A nurse is caring for a client who has a traumatic brain injury and is being mechanically ventilated. Which of the following can cause unfavorable outcomes for this client?

Choice A rationale
Bruising over the mastoid process, also known as Battle’s sign, is a classic clinical sign of a basilar skull fracture.
Choice B rationale
Pooling of blood and edema around the eyes, or ‘raccoon eyes’, is another sign of a basilar skull fracture.
Choice C rationale
The ability to recall how the injury occurred is not directly related to the presence of a basilar skull fracture. Memory loss or confusion could be symptoms of a traumatic brain injury, but they are not specific to a basilar skull fracture.
Choice D rationale
Chvostek’s sign is a clinical sign of hypocalcemia, not a basilar skull fracture

Choice A rationale

Respiratory therapy is primarily concerned with the treatment and management of a patient’s breathing. While swallowing difficulties can potentially lead to respiratory issues such as aspiration pneumonia, the primary role of evaluating and treating swallowing difficulties falls outside the scope of respiratory therapy.
Choice B rationale
Nutritional therapy would be involved in managing the dietary needs of a patient with Parkinson’s disease, including modifications to food texture and liquid consistency if swallowing difficulties are present. However, the evaluation and treatment of the swallowing difficulty itself would be managed by a speech therapist.
Choice C rationale
Occupational therapy could assist with adaptations to enhance the patient’s feeding skills and independence during meals. However, the specific evaluation and treatment of swallowing function is typically within the scope of a speech therapist.
Choice D rationale
Speech therapists, or speech-language pathologists, are the professionals specifically trained to evaluate and treat individuals with speech, language, voice, and swallowing disorders. This would include a patient with Parkinson’s disease experiencing difficulty swallowing.