A client was brought to the emergency department after suffering a closed head injury and lacerations around the face due to a hit-run accident. The client is unconscious and has a minimal response to noxious stimuli. Which of the following assessment findings if observed after few hours, should be reported to the physician immediately?

Rationale: A. Mild periorbital bruising (“raccoon eyes”) and minimal swelling are common findings after facial trauma and are not immediately life-threatening. These findings should be monitored but do not require urgent reporting unless they worsen significantly or are accompanied by other neurologic changes. B. Withdrawal to pain is a normal protective reflex and indicates some preserved neurologic function. While ongoing neurologic assessment is important, this response alone does not indicate an acute deterioration that requires immediate physician notification. C. Clear fluid drainage from the nose may indicate cerebrospinal fluid (CSF) leakage, which suggests a basal skull fracture or dura mater injury. This is a serious complication that increases the risk of meningitis, brain herniation, or other neurologic compromise and must be reported to the physician immediately for prompt evaluation and management. D. Bleeding from facial lacerations is expected after trauma and can usually be managed with standard wound care. While it should be monitored and treated, it is not as urgent as signs of CSF leakage or neurologic deterioration.