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

Choice A rationale
While a stiff neck can be a symptom of a cerebral aneurysm, it is not a definitive sign. A stiff neck is more commonly associated with conditions like meningitis.
Choice B rationale
Most cerebral aneurysms do not cause symptoms until they rupture or become very large. Therefore, a person with a cerebral aneurysm typically will have no symptoms.
Choice C rationale
Seizures can occur if a cerebral aneurysm ruptures and causes bleeding in the brain. However, seizures are not a common symptom of unruptured cerebral aneurysms.
Choice D rationale
Nausea and vomiting can occur if a cerebral aneurysm ruptures and causes a sudden increase in intracranial pressure. However, these are not typical symptoms of an unruptured cerebral aneurysm.

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.