Which of the following is an early sign of intracranial pressure?

Choice A: Referral to counselor, social worker, home health care, support groups is correct because it can help the patient cope with the emotional, social, and practical aspects of living with a brain tumor. It can also provide information, resources, and assistance to the patient and their caregivers.

Choice B: Presence of family, friends, spiritual advisor, and health care personnel may be supportive is correct because it can provide comfort, companionship, and guidance to the patient. It can also help the patient express their feelings, needs, and preferences.

Choice C: Encourage independence for as long as possible is correct because it can enhance the patient's self-esteem, dignity, and quality of life. It can also help the patient maintain their physical and mental abilities and prevent complications such as depression, anxiety, or immobility.

Choice D: All of the above are correct because they are part of the holistic nursing care for the patient with nervous system metastases or primary brain tumor. They can address the physical, psychological, social, and spiritual needs of the patient and their family.

Choice A: Pressure ulcer is not the most serious complication of a patient with altered level of consciousness, but rather a common and preventable complication that can cause skin breakdown, infection, and pain.

Choice B: Aspiration is the most serious complication of a patient with altered level of consciousness, as it can cause pneumonia, respiratory failure, and death.

Choice C: Contractures is not the most serious complication of a patient with altered level of consciousness, but rather a potential and reversible complication that can cause muscle stiffness, joint deformity, and reduced mobility.

Choice D: Deep vein thrombosis is not the most serious complication of a patient with altered level of consciousness, but rather a possible and treatable complication that can cause blood clots, swelling, and pain in the legs.