NIHSS Group A Patient 4

Question 1

In the Group A patient scenario, what is the maximum possible total NIHSS score that indicates the most severe stroke deficit?

Accepted Answer

42

Answer

The maximum NIHSS total score is 42, indicating the most severe neurological deficit.

Question 2

When scoring Item 1a (Level of Consciousness) for Group A patient, the patient opens eyes only to painful stimuli but makes no purposeful movements. What score applies?

Accepted Answer

2 — not alert, requires repeated stimulation

Answer

Score 2 is assigned when the patient requires repeated stimulation or painful stimuli to make any movement and is not fully arousable.

Question 3

The Group A patient has a right-sided facial palsy with complete absence of movement in the lower face but preserved forehead movement. What Item 4 score is correct?

Accepted Answer

2 — partial paralysis of lower face

Answer

Partial paralysis (score 2) describes lower facial weakness with sparing of the forehead, consistent with an upper motor neuron lesion.

Question 4

In the Group A patient assessment, the patient has cerebellar ataxia but is also hemiplegic on the same side. How should Item 7 (Limb Ataxia) be scored for the hemiplegic limb?

Accepted Answer

Score as 0 — not scored in hemiplegic limb

Answer

Limb ataxia is only scored if present and out of proportion to weakness; a paralyzed limb cannot demonstrate ataxia and is scored 0.

Question 5

For Group A patient Item 2 (Best Gaze), the patient has right-sided gaze preference but can cross midline with full range on command. What is the score?

Accepted Answer

1 — partial gaze palsy

Answer

Partial gaze palsy (score 1) applies when the patient has a gaze preference that can be overcome voluntarily or with oculocephalic maneuver.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Group A Patient 4