CBIS EXAM 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS, Exams of Nursing

Download CBIS EXAM 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS and more Exams Nursing in PDF only on Docsity! 1 | P a g e CBIS EXAM 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST|GUARANTEED PASS|LATEST UPDATE What are the most common post-concussion symptoms across the spectrum of brain injury severity? Fatigue Physiological fatigue may result from depletion of .... energy, hormones, or reduction of number of What is primary vs secondary fatigue sleep disturbance pain stress anxiety depression True or False: Studies have shown a significant association between fatigue severity following brain injury and age FALSE Describe the Coping hypothesis. fatigue may come from the compensatory effort, impaired attention, and speed of processing 2 | P a g e A decline in this wake-promoting neurotransmitter may be associated with increased daytime sleepiness in individuals with TBI, which may be experienced as fatigue. hypocretin Name the 3 levels of consciousness from lowest to highest functioning. coma vegetative minimally conscience What system is the brain is responsible for maintaining arousal? RAS - dimmer switch (turned on or turned off) This term refers to an individual's ability to receive and process sensory information and use that information to relate to an intentional way to the outside world. It is required for voluntary responses to stimuli and is regulated by the higher cortical in the cerebrum. Awareness True or False: Usually coma is rarely a persistent condition. It usually resolves in 2-4 weeks TRUE _______________ is characterized by the complete absence of behavioral evidence for awareness of self and environment, with preserved capacity for spontaneous or stimulus-induced arousal. Vegetative State yes arousal no awareness If a person is classified as having emerged out of disorder of consciousness, they have met one of the following two criteria. Functional communication (verbal or gestural) Functional use of two or more objects (i.e. hairbrush, cup) What are the three medical management goals for persons with DOC (Disorders of Consciousness) vs a traditional rehab candidate. 1. Response - Based 2. Tolerance for stimuli or intervention 3. risk management 4. caregiver development What score on the GCS (Glasgow Coma Scale) correlates to mild TBI 13 to 15 What is the fundamental cognitive skill that impacts all other cognitive skills? attention 5 | P a g e When an organism responds differently to similar stimuli Discrimination When an organism responds similarly to different/un-trained stimuli or situation. Generalization A technique in which successively closer approximations to the target response are reinforced until the target response occurs Shaping True or False: The following are all de-escalation techniques for crisis intervention: redirection, active listening, and withdrawing attention TRUE What are the predominant factors for persons who were 5-10 years post injury, relating to disability? Cognitive, Behavior, and personality changes Inability to communicate through writing agraphia True or False: There is a definitive link between brain injury and future risk of Alzheimer's Disease. False - suggested relationship What is a dual diagnosis a relationship of a set of symptoms Name the 4 factors to consider for the post-injury development of psychiatric disorder. 1. Neurophysicalogical effects of the injury 2. Psychological vulnerability 3. Self-awareness of deficits 4. social influences Disturbances in the following neurotransmitters, serotonin, glutamate, dopamine, can create what kind of symptoms. MDD / Depression True or False: Patients with TBI are at an increased risk for certain psychiatric disorders including: depression, bipolar disorder, panic disorder, generalized anxiety, schizophrenia. True ____________is the most common result and diagnoses after a TBI. It is characterized by at least 2 weeks in which the individual experiences loss of interest (anhedonia) or depressed mood accompanied by at least 4 additional symptoms. 6 | P a g e Major Depressive Disorder True or False: Location of the injury plays a role in depression following TBI True Define Manic Episode a period of 1 week extremely amp'd self-esteem decreased desire of sleep What is cyclothymic disorder depressive and hypermanic states What percentage of individuals with TBI also experience biopolar disorder 4% This disorder is characterized by repetitive, ritualistic behavior that is so severe that it becomes time- consuming OCD -obsessive compulsive disorder Personality disorders were reported in 23% of persons with TBI. The most common personality disorders were avoidance, paranoid, and Schizoid True or False: A history of at least 1 TBI is associated with more severe substance misuse, later age at first substance use and increased likelihood for other disorders. FALSE- earlier age Current research indicates for individuals receiving either TBI or substance misuse rehab, up to _________ had a history of TBI and substance misuse. 2/3 If an individual misused alcohol or other drugs prior to their injury, the risk of returning to substance misuse after injury is how much higher 10x Describe CAGE: standardized tool that looks at 4-signs of alcohol dependency: 1. Cut down on drinking (Have you ever felt) 2. Have people ANNOYED you by criticizing your drinking 3. Have you ever felt bad or GUILTY about your drinking 4. Have you ever had a drink 1st thing in the morning to steady your nerves (EYE OPENING) 7 | P a g e True or False: The prognosis for acquiring new skills is worse the younger the child is at the time of the brain injury TRUE Of the ages 0-4, most emergency department admissions are due to: FALLS List the 5 normal peaks for brain maturation 3 to 5 8 to 10 14 to 15 17 to 19 21 to 22 The most brain maturation occurs during which ages 0-5 years This age maturation stage primarily involves the elaboration of the visuospatial functions and includes maturation of the visuoauditory regions: 8 to 10 True or False: It is estimated that between 50-80% head trauma related deaths in children under two are from abuse, with 80% being under the age of 1. False - 57% What is the second impact syndrome brain has not fully recovered before sustaining another injury True or False: For children aged 0-19 who acquire a brain injury, referral rates for special education are 98% False - 2% What is IDEA Federal education mandate to provide public education through special education and support services to children with eligible disabilities. IEP - Individualized Education Plan Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease resulting from multiple mTBIs May show in symptoms: Dementia Aggression Confusion 10 | P a g e Define exploitation use of dependents property illegally or without consent to the individual What are the 5 title of the ADA? I - Employment II- State & Local Government III- Public Accommodations IV- Telecommunications V- Misc Provisions Describe the 5 domains of critical case management. 1. Processes and services 2. Resource Utilization and Management 3. Psychosocial and Economic support 4. Rehabilitation 5. Outcomes 6. Legal and Ethical Practices What are the key criteria to establishing a life care plan? specific to the individual reflect full understanding of injuries and resultant disabilities must consider possible complications or comorbidities must look at both short and long term needs A dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research which provides an organized. concise plan for current and future needs, with associated costs, for individuals who have experienced catastrophic injury or have chronic health care needs" is called Life Care Plan This term refers to the assets of any individual other than the individual with the injury or disability. These types of trusts are most widely used as an estate planning technique for families who want a loved one with a disability to maintain eligibility, either currently or in the future, for means-tested benefits such as Medicaid or social security. Typically, parents who include this type of trust in their overall estate plan are focused on what takes place after their death and/or the death of a surviving spouse. Third Party Special Needs Trust What separates a Life Care Plan from a Care Plan inclusion of cost date in included in the a Life Care Plan True or False: Life care plans for children who acquired a brain injury must consider the timing of their injury and the status of brain development of the time of injury. 11 | P a g e True ___________is a person or organization that speaks or writes in support or defense of an individual or a cause. Advocate This type of Medicare covers physician services, outpatient hospital care, including limited amounts of therapy, preventative and laboratory services, and certain equipment and supplies. Medicare Part B This Act authorized the establishment of home and community based Medicaid waivers, which allow states to provide medical and related services tailored to the unique needs of a specific population in the state. Omnibus Budge Reconciliation Act What is CHIP Childrens Health Insurance Program to cover uninsured children in families with incomes that are modest, but too high to qualify for Medicaid. Gap Kids sliding scale based upon income This Act was signed into Law in 2001 and provides financial incentives to states to improve their special education services and services for all students No Child Left Behind Act This is a "gathering of people who share a common health interest or concern." support group True or False: The structure of the support group does have an impact on the overall support group outcomes. True Define validity measures what it is suppose to measure Define reliability measurement is consistent This term is when an assessment is too challenging and many individuals receive the lowest score. Floor Effect This was established in 1987 through a grant from the United States Department of Education, National Institute on Disability Rehabilitation and Research (NIDRR) and evolved through two goals development 12 | P a g e of an exemplary system of care; and uniform data collection related to important research questions (16 facilities across country) TBI Model Systems True or False: The longer the period of PTA, the less likely it is that the person will experience long-term issues False - more A Glasgow Coma scale score of 13 indicates what severity level of injury Mild Measurement of outcomes for children with ABI must not only consider functioning over time after injury, but also how the child functions with respect to development norms What is considered the gold standard of success in rehabilitation after Brain Injury Return to work Employment rates after brain injury are reported at 10-40% Describe the supported employment model intensive individualized assistance to help him or her with gaining and maintaining employment. Real job, Real pay, community-based What is Resource Facilitation a partnership that helps people and communities to make informed choices and choose, get, and keep information, services, and supports Describe Wehman's individualized approach to supported employment VR person acting as a job coach What ACT provides federal grants to states to operate comprehensive programs of vocational rehabilitation services to person with disabilities? Rehab Act of 1973 Name some workplace supports compensatory strategies Memory aides Decreased stimulus The ratio of brain injuries from males to females is approximately 2:1 15 | P a g e TBI is a contributing factor to what fraction of all injury related deaths in the US 1/3 Acquired Brain Injury is the second most prevalent disability in the US True What percent of TBI's that occur each year are concussions? 75% ABI is a type of TBI True Risk of second injury is how many times greater after initial injury 3x's Risk of 3rd injury is how many times greater after second injury? 8x's Name 5 risk factors for having a brain injury which are also indicators of how a brain injury might affect one's life. 1. Age of Injury 2. Being male 3. Severity of injury 4. Alcohol misuse 5. Domestic Violence 6. Military Service 7. Participation in sports A ____________ is a mild TBI caused by a bump, blow, or jolt to the head that can change the way the brain works? Concussion Groups with the highest rate of falls causing TBI are? 1. Children 0 to 4 2. Adults 65 to 75 or older Greatest number of TBI related ED visits are caused by Falls Leading cause of TBI related death is MVA TBI related deaths caused by MVA are highest in what age range 16 | P a g e 20-24 years of age True or False: Moderate TBI will be marked by loss of consciousness for a period of 4-24 hours. FALSE - Moderate TBI LOC is 0-24 hours Rates for TBI are highest in which sports? mens football and womens soccer What is the estimated cost (due to medical and low productivity) for people with TBI? $76.5 billion What Supreme Court decision asserts that states administer their services, programs, and activities "in the most integrated setting appropriate to the needs of qualified individuals with disabilities" regardless of age? Olmstead Describe the TBI Act of 1996 1. NIH (National Institutes of Health) to focus on: conducting research 2. HRSA - improving services 3. CDC - preventing TBI What was established in 1987 by NIDRR and what was its purpose? TBI Model systems - to conduct prospective, longitudinal research to demonstrate the course of recovery and outcomes following TBI at 16 centers. Maintains the Model Systems Knowledge Translation Center. True or False: Persons with TBI are twice as likely to die as similar non-brain injured persons and have a life expectancy of approximately 7 years less than age-related peers TRUE Name 2 NeuroEndocrine disorders associated with TBI. Hypothyroidism Growth Hormone Gonadotropin Deficiency What is apoptosis Cell death True or False: Immediately following a head injury, rapidly progressive severe headache may signal a more significant injury process. TRUE What is the most common inner ear disorder secondary to MTBI which occurs after a change in head position? 17 | P a g e BPPV Vertigo True or False: Post concussive syndrome and post concussive symptoms are different phenomenon. PCS vs. PPCS FALSE What are the predictive Persistent Post-Concussive Symptoms (PPCS) risk factors? 1. Pending litigation 2. Over age of 40 3. Female 4. Traumatically injured 5. Hx of substance abuse 6. low socioeconomic status 7. previous psych history True or False: Sensory sensitivity, sleep disturbance, headache, and nausea are symptomology overlap between mild TBI and PTSD FALSE - because nausea is not a symptom What is the parapsychologists role in diagnosing PPCS? determining symptom causation through providing early intervention making recommendations for therapies monitor return to work, school treat emotional problems that arise during recovery True or False: Sleep disruption can increase the seizure threshold FALSE -should decrease the threshold True or False: Most persons who sustain a mTBI (minor Traumatic Brain Injury) recover their functional abilities within 2-4 weeks after injury. TRUE What imaging is the standard of care for a person who has sustained a significant head injury to determine if a skull fracture had occurred? CT - Start MRI - for additional The incidence of spinal cord injury in the US it is estimated that 40 per million in the population (roughly 12,000) new case annually) which is small compared to TBI. However what percentage of those with SCI have a concomitant TBI? 60% 20 | P a g e cervical injury site: incomplete injury presents with numbness in arms more than legs often accompanied by bowel /bladder incontinence Brown-Sequard Syndrome only one side of the spinal cord is injured Anterior cord syndrome more common loss of muscle control, pain, and temperature sensation intact proprioception and touch sensation What is experience-dependent learning as it relates to neuroplasticity? motor map as our experience changes so does the brains morphology It is estimated that between _________ and __________ million people are living a long-term disability as the result of brain injury. 3.2 and 5.3 Cardiac and respiratory problems after brain injury can occur: immediately chronically as later complications What is dysautonomia? storming - over activity of the autonomic system What are common musculoskeletal complications after brain injury? Spasticity Contractures Hyperreflexia Why does premature osteoporosis occur in both males and females following brain injury? because of testosterone and estrogen levels may be diminished How are UTI's typically detected after brain injury (signs/symptoms)? increased agitation decreased alertness True or False: The Frazier Free Water Protocol requires stringent oral care with oral suction pre and post hydration to minimize aspiration of any oral food particles. TRUE 21 | P a g e True or False: Patients on a Level III Dysphagia Diet need their liquids mixed to a honey-like consistency FALSE Dysphagia applies to Food not Liquids True or False: Metabolic needs decrease significantly following moderate to severe brain injury. FALSE Why might Diabetes Insipidus (DI) occur in both the acute care and long term phase of recovery after brain injury? changes to the hypothalamus and causes by certain medications What are signs and symptoms of SIADH Nausea irritability vomiting seizures confusion coma What is the largest of the bodys organ systems which accounts for 12-15% of total body weight? Skin / Integumentary system How can pressure sores be prevented? Keeping skin clean and dry pressure relief changing positions every 2 hours Which stage of ulcers are the most severe? stage 4 / IV In the past several years, what staph bacteria causing infection has had the greatest prominence in both hospital and community settings? And what is this type of infection typically a product of? MRSA poor hygiene, poor hand washing, repeated use of soiled clothing UTI or urosepsis is typical after brain injury. More than _______percent of individuals with brain injuries will experience a UTI within 6 weeks after the injury. 60% What are the 4 contributing factors for UTI 1. Age 2. co-impairments 22 | P a g e 3. physical disability 4. incontinence What is cellulitis skin infection caused by bacteria Name 3 different sleep disorders that are reported by 30-70% of individuals with TBI. 1. Narcolepsy 2. Sleep Apnea 3. Post traumatic hypersomnia 4. Periodic Limb movement 5. Insomnia Define Cataplexy sudden loss of bilateral muscle tone What lifestyle changes are included in the treatment of insomnia after Brain injury? Lifestyle modifications exercise regular sleep schedule avoiding naps limiting fluid before bed limiting caffiene What are the three categories of seizures occurring following a TBI IPTC- Immediate EPTS- Early post LPTS- Late post traumatic True or False: The emergence of Status Epilepticus after brain injury increases mortality? TRUE - medical emergency What is the time frame within which early post-traumatic seizures (EPTS) occur following brain injury within 1 week Why is the detection and treatment of EPTS necessary? Early treatment secondary damage < brain What are the strongest risk factors for Late Post Traumatic Seizures (LPTS)? Missile wounds bilateral or multiple contussions and multiple craniotomies 25 | P a g e Which of the following is not included in the sub categories for disorders of consciousness? Brain death An example of working memory is... Rehearsing a phone number than writing it down Which of the following should not be a practical strategy to manage an individual emerging from coma? Implement a consequence based behavior program In what setting are neuropsychologist's results of an assessment not typically used to make a diagnosis, identify treatment targets, determine the level of disability, and make recommendations for accommodations? HCBIS Which of the scenarios best describes an intermittent schedule of reinforcement? A slot machine pays out twice during one hour of continuous play A traumatic brain injury... Creates an alteration in brain function, results from external physical force, can be opened or closed According to the CDC, mTBI represents what percentage of all TBIs? 75% What is the safest recommendation for managing individuals during coma emergent agitation? Environmental management It is difficult to measure fatigue because... There is no single tool for measurement and fatigue is subjective Sustained attention is... The ability to maintain attention to complete a task accurately and efficiently over a period of time A rare progressive degenerative condition of the central nervous system that is seen an repetitive brain trauma in causes a cell to become infiltrated with a Tau protein is called... Chronic Traumatic Encephalopathy (CTE) Impairment in metacognition affects a persons... Insight into how deficits impact her functio The lobe integrate sensory information from the body The parietal lobe Which of the following is NOT a characteristic of a neuron? 26 | P a g e Helps to nourish the vascular system of the brain and is the only cell type in the brain Which cognitive impairment should be addressed first when providing cognitive intervention and a hierarchal fashion? Impaired attention Which act provided federal grants two states to operate comprehensive programs of vocational rehabilitation? The rehab act of 1973 The most effective means of reducing the level of disability experience by the person with mTBI... Early interventions The blood brain barrier: Prevents harmful substances from entering the brain Which lobe of the brain is associated with memory and language? Temporel What was important about the Olmsted decision? It challenged state, federal, and local governments to provide community based services for individuals with disabilities The ratio of brain injuries from males to females is approximately... 2:1 Assistive technology for cognition includes: High and low tech systems and main stream devices like smart phones or tablets Most brain in maturation occurs during the following time period 0-5 years A diagnosis of dementia must be... Coupled with a limitation in every day life due to cognitive change Psychiatric symptoms make a cur at or near the end of formal rehabilitation and may interfere with community reentry. Which of these factors play role and determining duration of symptoms? Stressors related to living with a disability Special education supports and services may be provided to a children as a result of the... Individuals with disabilities education act Acute measures use early after injury may include all except... 27 | P a g e Mayo Portland adaptability inventory What is considered for the post injury development of psychiatric disorder? Neuropsychological effects of the injury, psychological vulnerability, self awareness of the deficits, and social influences What should the following contributes to the development of pressure sores? Dependence on others for mobility needs A model of disability has a rehabilitation and treatment philosophy inherently associated with it. Which model views disability as a result of sin, evil, or a character flaw? Moral or religious model The first stage of the case management services process is... assess Which model of disability focuses on principles of person centered care, taking into account of individuals interest and meaningful participation? Functional model The IEP team must develop an individual transition plan ITP that addresses... Transition to life after high school and vocational training, living arrangements, and community participation Which tenants are not true under the philosophy of person centered approach? Some people cannot be trusted to lead their own lives Spasticity and hyperreflexia, contractures, and heterotypic ossification are... Musculoskeletal complications of brain injury A power of attorney is... Is a legal document appointing another to make legal or financial decisions on their behalf when they become incapacitated An IEP is... A legal contract between the special education team and the students family designating the kinds and extent of services that the student needs The definition of culture is... A group that shares a theme or issues, can entail social mores from countries of origin, these social mores and historical traditions are handed down the generations A life care plan must...