Practice Test GeeksNIHSS - National Institutes of Health Stroke Scale Practice Test
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Visual Field Testing Flashcards

7 cards from real NIHSS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Visual Field Testing flashcards as text

  1. The NIHSS visual field item uses confrontation testing. How many fingers does the examiner typically use when testing each quadrant?

    Answer: Two fingers simultaneously in opposing quadrants

    The standard technique is simultaneous finger counting in upper and lower quadrants to detect field defects efficiently.

  2. A patient correctly detects finger movement in the left visual field but misses it every time it is presented simultaneously with the right. Without simultaneous presentation, the left field is intact. What does this finding suggest?

    Answer: Left visual extinction/neglect

    Extinction only on simultaneous bilateral stimulation indicates visual neglect (extinction), not a true field cut.

  3. On NIHSS item 3, a patient has a right superior quadrantanopia ('pie in the sky' defect). What score is assigned?

    Answer: 1

    A quadrantanopia is a partial field defect and scores 1 on NIHSS item 3.

  4. Why is it important to test each eye's visual fields from directly in front during NIHSS assessment rather than from the side?

    Answer: To ensure fixation is maintained and peripheral fields are tested symmetrically

    Testing from in front while the patient fixates on the examiner's nose ensures symmetric evaluation of all four quadrants without head-turn compensation.

  5. A patient scores 1 on NIHSS item 3 due to left inferior quadrantanopia after an acute stroke. Which cortical area is most likely affected?

    Answer: Right parietal-occipital junction (superior optic radiation)

    Inferior quadrantanopia ('pie in the floor') results from damage to the superior optic radiations in the parietal-occipital region.

  6. During NIHSS assessment, the examiner tests visual fields before assessing ocular movements. Why is this order clinically significant?

    Answer: Eye movement deficits may confound visual field results if gaze is deviated

    Knowing about gaze deviation (item 2) before scoring fields helps the examiner interpret apparent field deficits that may actually reflect gaze palsy, but the structured NIHSS order is designed so fields are tested with eyes in primary position.

  7. A stroke patient can only perceive hand motion centrally in both eyes and has no peripheral vision. What is the NIHSS item 3 score?

    Answer: 3 — bilateral blindness

    Bilateral visual field loss resulting in near-total blindness is scored 3, the maximum for NIHSS item 3.

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Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

  1. ninds.nih.gov — Exam format · verified Oct 2026
  2. elearning.heart.org — Test delivery, eligibility, fees, renewal, score validity, retake fee, retake policy · verified Oct 2026