LATEST NIH Stroke Scale EXAM AND PRACTICE EXAM NEWEST ACTUAL EXAM COMPLETE 250 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A
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NIH Stroke Scale
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NIH Stroke Scale
LATEST NIH Stroke Scale EXAM AND PRACTICE EXAM
NEWEST ACTUAL EXAM COMPLETE 250 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
When should the NIHSS be administered? - CORRECT
ANSWER C. As soon as possible and if there is a sudden
change in status
What is on...
EXAM AND PRACTICE EXAM
LATEST NIH Stroke Scale
NEWEST ACTUAL EXAM COMPLETE 250 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
When should the NIHSS be administered? - CORRECT
ANSWER C. As soon as possible and if there is a sudden
change in status
What is one way that the NIHSS is reproducible? - CORRECT
ANSWER C. Use by certified professionals Correct
Worsening scores in which of the following NIHSS
categories is associated with neurological deterioration
when observed within 120 minutes after TPA
administration? - CORRECT ANSWER A. Level of
consciousness
When administering the NIHSS to a non-English speaking
patient, what additional resources should the nurse plan to
have for the assessment? - CORRECT ANSWER B.
Language services or an interpreter
What is the NIHSS category score for 1c (LOC-Commands)
when the patient attempts to follow instructions but is too
weak? - CORRECT ANSWER A. 0 - Performs both tasks
correctly
For which category of the NIHSS would the nurse ask the
patient to "follow my finger" as the nurse moves a finger
,horizontally to the left and right? - CORRECT ANSWER B.
Best gaze
When assessing Motor Arm function for a patient sitting in a
wheelchair, should the palm be up or down? And, at what
angle should the arms be? - CORRECT ANSWER D. Down,
90
The nurse is evaluating the Motor Arm function, right arm.
The provider positions the arm in the correct position and
then releases the arm. The arm slightly dips, returns to
normal position, and the position is held. What is the
appropriate score? - CORRECT ANSWER A. 0 - No drift
What is the severity of a patient's stroke if they have a
NIHSS of 4? - CORRECT ANSWER B. Minor stroke
How to assess Level of Consciousness? - CORRECT
ANSWER 1a. Deteremine if patient is alert, oriented x4
1b. The patient is asked the month and his/her age.
The answer must be correct - there is no partial credit for
being close. Aphasic and stuporous patients who do not
comprehend the questions will score 2. It is important that
only the initial answer be graded and that the examiner not
"help" the patient with verbal or non-verbal cue.
1c. The patient is asked to open and close the
eyes and then to grip and release the non-paretic hand. If
the patient does not respond to command, the task
should be demonstrated to him or her (pantomime), and the
result scored (i.e., follows none, one or two commands)
,What are the results? - CORRECT ANSWER 0 = Alert;
keenly responsive.
1 = Not alert; but arousable by minor stimulation to obey,
answer, or respond.
2 = Not alert; requires repeated stimulation to attend, or is
obtunded and requires strong or painful stimulation to
make movements (not stereotyped).
3 = Responds only with reflex motor or autonomic effects or
totally unresponsive, flaccid, and areflexic.
0 = Answers both questions correctly.
1 = Answers one question correctly.
2 = Answers neither question correctly
0 = Performs both tasks correctly.
1 = Performs one task correctly.
2 = Performs neither task correctly.
How to assess best gaze? - CORRECT ANSWER Only
horizontal eye movements will be tested.
Voluntary or reflexive (oculocephalic) eye movements will
be scored, but caloric testing is not done. If the patient has
a conjugate deviation of the eyes that can be overcome by
voluntary or reflexive activity, the score will be 1If a patient
has an isolated peripheral nerve paresis (CN III, IV or VI),
score a 1
What are the results? - CORRECT ANSWER 0 = Normal.
1 = Partial gaze palsy; gaze is abnormal in one or both eyes,
but forced deviation or total gaze paresis is not present.
2 = Forced deviation, or total gaze
, How to assess visual gaze? - CORRECT ANSWER Visual
fields (upper and lower quadrants) are tested by
confrontation, using finger counting or visual threat, as
appropriate.
If there is unilateral blindness or enucleation, visual fields in
the remaining eye are scored.
If patient is blind from any cause, score 3.
Double simultaneous stimulation is performed at this point.
If there is extinction, patient receives a 1, and the results
are used to respond to item 11.
What are the results? - CORRECT ANSWER 0 = No visual
loss.
1 = Partial hemianopia.
2 = Complete hemianopia.
3 = Bilateral hemianopia (blind including cortical blindness).
How to assess facial palsy? - CORRECT ANSWER 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.
What are the results? - CORRECT ANSWER 0 = Normal
symmetrical movements.
1 = Minor paralysis (flattened nasolabial fold, asymmetry on
smiling).
2 = Partial paralysis (total or near-total paralysis of lower
face).
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