Difficulty: Medium
Average Score: 90%
Practice
A 59-year-old male client is brought to the emergency room where he is assessed to have a Glasgow Coma Scale of 3. Based on this assessment, how should the nurse characterize the client's condition?
Correct answer
D
Rationale
The correct answer is D because a Glasgow Coma Scale of 3 indicates severe neurological impairment and the client is in a coma. A GCS score of 3 indicates minimal to no eye opening, no verbal response, and no motor response. This signifies a very poor prognosis as the client is in a deep unconscious state with little to no neurological function.
Rationale:
A: Increased intracranial pressure typically presents with symptoms such as headache, vomiting, and altered level of consciousness, but a GCS of 3 indicates a more severe neurological impairment.
B: A good prognosis is unlikely with a GCS score of 3 as it indicates a very serious neurological condition.
C: While the client may be conscious in terms of physiological function, a GCS of 3 indicates a lack of meaningful responses, so the client is not just disoriented but in a severe state of unconsciousness.
Rationale:
A: Increased intracranial pressure typically presents with symptoms such as headache, vomiting, and altered level of consciousness, but a GCS of 3 indicates a more severe neurological impairment.
B: A good prognosis is unlikely with a GCS score of 3 as it indicates a very serious neurological condition.
C: While the client may be conscious in terms of physiological function, a GCS of 3 indicates a lack of meaningful responses, so the client is not just disoriented but in a severe state of unconsciousness.