NIHSS Language and Aphasia 3

Question 1

Which NIHSS item directly tests the patient's ability to read and name objects from a standardized card set?

Accepted Answer

Item 9 — Language

Answer

NIHSS Item 9 assesses language using a picture description task, object naming card, and reading sentences from a standardized card.

Question 2

A right-handed stroke patient has fluent speech, intact comprehension, but makes frequent sound substitution errors (e.g., 'spoot' for 'spoon'). This pattern most suggests:

Accepted Answer

Phonemic paraphasia from conduction aphasia

Answer

Sound-level substitution errors (phonemic paraphasias) with intact comprehension and fluency are hallmarks of conduction aphasia.

Question 3

In NIHSS training, which patient behavior during the language assessment would NOT be counted as aphasia?

Accepted Answer

Slurred but intelligible speech when naming objects

Answer

Slurred but intelligible speech reflects dysarthria (Item 10), not aphasia (Item 9), so it does not increase the language score.

Question 4

Global aphasia results from large infarcts typically involving which artery's territory?

Accepted Answer

Left middle cerebral artery

Answer

Large left MCA territory infarcts damage both Broca's and Wernicke's areas, causing global aphasia with severe expressive and receptive deficits.

Question 5

A stroke patient can write a sentence correctly but cannot speak. What aphasia type does this pattern suggest?

Accepted Answer

Pure word mutism / aphemia

Answer

Aphemia (pure word mutism) spares written language while impairing speech output, suggesting damage to motor speech areas without broader language network involvement.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Language and Aphasia 3