NIHSS Level of Consciousness 4

Question 1

A patient opens their eyes spontaneously, follows simple commands, but cannot state the current month correctly. Their combined NIHSS LOC score (Items 1a + 1b + 1c) would be at minimum:

Accepted Answer

1

Answer

1a=0 (alert), 1b=1 (one question wrong), 1c=0 (commands followed) = minimum total of 1 for the LOC section.

Question 2

Which NIHSS item score would NOT change if a patient transitions from stuporous to comatose between assessments?

Accepted Answer

All LOC items would change

Answer

A transition from stupor (score 2 on 1a) to coma (score 3 on 1a) would also affect 1b and 1c as the patient becomes unable to respond.

Question 3

For NIHSS Item 1c, which two commands are standardly used?

Accepted Answer

Open/close eyes and grip/release hand

Answer

The standard NIHSS Item 1c commands are 'open and close your eyes' and 'grip and release your hand.'

Question 4

A patient with a right hemispheric stroke only responds to sternal rub and does not open their eyes to voice. NIHSS Item 1a score is:

Accepted Answer

2

Answer

Requiring repeated or painful stimulation (sternal rub) to elicit any response scores a 2 on Item 1a.

Question 5

A patient correctly answers what month it is but cannot state their age. How is Item 1b scored?

Accepted Answer

1 - only one question answered correctly

Answer

Answering only one of the two orientation questions correctly yields a score of 1 on Item 1b.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Level of Consciousness 4