Difficulty: Medium
Average Score: 65%
Simulated
A nurse is receiving a transfer report for a client who has a head injury. The client has a Glasgow Coma Scale (GCS) score of 3 for eye opening, 5 for best verbal response, and 5 for best motor response. Which of the following is an appropriate conclusion based on this data?
Correct answer
B
Rationale
The correct answer is B: The client opens his eyes when spoken to. This is because a GCS score of 3 for eye opening indicates that the client opens eyes only in response to voice. The other choices are incorrect because a GCS score of 5 for best verbal response and 5 for best motor response suggest that the client is not completely unresponsive or unable to make vocal sounds (Choice A), unconscious (Choice C), or unable to follow simple motor commands (Choice D). It's important to interpret the GCS score accurately to determine the client's level of consciousness and responsiveness.