A nurse is caring for a client who was involved in a motor vehicle accident. The client is alert and oriented and reports a loss of consciousness immediately after the accident. Which of the following additional manifestations should the nurse assess the client for?
(Select All that Apply.)

Choice A Reason:

Client responds to name is incorrect. Responding to one's name is a positive sign indicating consciousness and orientation. It suggests that the client's level of consciousness is relatively intact.

Choice B Reason:

Eyes open to painful stimuli is correct. Opening the eyes in response to painful stimuli is a concerning sign, indicating a decrease in consciousness and potentially worsening neurological status. It suggests that the client's level of arousal is diminishing and may indicate a decline in condition.

Choice C Reason:

Client states day of the week is correct. Oriented behavior, such as knowing the day of the week, is a positive sign indicating intact cognition and orientation. It suggests that the client's mental status is relatively preserved.

Choice D Reason:

Client is confused is correct. Confusion is a concerning sign, indicating altered mental status and potentially worsening neurological function. It suggests that the client's cognition is impaired, which may be indicative of a decline in condition.

Choice E Reason:

Client mumbles inappropriate words is correct. Mumbling inappropriate words suggests disorientation and altered mental status, which are concerning signs indicating a decline in neurological function.

Choice F Reason:

Eyes do not open to name is incorrect. Failure to open the eyes in response to verbal stimuli, such as one's name, is a concerning sign indicating a decrease in consciousness and potentially worsening neurological status. It suggests that the client's level of arousal is diminished and may indicate a decline in condition.

Choice A Reason:

Chronic obstructive pulmonary disease (COPD) is inappropriate.COPD is a chronic lung disease characterized by airflow limitation. While COPD does not directly cause spinal stenosis, some individuals with COPD may have comorbidities or risk factors, such as osteoporosis or degenerative changes in the spine, which can contribute to spinal stenosis.

Choice B Reason:

Laminectomy is appropriate. A laminectomy is a surgical procedure used to decompress the spinal cord or nerves by removing the lamina (back part of the vertebra). While a laminectomy can be a treatment option for spinal stenosis, it is not a risk factor for developing the condition.

Choice C Reason:

Hysterectomy is inappropriate. Hysterectomy, the surgical removal of the uterus, is not directly associated with spinal stenosis. However, certain conditions or factors leading to a hysterectomy, such as pelvic tumors or endometriosis, may indirectly contribute to spinal stenosis if they cause changes in the spine or affect posture.

Choice D Reason:

Hyperthyroidism is appropriate. Hyperthyroidism, a condition characterized by excessive production of thyroid hormones, is not a known risk factor for spinal stenosis.