NIH STROKE SCALE TRAINING AND
CERTIFICATION COMPREHENSIVE EXAM 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Part 2-3. Answer: *EYES*
*2: Gaze*
0 = Normal
1 = Gaze deviation that can be overcome (preference)
2 = Forced gaze deviation (palsy)
*Isolated palsy = 1
*3: Visual Fields* via confrontation or threat if comatose
1 = partial hemianopia
2 = complete hemianopia
3 = total blindness bilat (cortical blindness)
*If pt has unilat blindness, use good eye for fields
◉ Part 4. Answer: *FACE* - Ask patient to smile and raise eyebrows. If
obtunded, use grimace to pain.
1 = mild asymmetry (nasolabial field flattened)
2 = lower facial droop
, 3 = complete paralysis of 1 or both sides of face including upper face
◉ Part 5-6. Answer: *MOTOR STRENGTH*
*5a and b* = *Arm strength* via raise each arm to 45 degrees if supine,
90 degrees if sitting.
0 = no drift
1 = mild drift w/o hitting bed
2 = limb drifts down to bed before 10 secs (arm) or 5 seconds (leg)
3 = no effort against gravity
4 = no movement at all
*UN - amputation or joint fusion, document why
*6a and 6b = Leg strength* via raise each leg to 30 degrees (supine).
0 = no drift
1 = mild w/o hitting bed
2 = limb drifts down to bed before 10 sec (arm) or 5 sec (leg)
3 = no effort against gravity
4 = no movement at all
*UN - amputation or joint fusion, document why
◉ Most strokes are _____. Weakness is greater _____ than ______..
Answer: *Cortical*, weaker proximally than distally
CERTIFICATION COMPREHENSIVE EXAM 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Part 2-3. Answer: *EYES*
*2: Gaze*
0 = Normal
1 = Gaze deviation that can be overcome (preference)
2 = Forced gaze deviation (palsy)
*Isolated palsy = 1
*3: Visual Fields* via confrontation or threat if comatose
1 = partial hemianopia
2 = complete hemianopia
3 = total blindness bilat (cortical blindness)
*If pt has unilat blindness, use good eye for fields
◉ Part 4. Answer: *FACE* - Ask patient to smile and raise eyebrows. If
obtunded, use grimace to pain.
1 = mild asymmetry (nasolabial field flattened)
2 = lower facial droop
, 3 = complete paralysis of 1 or both sides of face including upper face
◉ Part 5-6. Answer: *MOTOR STRENGTH*
*5a and b* = *Arm strength* via raise each arm to 45 degrees if supine,
90 degrees if sitting.
0 = no drift
1 = mild drift w/o hitting bed
2 = limb drifts down to bed before 10 secs (arm) or 5 seconds (leg)
3 = no effort against gravity
4 = no movement at all
*UN - amputation or joint fusion, document why
*6a and 6b = Leg strength* via raise each leg to 30 degrees (supine).
0 = no drift
1 = mild w/o hitting bed
2 = limb drifts down to bed before 10 sec (arm) or 5 sec (leg)
3 = no effort against gravity
4 = no movement at all
*UN - amputation or joint fusion, document why
◉ Most strokes are _____. Weakness is greater _____ than ______..
Answer: *Cortical*, weaker proximally than distally
