Actually YES i have but my nurse manager / teacher said that i didn't answer that question FULLY . . . My answer: Subtle changes or altered Level of Consciousness can result from a variety of factors, including insufficient oxygen or blood flow in the brain and excessive pressure within the skull. Decreased LOC correlates to increased morbidity & mortality ..... Guess ... She's not happy with my answer and that i didn't answer it fully. thanks in anticipation for any response