normal. Right leg holds 30° for 5 seconds. Left leg is normal. Limb ataxia is
absent. Sensation is intact. Patient has word-finding difficulties but can describe a picture.
Speech is slightly slurred. No neglect.
Q1: Based on the scenario, what is the score for Item 1a - Level of Consciousness?
A. 0
B. 1
C. 2
D. 3
Q2: Based on the scenario, what is the score for Item 1b - LOC Questions?
A. 0
B. 1
C. 2
D. 3
Q3: Based on the scenario, what is the score for Item 1c - LOC Commands?
A. 0
,2
B. 1
C. 2
D. 3
Q4: The patient is asked to look at the examiner's finger and follow it to the left and right. Both
eyes move fully and symmetrically. What is the score for Item 2 - Best Gaze?
A. 0 [CORRECT]
B. 1
C. 2
D. 3
Q5: Visual fields are tested by confrontation in all quadrants. The patient correctly counts fingers
in all fields. What is the score for Item 3 - Visual?
A. 0 [CORRECT]
B. 1
C. 2
D. 3
Q6: The patient is asked to show teeth or smile. There is flattening of the left nasolabial fold and
asymmetry in the smile, but the patient can close the eye tightly on command. What is the score
for Item 4 - Facial Palsy?
A. 0
B. 1 [CORRECT]
C. 2
D. 3
Q7: The patient holds their right arm at 90 degrees. After 7 seconds, the arm drifts downward but
does not hit the bed before 10 seconds elapse. What is the score for Item 5 - Motor Arm (Right)?
A. 0
, 3
B. 1 [CORRECT]
C. 2
D. 3
Q8: The patient holds their right leg at 30 degrees. It maintains the position for the full 5 seconds
without movement. What is the score for Item 6 - Motor Leg (Right)?
A. 0 [CORRECT]
B. 1
C. 2
D. 3
Q9: The patient has clear word-finding difficulty and paraphasic errors (substituting words), but
their comprehension of commands is intact. They can name objects and describe the picture
fragmentedly. What is the score for Item 9 - Best Language?
A. 0
B. 1 [CORRECT]
C. 2
D. 3
Q10: Calculate the Total NIHSS Score for Patient 1 based on the findings provided.
A. 2
B. 4
C. 6
D. 8
Correct Answer: A
Rationale: The patient is alert, keenly responsive (0). Answers both month and age correctly (0).
Performs both commands correctly (0). Gaze is normal (0). Visual fields are normal (0). Facial
palsy is minor (1). Right arm drifts (1). Motor legs are normal (0, 0). Limb ataxia absent (0).
