NIHSS Group A Patient 2 — Questions and Answers
Question 1: In the NIHSS Group A patient scenario, when assessing Item 1b (LOC Questions), the patient correctly answers the month but not their age. What score is recorded?
- 0 — both answers correct
- 1 — one answer correct (Correct answer)
- 2 — neither answer correct
- 3 — unable to assess
Correct answer: 1 — one answer correct
Item 1b scores 1 when the patient answers exactly one of the two questions (month and age) correctly.
Question 2: The Group A patient is asked to 'grip your hand, now let go' for Item 1c (LOC Commands). The patient grips but does not release. What is the correct score?
- 0 — performs both tasks correctly
- 1 — performs one task correctly (Correct answer)
- 2 — performs neither task
- NT — not testable
Correct answer: 1 — performs one task correctly
Item 1c scores 1 when the patient successfully completes only one of the two commanded tasks.
Question 3: During the Group A patient assessment, the examiner observes the patient's eyes deviate to the left and cannot be overcome by oculocephalic maneuver. What is the Item 2 (Best Gaze) score?
- 0 — normal
- 1 — partial gaze palsy
- 2 — forced deviation (Correct answer)
- 3 — complete gaze palsy
Correct answer: 2 — forced deviation
A forced deviation that cannot be overcome by oculocephalic maneuver is scored as 2 on Item 2.
Question 4: For Item 4 (Facial Palsy) in the Group A patient scenario, the patient shows minor flattening of the nasolabial fold on the right side with slight asymmetry on smile. What score applies?
- 0 — normal symmetrical movement
- 1 — minor paralysis (Correct answer)
- 2 — partial paralysis
- 3 — complete paralysis
Correct answer: 1 — minor paralysis
Minor paralysis (1) applies when there is flattening of the nasolabial fold with only slight asymmetry during voluntary movement.
Question 5: The Group A patient's right arm drifts down and hits the bed before 10 seconds but after 5 seconds. No effort against gravity is maintained. What is the Item 5b (Right Motor Arm) score?
- 1 — drifts down but does not hit bed
- 2 — some effort against gravity but cannot maintain
- 3 — no effort against gravity, limb falls (Correct answer)
- 4 — no movement
Correct answer: 3 — no effort against gravity, limb falls
Score 2 is given when the limb drifts down to the bed within 10 seconds but some effort against gravity was present initially.
Question 6: In the Group A patient assessment of Item 7 (Limb Ataxia), ataxia is present in one limb only. What is the correct score?
- 0 — absent
- 1 — present in one limb (Correct answer)
- 2 — present in two limbs
- NT — not testable due to paralysis
Correct answer: 1 — present in one limb
Item 7 scores 1 when ataxia is present in exactly one limb (either arm or leg).
Question 7: When assessing Item 9 (Best Language) in the Group A patient, the patient names items and reads sentences with some errors but without significant paraphasia. What score is appropriate?
- 0 — no aphasia
- 1 — mild to moderate aphasia (Correct answer)
- 2 — severe aphasia
- 3 — mute or global aphasia
Correct answer: 1 — mild to moderate aphasia
Mild to moderate aphasia (score 1) applies when the patient communicates with noticeable errors but some meaning is exchangeable.
NIHSS Group A Patient 2
In the NIHSS Group A patient scenario, when assessing Item 1b (LOC Questions), the patient correctly answers the month but not their age.
What score is recorded?