A head injured patient, who opens eyes to painful stimulus, is confused and localizes to pain. What is the Glassgow coma score :

**Core Concept**
The Glasgow Coma Scale (GCS) is a neurological scale used to assess the level of consciousness in a patient, particularly after a head injury. It evaluates three components: eye opening, verbal response, and motor response. The total score ranges from 3 (deep coma) to 15 (fully awake).

**Why the Correct Answer is Right**
The patient in question opens eyes to painful stimulus, which scores 2 points, verbal response is confusion, scoring 4 points, and localizes to pain, scoring 5 points. To calculate the GCS, we add the scores of these three components: 2 (eye opening) + 4 (verbal response) + 5 (motor response) = 11.

**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because the patient's eye opening to painful stimulus scores 2 points, not 1, which would be the case if they opened their eyes spontaneously.
**Option B:** Incorrect because the patient's verbal response is confusion, scoring 4 points, not 5, which would be the case if they spoke coherently.
**Option D:** Incorrect because the patient's motor response is localization to pain, scoring 5 points, not 8, which would be the case if they obeyed commands.

**Clinical Pearl / High-Yield Fact**
Remember to use the GCS to assess the level of consciousness in patients with head injuries, and to update the score regularly as the patient's condition changes.

**✓ Correct Answer: C. 11**