A newly licensed nurse is learning about coup and contrecoup injuries.
Which statement by the newly licensed nurse demonstrates a clear understanding of the topic?

Choice A rationale
Penetrating traumatic brain injuries can cause significant damage to the brain. The extent of this damage is often related to the size, route, and speed of the object entering the brain. A larger, faster object or one that follows a path through vital areas of the brain can cause more severe injury. This is because the object can disrupt normal brain tissue and function, leading to a range of potential effects, from temporary changes in brain function to long-term complications or even death.
Choice B rationale
While it is true that a penetrating injury can cause leakage of cerebrospinal fluid (CSF), this is not the primary source of damage in such injuries. CSF leakage can lead to complications such as meningitis, an infection of the protective membranes covering the brain and spinal cord.
However, the primary damage in penetrating brain injuries comes from the direct physical disruption of brain tissue by the object.
Choice C rationale
Coup and contrecoup injuries are terms used to describe injuries that occur at the site of impact (coup) and on the opposite side of the brain (contrecoup). These injuries are typically associated with blunt force trauma, not penetrating injuries. In a penetrating injury, the damage is localized to the path that the object has taken through the brain, rather than at the point of impact and its opposite side.

Choice D rationale
While a penetrating object can indeed shatter the skull and potentially cause an infection, the primary damage in penetrating brain injuries is caused by the direct injury to the brain tissue itself. Infections are a secondary complication that can occur if bacteria enter the brain through the wound.

Choice A rationale
A patient in the intensive care unit who was admitted with severe head trauma and cerebral edema, who opens their eyes spontaneously, is oriented, and obeys commands, would be experiencing a decline in their condition if they become confused. Confusion can be a sign of worsening brain function, indicating that the brain is not receiving enough oxygen or is being affected by a buildup of toxins. This could be due to increased intracranial pressure, decreased blood flow to the brain, or further injury to the brain tissue.
Choice B rationale

Mumbling inappropriate words can also be a sign of a decline in a patient’s condition. However, it is less specific than confusion. It could be due to a variety of factors, including medication side effects, sleep deprivation, or mental health issues.
Choice C rationale
If a patient’s eyes do not open to their name, it could indicate a significant decline in their condition. However, this is a more severe symptom than confusion and may not be the first sign of a decline.