A nurse is caring for a client who has headaches.
Which of the following precipitating factors is common in both tension-type headaches and cluster headaches?

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.

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.