NIH STROKE SCALE TRAINING AND
CERTIFICATION EXAMINATION TEST 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ 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 areflexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
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.
If patient is blind from any cause, score 3.
Double simultaneous stimulation is performed at this point. If there is
extinction, patient receives a 1, and the results are used to respond to
item 11.
CERTIFICATION EXAMINATION TEST 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ 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 areflexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
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.
If patient is blind from any cause, score 3.
Double simultaneous stimulation is performed at this point. If there is
extinction, patient receives a 1, and the results are used to respond to
item 11.
