Which vital sign change would indicate increased ICP?

• A. Tachypnea
• B. Bradycardia
• C. Hypotension
• D. Narrowing pulse pressure

Answer: (B)

Rising intracranial pressure triggers a brainstem reflex known as the Cushing response, which includes increased blood pressure with a slow heart rate and irregular breathing. The bradycardia seen with this reflex is a hallmark sign that ICP is high and the brain is under pressure. The other options don’t fit as cleanly: tachypnea can occur but isn’t as specific to ICP, hypotension is not typical early in ICP elevation (the body often maintains or raises BP to preserve cerebral perfusion), and narrowing pulse pressure isn’t the usual pattern (in ICP elevation the pulse pressure tends to widen). So bradycardia best indicates increased ICP.