NIH Stroke Scale - Best Study Guide and Exam
Questions with Correct Verified Answers
How to assess Level of Consciousness? - Answer-
1a. Determine if patient is alert, oriented x4
1b. The patient is asked the month and his/her age.
The answer must be correct - there is no partial credit for being close. Aphasic
and stuporous patients who do not comprehend the questions will score 2. It is
important that only the initial answer be graded and that the examiner not "help"
the patient with verbal or non-verbal cue.
1c. The patient is asked to open and close the eyes and then to grip and release
the non-paretic hand. If the patient does not respond to command, the task
should be demonstrated to him or her (pantomime), and the result scored (i.e.,
follows none, one or two commands)
What are the results? - Answer-
0 = Alert; keenly responsive.
1 = Not alert; but arousable by minor stimulation to obey,answer, or respond.
2 = Not alert; requires repeated stimulation to attend, or is obtunded and
requires strong or painful stimulation to make movements (not stereotyped).
3 = Responds only with reflex motor or autonomic effects or totally unresponsive,
flaccid, and are flexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
, NIH Stroke Scale - Best Study Guide and Exam
Questions with Correct Verified Answers
2 = Answers neither question correctly
0 = Performs both tasks correctly.
1 = Performs one task correctly.
2 = Performs neither task correctly.
How to assess best gaze? - Answer- Only horizontal eye movements will be
tested.
Voluntary or reflexive (oculocephalic) eye movements will be scored, but caloric
testing is not done. If the patient has a conjugate deviation of the eyes that can
be overcome by voluntary or reflexive activity, the score will be 1If a patient has
an isolated peripheral nerve paresis (CN III, IV or VI), score a 1
What are the results? - Answer-
0 = Normal.
1 = Partial gaze palsy; gaze is abnormal in one or both eyes,but forced deviation
or total gaze paresis is not present.
2 = Forced deviation, or total gaze
How to assess visual gaze? - Answer- Visual fields (upper and lower quadrants) are
tested by confrontation, using finger counting or visual threat, as appropriate.
If there is unilateral blindness or enucleation, visual fields in the remaining eye
are scored.
Questions with Correct Verified Answers
How to assess Level of Consciousness? - Answer-
1a. Determine if patient is alert, oriented x4
1b. The patient is asked the month and his/her age.
The answer must be correct - there is no partial credit for being close. Aphasic
and stuporous patients who do not comprehend the questions will score 2. It is
important that only the initial answer be graded and that the examiner not "help"
the patient with verbal or non-verbal cue.
1c. The patient is asked to open and close the eyes and then to grip and release
the non-paretic hand. If the patient does not respond to command, the task
should be demonstrated to him or her (pantomime), and the result scored (i.e.,
follows none, one or two commands)
What are the results? - Answer-
0 = Alert; keenly responsive.
1 = Not alert; but arousable by minor stimulation to obey,answer, or respond.
2 = Not alert; requires repeated stimulation to attend, or is obtunded and
requires strong or painful stimulation to make movements (not stereotyped).
3 = Responds only with reflex motor or autonomic effects or totally unresponsive,
flaccid, and are flexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
, NIH Stroke Scale - Best Study Guide and Exam
Questions with Correct Verified Answers
2 = Answers neither question correctly
0 = Performs both tasks correctly.
1 = Performs one task correctly.
2 = Performs neither task correctly.
How to assess best gaze? - Answer- Only horizontal eye movements will be
tested.
Voluntary or reflexive (oculocephalic) eye movements will be scored, but caloric
testing is not done. If the patient has a conjugate deviation of the eyes that can
be overcome by voluntary or reflexive activity, the score will be 1If a patient has
an isolated peripheral nerve paresis (CN III, IV or VI), score a 1
What are the results? - Answer-
0 = Normal.
1 = Partial gaze palsy; gaze is abnormal in one or both eyes,but forced deviation
or total gaze paresis is not present.
2 = Forced deviation, or total gaze
How to assess visual gaze? - Answer- Visual fields (upper and lower quadrants) are
tested by confrontation, using finger counting or visual threat, as appropriate.
If there is unilateral blindness or enucleation, visual fields in the remaining eye
are scored.
