NIHSS - Level 1 Patient B Questions With Complete
Solutions
A great deal of information about comprehension will be
obtained during the preceding sections of the examination. For
this scale item, the patient is asked to describe what is happening
in the attached picture, to name the items on the attached naming
sheet and to read from the attached list of sentences.
Comprehension is judged from responses here, as well as to all
of the commands in the preceding general neurological exam. If
visual loss interferes with the tests, ask the patient to identify
objects placed in the hand, repeat, and produce speech. The
intubated patient should be asked to write. The patient in a coma
(question 1a=3) will automatically score 3 on this item. The
examiner must choose a score for the patient with stupor or
limited cooperation, but a score of 3 should be used only if the
patient is mute and follows no one-step commands. Correct
Answer 9 Best language
1-Mild to moderate aphasia; some obvious loss of fluency or
facility of comprehension, without significant limitation on ideas
expressed or form of expression. Reduction of speech and/or
comprehension, however, makes conversation about provided
material difficult or impossible.
A great deal of information about comprehension will be
obtained during the preceding sections of the examination. For
this scale item, the patient is asked to describe what is happening
in the attached picture, to name the items on the attached naming
sheet and to read from the attached list of sentences.
Comprehension is judged from responses here, as well as to all
of the commands in the preceding general neurological exam. If
,visual loss interferes with the tests, ask the patient to identify
objects placed in the hand, repeat, and produce speech. The
intubated patient should be asked to write. The patient in a coma
(question 1a=3) will automatically score 3 on this item. The
examiner must choose a score for the patient with stupor or
limited cooperation, but a score of 3 should be used only if the
patient is mute and follows no one-step commands. Correct
Answer 9. Best Language
0. no aphasia, normal
A great deal of information about comprehension will be
obtained during the preceding sections of the examination. For
this scale item, the patient is asked to describe what is happening
in the attached picture, to name the items on the attached naming
sheet and to read from the attached list of sentences.
Comprehension is judged from responses here, as well as to all
of the commands in the preceding general neurological exam. If
visual loss interferes with the tests, ask the patient to identify
objects placed in the hand, repeat, and produce speech. The
intubated patient should be asked to write. The patient in a coma
(question 1a=3) will automatically score 3 on this item. The
examiner must choose a score for the patient with stupor or
limited cooperation, but a score of 3 should be used only if the
patient is mute and follows no one-step commands. Correct
Answer 9. Best Language
0. no aphasia, normal
Ask, or use pantomime to encourage the patient to show teeth or
raise eyebrows and close eyes. Score symmetry of grimace in
response to noxious stimuli in the poorly responsive or non-
comprehending patient. If facial trauma/bandages, orotracheal
, tube, tape or other physical barriers obscure the face, these
should be removed to the extent possible. Correct Answer 4.
Facial Palsy
0. normal symmetrical movement.
Ask, or use pantomime to encourage the patient to show teeth or
raise eyebrows and close eyes. Score symmetry of grimace in
response to noxious stimuli in the poorly responsive or non-
comprehending patient. If facial trauma/bandages, orotracheal
tube, tape or other physical barriers obscure the face, these
should be removed to the extent possible. Correct Answer 4.
Facial Palsy
1-Minor Paralysis (Flattened nasolabial fold, asymmetry on
smiling).
Ask, or use pantomime to encourage the patient to show teeth or
raise eyebrows and close eyes. Score symmetry of grimace in
response to noxious stimuli in the poorly responsive or non-
comprehending patient. If facial trauma/bandages, orotracheal
tube, tape or other physical barriers obscure the face, these
should be removed to the extent possible. Correct Answer 4.
Facial Palsy
1. minor paralysis
If patient is thought to be normal, an adequate sample of speech
must be obtained by asking patient to read or repeat words from
the attached list. If the patient has severe aphasia, the clarity of
articulation of spontaneous speech can be rated. Only if the
patient is intubated or has other physical barriers to producing
speech, the examiner should record the score as untestable (UN),
and clearly write an explanation for this choice. Do not tell the