What does a RASS score of 0 indicate?

• A. Restless, anxious, apprehensive but not yet agitated
• B. Combative, violent, immediate danger to self or others
• C. Alert and calm
• D. Very agitated, aggressive, concern for future violence

Answer: (C)

The RASS is used to gauge how awake or sedated a patient is by rating agitation and sedation on a scale from +4 (very agitated) to -5 (unresponsive). A score of zero sits at the center and means the patient is alert and calm, with no agitation or sedation. This baseline helps clinicians titrate sedation: positive numbers mean increasing agitation, negative numbers mean increasing sedation. In this item, “alert and calm” directly describes the baseline state, so it’s the correct choice. The other descriptions depict higher levels of agitation or aggression, which would yield positive scores, not zero.