A 29-year-old student is admitted with a 24-hour history of headache, nausea, vomiting and listlessness. There is neck stiffness on physical examination. Which physical sign would preclude the taking of a cerebrospinal fluid via lumbar puncture?

1
A positive Kernig's sign
2
Tachycardia, i.e. heart rate above 150 per minute, and hypotension
3
Purpuric skin rash
4
Blurred disc on ophthalmoscopy

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