What symptom suggests a deterioration in Mr. Wiggins's level of consciousness after initial assessment?

The correct answer highlights a significant change in Mr. Wiggins's behavior, specifically his confusion and use of inappropriate words. This symptom indicates a deterioration in his level of consciousness because it shows a decline in cognitive function and the ability to communicate effectively. In an initial assessment, a patient who is oriented and able to respond appropriately would typically demonstrate clarity in thought and language.

Confusion and inappropriate word usage can point to various underlying issues, such as neurological impairment, decreased cerebral perfusion, or the impact of medications. In contrast, while opening eyes to voice can demonstrate responsiveness, it does not necessarily reflect cognitive clarity or an overall decline in consciousness. Similarly, not responding to commands could imply a more severe level of impairment, but the confusion and inappropriate language specifically suggest a disruption in cognitive processing that distinguishes it as a more critical concern. Memory loss, while also significant, does not directly correlate with an immediate deterioration in consciousness as vividly as confusion and inappropriate communication do.