The nurse is assessing the level of consciousness of a client who suffered a head injury.She uses the Glasgow Coma Scale and determines that the client's score is 15.Which responses did the nurse assess in this client? Select all that apply.
A) Spontaneous eye opening
B) Tachypnea, bradycardia, and hypotension
C) Unequal pupil size
D) Orientation to person, place, and time
E) Motor response to pain localized

Question

Quizplus · Accepted Answer

The Glasgow Coma Scale assesses level of consciousness by testing and scoring three observations: eye opening,motor response,and verbal stimuli response.Clients are scored on their best responses and these scores are totaled.The highest score is 15.The highest responses in these three categories are spontaneous eye opening,obeying motor commands,and orientation to time,place,and person.

The Nurse Is Assessing the Level of Consciousness of a Client