A nurse is caring for an older adult patient in the emergency department who sustained a head injury due to a fall. Which of the following are common causes of head injuries in older adults?

Choice A rationale
Swelling of the optic nerve, also known as papilledema, can be a sign of increased intracranial pressure (ICP). However, it is not a direct indicator of a worsening neurological condition.
Choice B rationale
The Glasgow Coma Scale (GCS) is a clinical tool used to assess a patient’s level of consciousness and neurological functioning. A decreasing GCS score indicates a worsening neurological condition, which could be due to increasing ICP12. Therefore, a decreasing GCS score is a direct indicator of a worsening neurological condition.
Choice C rationale
A blood pressure of 108/76 mm Hg is within the normal range and does not directly indicate a worsening neurological condition. However, drastic changes in blood pressure could potentially indicate a problem.
Choice D rationale

Changes in pupil size and shape can be a sign of increased ICP, but these changes are not specific to a worsening neurological condition. They could be due to various factors, including medication effects or damage to the cranial nerves.
Choice E rationale
A respiratory rate of 12/min is within the normal range for adults. Changes in respiratory patterns could potentially indicate a worsening neurological condition, but a rate of 12/min does not directly indicate this.

Choice A rationale
While improved rehabilitation outcomes and temporary behavior changes can occur after a neurological injury, they are not typically considered psychosocial changes. Psychosocial changes often involve alterations in the way individuals perceive, interact with, and navigate their social environments.
Choice B rationale
Improved mood stability and temper control are not typically associated with the aftermath of a neurological injury. In fact, individuals may experience mood swings, irritability, and difficulties with emotional regulation.
Choice C rationale
Changes to social cognition and challenges to inhibitory control are indeed possible psychosocial changes a client might have after sustaining a neurological injury. Social cognition involves understanding and interpreting social cues, which can be affected by brain injury.
Challenges to inhibitory control can lead to impulsive behavior and difficulties in social situations.
Choice D rationale
While a sense of purpose, improved motivation, and stable relationships can be part of a successful recovery process, they are not typically direct outcomes of a neurological injury. In

fact, relationships may be strained and motivation can be affected due to the physical and emotional challenges associated with such an injury.