NIHSS Motor Function Assessment 2 — Questions and Answers
Question 1: A patient holds their right arm at 90° but it drifts down within 3 seconds without hitting the bed. What NIHSS Item 5a score applies?
- 0 - No drift
- 1 - Drift but does not hit bed (Correct answer)
- 2 - Some effort against gravity but drifts to bed
- 3 - No effort against gravity
Correct answer: 1 - Drift but does not hit bed
A score of 1 is assigned when the limb drifts before 10 seconds but does not fall all the way to the bed.
Question 2: When assessing leg motor function (Item 6), at what angle is the leg held for testing in a supine patient?
- 30 degrees (Correct answer)
- 45 degrees
- 60 degrees
- 90 degrees
Correct answer: 30 degrees
The leg is held at 30° off the bed for 5 seconds during NIHSS Item 6 assessment.
Question 3: A patient with hemiplegia cannot move the affected arm against gravity at all. What is the NIHSS motor arm score?
- 1
- 2
- 3 (Correct answer)
- 4
Correct answer: 3
A score of 3 means no effort against gravity; the limb falls immediately when placed in position.
Question 4: Which NIHSS item specifically evaluates left leg motor function?
- Item 5b
- Item 6a
- Item 6b (Correct answer)
- Item 7
Correct answer: Item 6b
Item 6b assesses the left leg motor function, while 6a assesses the right leg.
Question 5: A patient is asked to hold the arm up but makes no movement whatsoever due to amputation. How is this NIHSS item scored?
- 0
- 4
- UN (untestable) (Correct answer)
- 9 (not applicable)
Correct answer: UN (untestable)
Amputation or joint fusion results in an 'UN' (untestable) score with an explanation noted.
Question 6: A comatose patient's leg immediately falls to the bed when placed at 30°. What NIHSS Item 6 score is recorded?
- 2
- 3 (Correct answer)
- 4
- UN
Correct answer: 3
A score of 3 is given when there is no effort against gravity and the limb falls immediately.
Question 7: How long must the arm be held at 90° (seated) or 45° (supine) before scoring NIHSS Item 5?
- 5 seconds
- 10 seconds (Correct answer)
- 15 seconds
- 20 seconds
Correct answer: 10 seconds
The arm must be held in position for 10 seconds during the NIHSS arm motor assessment.
NIHSS Motor Function Assessment 2
A patient holds their right arm at 90° but it drifts down within 3 seconds without hitting the bed.
What NIHSS Item 5a score applies?