ACCS Practice Exam 2026 – Complete Test Preparation Guide

To determine the Glasgow Coma Scale (GCS) score for a patient who is angry, combative, and withdraws to painful stimuli, it's important to break down the components of the GCS, which assesses three parameters: eye-opening response, verbal response, and motor response.

1. **Eye Opening Response**: The maximum score for eye-opening is 4 (spontaneous), but if the patient is only responding to painful stimuli (not spontaneously opening eyes), they would typically score 1 (none) or 2 (to pain). In this context, we will assume the patient isn't responding spontaneously and is not scoring the maximum.

2. **Verbal Response**: An angry, combative patient would likely be scoring in the range of 3 to 4 for verbal response. If they are making incomprehensible sounds or are unable to have an appropriate conversation, they might score as low as 2. In this case, they may score around 3 if they can vocalize in an angry tone.

3. **Motor Response**: A patient who withdraws to painful stimuli typically scores 4 in this domain. This indicates a purposeful movement to avoid pain, which suggests a higher level of consciousness than would be seen