APEX NIH Stroke Scale Group A Patients 1-6
(Complete 2025) | Verified Answers & Full
Patient Assessment
PATIENT 1: ACUTE ISCHEMIC STROKE - RIGHT MCA SYNDROME
Presentation: 68-year-old male, sudden left-sided weakness and facial droop, arrived within 2
hours of onset. GCS 14, alert but confused.
Question 1: What is the patient's most appropriate initial NIH Stroke Scale score for 'Level of
Consciousness'?
A) 0 - Alert
B) 1 - Drowsy
C) 2 - Obtunded
D) 3 - Coma
Correct Answer: B) 1 - Drowsy
Explanation: The patient is alert but confused, which corresponds to a score of 1 (not fully alert;
arousable with minor stimulation). A score of 0 requires being fully alert and responsive.
, Question 2: The patient has left homonymous hemianopsia. What is the NIH score for 'Visual'
fields?
A) 0 - No visual loss
B) 1 - Partial hemianopia
C) 2 - Complete hemianopia
D) 3 - Bilateral hemianopia
Correct Answer: C) 2 - Complete hemianopia
Explanation: Homonymous hemianopsia affecting both eyes on the same side constitutes a
complete hemianopia, scoring 2 points on the NIHSS.
Question 3: The patient has left facial droop and cannot move his left arm or leg. What is the score
for 'Motor Arm' and 'Motor Leg' on the left side?
A) 0 - No drift
B) 1 - Drift
C) 2 - Some effort against gravity
D) 4 - No movement
Correct Answer: D) 4 - No movement
Explanation: Complete lack of movement in the left arm and leg due to flaccid paralysis scores 4 on
both motor scales, indicating severe motor impairment.
(Complete 2025) | Verified Answers & Full
Patient Assessment
PATIENT 1: ACUTE ISCHEMIC STROKE - RIGHT MCA SYNDROME
Presentation: 68-year-old male, sudden left-sided weakness and facial droop, arrived within 2
hours of onset. GCS 14, alert but confused.
Question 1: What is the patient's most appropriate initial NIH Stroke Scale score for 'Level of
Consciousness'?
A) 0 - Alert
B) 1 - Drowsy
C) 2 - Obtunded
D) 3 - Coma
Correct Answer: B) 1 - Drowsy
Explanation: The patient is alert but confused, which corresponds to a score of 1 (not fully alert;
arousable with minor stimulation). A score of 0 requires being fully alert and responsive.
, Question 2: The patient has left homonymous hemianopsia. What is the NIH score for 'Visual'
fields?
A) 0 - No visual loss
B) 1 - Partial hemianopia
C) 2 - Complete hemianopia
D) 3 - Bilateral hemianopia
Correct Answer: C) 2 - Complete hemianopia
Explanation: Homonymous hemianopsia affecting both eyes on the same side constitutes a
complete hemianopia, scoring 2 points on the NIHSS.
Question 3: The patient has left facial droop and cannot move his left arm or leg. What is the score
for 'Motor Arm' and 'Motor Leg' on the left side?
A) 0 - No drift
B) 1 - Drift
C) 2 - Some effort against gravity
D) 4 - No movement
Correct Answer: D) 4 - No movement
Explanation: Complete lack of movement in the left arm and leg due to flaccid paralysis scores 4 on
both motor scales, indicating severe motor impairment.
