A nurse is preparing to discharge a client who had a concussion from the emergency department. Which of the following instructions should the nurse include in the discharge teaching?

Choice A reason:

This is an incorrect answer. The nurse should not instruct the client to return to work or school as soon as possible after a concussion. The client should rest and avoid cognitive tasks that require concentration, attention, or memory until their symptoms resolve and they are cleared by their provider.

Choice B reason:

This is a correct answer. The nurse should instruct the client to avoid driving or operating machinery until cleared by the provider after a concussion. Driving or operating machinery can be dangerous and impairing for the client who may have symptoms such as headache, dizziness, fatigue, blurred vision, or slowed reaction time.

Choice C reason:

This is an incorrect answer. The nurse should not instruct the client to resume sports or physical activities within a week after a concussion. The client should avoid strenuous or risky activities that could cause another concussion or worsen their symptoms until they are asymptomatic and cleared by their provider.

Choice D reason:

This is an incorrect answer. The nurse should not instruct the client to take ibuprofen or aspirin for pain relief after a concussion. Ibuprofen and aspirin are nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of bleeding in the brain or interfere with blood clotting.

Choice A reason:

This is an incorrect answer. The client does not need immediate reporting if they have a GCS score of 15. This is the highest possible score on the GCS, which indicates that the client is fully alert and oriented.

Choice B reason:

This is a correct answer. The client needs immediate reporting if they have unequal pupils with a difference of 2 mm. This is an abnormal finding that indicates increased intracranial pressure (ICP) or cranial nerve damage, which can be life-threatening.

Choice C reason:

This is an incorrect answer. The client does not need immediate reporting if they have a positive Babinski reflex on both feet. This is a normal finding in infants and young children, but an abnormal finding in adults. However, it does not indicate an acute or urgent condition, but rather a chronic or long-term damage to the corticospinal tract.

Choice D reason:

This is an incorrect answer. The client does not need immediate reporting if they have difficulty performing finger-to-nose test. This is an abnormal finding that indicates cerebellar dysfunction, which affects coordination and balance. However, it does not indicate an acute or urgent condition, but rather a mild or moderate impairment.