NIHSS Score Administration and Interpretation 4

Question 1

A patient with a known language barrier due to being non-English-speaking cannot follow verbal commands during NIHSS testing. How should the examiner proceed?

Accepted Answer

Use pantomime and visual cues as permitted by the protocol

Answer

The NIHSS allows pantomime and visual cues for language-related items when a language barrier exists, and the examiner must score based on observed responses.

Question 2

Which NIHSS item specifically evaluates the patient's ability to name objects and read sentences?

Accepted Answer

Best Language (Item 9)

Answer

Best Language (Item 9) assesses naming, reading, and comprehension to evaluate aphasia severity.

Question 3

A patient scores 2 on facial palsy, 2 on left arm motor, 2 on left leg motor, 1 on sensory, and 1 on best language. What is the total NIHSS score?

Accepted Answer

8

Answer

2+2+2+1+1 = 8; accurate addition across items is essential for correct severity classification.

Question 4

During the limb ataxia item, the examiner notes the patient cannot move her arm due to paralysis. The correct score is:

Accepted Answer

0 — scored as absent because weakness explains the finding

Answer

Limb ataxia is scored 0 (absent) when weakness or paralysis is sufficient to explain the incoordination, per NIHSS protocol.

Question 5

An NIHSS score of 16–20 is categorized as:

Accepted Answer

Moderate-to-severe stroke

Answer

Scores of 16–20 fall in the moderate-to-severe range, indicating significant neurological deficit requiring aggressive management.

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS - National Institutes of Health Stroke Scale Practice Test

NIHSS Score Administration and Interpretation 4