A patient, recovering from being struck by lightning 36 hours prior to admission, is demonstrating an acute onset of confusion and muscle weakness. Which of the following would explain this patient's symptoms?
1. the patient has an electrolyte imbalance
2. the patient has another neurological problem occurring
3. the patient has a seizure disorder
4. the onset of neurological symptoms after a lightning injury can be delayed
4
Rationale: Neurological effects are common with electrical and lightning injuries. The onset of clinical manifestations may be acute or delayed. Patients may experience confusion, exhibit a flat affect, lose the ability to concentrate, or have short-term memory problems. Seizures, headaches, peripheral nerve damage, and loss of muscle strength may also be observed. There is not enough information to determine if the patient has an electrolyte disturbance or has an underlying seizure disorder. It is also unlikely that the patient has another neurological problem occurring.
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