A nurse is caring for a client who has a traumatic brain injury (TBI). Which of the following groups should the nurse understand has a higher risk of sustaining a TBI?

A. Basketball, office jobs, and listening to loud music: These activities are not typically associated with an increased risk of chronic traumatic encephalopathy (CTE). While some recreational and occupational activities may involve physical or environmental risks, they are not commonly linked to the repetitive head trauma seen in CTE.

B. Swimming, working as a nurse, and painting: These activities are not commonly associated with an increased risk of CTE. Swimming is generally a low-risk activity for head injuries, while working as a nurse and painting are not typically associated with repetitive head trauma.

C. Football, military service, and physical abuse: This is the correct answer. Chronic traumatic encephalopathy (CTE) is strongly associated with repetitive head trauma, particularly in contact sports like football, as well as in military service where blast injuries and combat-related head trauma are common. Physical abuse, especially in contact sports, can also increase the risk of CTE due to repetitive blows to the head.

D. Golfing, working in construction, and horse roping: While some occupational and recreational activities may involve a risk of head injury, they are not commonly associated with the repetitive head trauma seen in CTE. Golfing, construction work, and horse roping typically do not involve the level of repetitive head impacts seen in activities like football or military service.

A) "Damage occurs from the penetrating object shattering the skull and causing an infection." While penetrating traumatic brain injuries can lead to skull fractures and subsequent infections, the primary mechanism of brain damage in these injuries is related to the direct impact of the penetrating object on brain tissue rather than the shattering of the skull.

B) "Damage to the brain is related to coup and contrecoup injuries." Coup and contrecoup injuries occur when the brain impacts the skull's interior surface due to rapid deceleration or acceleration, commonly seen in closed head injuries such as concussions. Penetrating traumatic brain injuries involve direct penetration of foreign objects into the brain tissue, and coup-contrecoup injuries are not typically associated with these types of injuries.

C) "Damage occurs from the penetrating injury causing leakage of cerebrospinal fluid." While penetrating injuries may result in cerebrospinal fluid leakage, this is not the primary mechanism through which they cause brain damage. Leakage of cerebrospinal fluid is more commonly associated with certain types of head trauma, such as skull fractures, rather than solely penetrating injuries.

D) "Damage to the brain is related to the size, route, and rate of speed of the object entering the brain." This statement is correct. The extent of brain damage in penetrating traumatic brain injuries depends on various factors, including the size, shape, and velocity of the penetrating object, as well as the route it takes through the brain tissue. Larger, faster-moving objects tend to cause more extensive damage, whereas smaller objects or those with slower velocities may cause more localized damage. Therefore, understanding these factors is crucial in assessing and managing patients with penetrating traumatic brain injuries.