Assessment of the patient with Parkinson's would include:

Choice A: Object penetrates the brain or trauma is so severe that the scalp and skull are opened is correct because it is the definition of an open traumatic brain injury. An open traumatic brain injury occurs when a foreign object such as a bullet, knife, or bone fragment enters the brain or when a blunt force trauma such as a fall, collision, or assault causes a fracture or laceration of the skull. This can damage the brain tissue, blood vessels, and nerves and cause bleeding, swelling, or infection.

Choice B: Stress is incorrect because it is not a type of traumatic brain injury. Stress is a psychological or emotional response to a challenging or threatening situation. It can affect the brain function and health, but it does not cause physical damage to the brain tissue.

Choice C: Acceleration/deceleration injury occurs when the head accelerates and then rapidly decelerates, damaging brain tissue is incorrect because it is not an open traumatic brain injury. It is a type of closed traumatic brain injury, which occurs when the head moves violently without breaking the skull. This can cause the brain to hit against the inner wall of the skull or twist within the skull, resulting in bruising, tearing, or shearing of the brain tissue.

Choice D: All of the above are incorrect because only choice a) describes an open traumatic brain injury. Choices b) and c) are not related to an open traumatic brain injury and do not match its characteristics. The nurse should know the different types and causes of traumatic brain injury and their implications for assessment and care.

Choice A: When patient is fully oriented is incorrect because it is a positive sign of recovery from a concussion. It means that the patient is aware of their person, place, time, and situation. The nurse should monitor the patient's orientation status but does not need to report it to the doctor immediately.

Choice B: Difficulty in awakening, lethargy, dizziness, confusion, irritability, anxiety are correct because they are signs of worsening brain injury or complications from a concussion. They may indicate increased intracranial pressure, bleeding, swelling, or infection in the brain. The nurse should report these symptoms to the doctor immediately and prepare for further diagnostic tests or interventions.

Choice C: When patient is easy to arouse is incorrect because it is also a positive sign of recovery from a concussion. It means that the patient responds quickly and appropriately to verbal or physical stimuli. The nurse should monitor the patient's level of consciousness but does not need to report it to the doctor immediately.

Choice D: All of the above are incorrect because only choice b) requires immediate reporting to the doctor. Choices a) and c) are normal or expected outcomes of a concussion and do not indicate any danger or complication. The nurse should use clinical judgment and follow the guidelines for concussion management and care.