A patient opens his eyes only when periorbital pressure is applied, makes incomprehensible sounds, and shows abnormal flexion to painful stimulus. What is the patient's Glasgow Coma Scale score?

1. A

   E2 V2 M3 = 7/15

2. B

   E2 V1 M4 = 8/15

3. C

   E3 V2 M4 = 9/15

4. D

   E3 V3 M4 = 10/15

Appeared in: NORCET-11 Prelims

Explanation

• Eye opening to pain is scored as E2 (2 points).
• Incomprehensible sounds are scored as V2 (2 points).
• Abnormal flexion to pain is scored as M3 (3 points).
• Total GCS is 2 + 2 + 3 = 7 out of 15.
• GCS is a key tool for assessing and monitoring neurological status.

Why Other Options Were Wrong

• Option B: E2 V1 M4 = 8/15 is incorrect because V1 (no verbal response) does not match the patient's incomprehensible sounds (should be V2), and M4 (withdrawal from pain) does not match abnormal flexion (should be M3).
• Option C: E3 V2 M4 = 9/15 is incorrect because E3 (eye opening to speech) does not match the patient's response (should be E2, eye opening to pain), and M4 (withdrawal) does not match abnormal flexion (should be M3).
• Option D: E3 V3 M4 = 10/15 is incorrect because both E3 (eye opening to speech) and V3 (inappropriate words) do not match the patient's actual responses (should be E2 and V2).

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Glasgow Coma Scale scoring and interpretation to guide bedside assessment, documentation, and the next nursing action.
• Accurate GCS scoring is essential for monitoring neurological status and detecting deterioration in patients with brain injury.
• Nurses use GCS to communicate patient status and guide escalation of care.
• What if? If the patient started making no verbal response (V1) instead of incomprehensible sounds (V2), the total GCS would decrease to 6, indicating a more severe impairment.

How to Approach the Question

• Identify each clinical cue and match it to the correct GCS component (eye, verbal, motor).
• Use a GCS chart to assign the correct score for each response.
• Add the three scores to get the total GCS.
• Compare your calculated score to the options provided.
• Double-check for subtle differences in the options, especially for similar-sounding responses.

Concept Tested & Keywords

• Concept Tested: Glasgow Coma Scale scoring and interpretation
• Stem keywords: periorbital pressure, incomprehensible sounds, abnormal flexion, Glasgow Coma Scale
• Lead-in keywords: What is the patient's Glasgow Coma Scale score?
• Clinical cues: Opens eyes to pain
• Clinical cues: Incomprehensible sounds

Question ID

QBFRK47kFrLyCLnsT3gB_8

Copy ID

Reference Book

E6 Nursing Fundamentals Taylor p. 412-414

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 196-198