Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What does a score of 4 on the eye opening component of the Glasgow Coma Scale indicate?

  1. Open to pain

  2. Spontaneous eye opening

  3. No response

  4. Open to verbal command

The correct answer is: Spontaneous eye opening

A score of 4 on the eye opening component of the Glasgow Coma Scale indicates spontaneous eye opening. This means that the patient is able to open their eyes without any external stimuli, reflecting a relatively high level of consciousness and responsiveness. It is an important indicator of brain function and responsiveness, often seen in patients who are alert and aware of their surroundings. The other options reflect varying levels of responsiveness related to eye opening. For example, opening eyes to verbal command indicates a lesser degree of reaction, where the individual must receive a prompt to open their eyes. Similarly, opening to pain requires a stimulus that is even more intrusive than verbal commands, suggesting a more significant impairment in responsiveness. No response indicates the absence of any eye opening, which is a critical sign of severe impairment or unconsciousness. Thus, spontaneous eye opening represents a more favorable assessment of neurological status on the scale.