A state that requires vigorous stimulation to elicit a response is best described as:

• A. Stupor
• B. Lethargy
• C. Obtundation
• D. Coma

Answer: (A)

Stupor describes a greatly reduced level of consciousness where the patient does not wake easily and only responds to vigorous or painful stimulation. In practice, you determine arousal by how much you must stimulate someone to elicit any response. Lethargy means the person is drowsy but can be roused with minimal stimulation and may speak slowly. Obtundation is a deeper level of decreased alertness, with arousal possible but responses are slowed and less attentive. Coma is total unresponsiveness to any stimulation, including painful stimuli. So the description of requiring vigorous stimulation to evoke a response fits stupor best, sitting between a barely responsive state and coma.