CBIS Exam Prep | 220 Questions with 100% Correct Answers | Verified | Updated 2024, Exams of Nursing

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CBIS Exam Prep | 220 Questions with

100%

Correct Answers | Verified | Updated

lost productivity - ✔✔one measure of the cost to society due to injury or disease; includes the loss of wages a person would have earned if they had not become unemployable due to disability, loss of taxes contributing to economy, costs to the government of supporting the individual, etc.; lost productivity costs DO NOT include cost of treatment and support post-injury or illness acquired brain injury (ABI) - ✔✔An injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma traumatic brain injury (TBI) - ✔✔an alteration in brain function, or other evidence of brain pathology, caused by an external force traumatic impact - ✔✔injuries resulting from contact (when head is struck by or against an object)

traumatic intertial injuries - ✔✔injury to the brain not caused by impact but as a result of inertial forces, such as acceleration- deceleration forces closed injuries - ✔✔injury to the brain resulting in brain lacerations, contusions or intracerebral hemorrhage open injuries - ✔✔injury to the head in which there is a breach of the skull or a breach of the meninges penetrating brain injury - ✔✔any injury that involves the penetration of a foreign object, munitions, fragment, bone chip, etc. through the dura mater non-traumatic brain injury - ✔✔damage to the brain caused by internal factors, such as oxygen or nutrient deprivation to brain cells, exposure to toxins, pressure from a tumor or blockage, or other neurological disorder

coup-contrecoup injury - ✔✔Coup injury: head injury that results from impact of a moving object--occurs at the site of impact Contrecoup effect: impact injury resulting from the moving head striking a stationary object--injury occurs at the side of the head opposite the point of impact primary injury - ✔✔initial cause of damage to the brain, from which injury severity ratings are obtained secondary injury - ✔✔pathophysiological events that occur following the initial primary injury to the brain loss of consciousness (LOC) - ✔✔temporary altered state, unlike sleep, when a person is unresponsive to stimuli; usually due to trauma, stroke, or other injury

risk factors for brain injury - ✔✔injury severity age at injury alcohol misuse domestic violence service in the military participation in sports history of prior brain injury chronic traumatic encephalopathy (CTE) - ✔✔a condition, diagnosed after death, relative to multiple concussions caused by significant force. A progressive degenerative disease, CTE is most often sustained by athletes participating in contact sports; may also be observed in domestic violence victims or abused children who have sustained numerous blows to the head

neurogenic bladder - ✔✔a secondary condition caused when a TBI affects the cerebral structures controlling bladder storage and emptying functions spasticity - ✔✔involuntary, abnormal motor patterns; may interfere with a person's general functioning, self-care, and mobility activities of daily living (ADLs) - ✔✔dressing, eating, showering, toileting, walking post-traumatic immune paralysis - ✔✔acute period after sustaining significant bodily trauma, when the immune response is significantly impaired; frequently associated with the high prevalence of potentially life-threatening infections post- injury computed tomography (CT) - ✔✔a cross-sectional series of X-rays used to view body organs, allowing medical professionals to view the scans in multiple individual layers; some scans can be reconstructed into a 3D image

magnetic resonance imaging (MRI) - ✔✔a technique that uses a magnetic field and radio waves to create detailed images of the organs and tissues within the body diffusion tensor imaging (DTI) - ✔✔an MRI method that maps the diffusion of molecules, primarily water, in a person's body non-invasively acceleration-deceleration forces - ✔✔sudden impact following a high velocity of speed, frequently resulting in brain injury intracranial pressure (ICP) - ✔✔Pressure inside the skull from the brain and CSF. Pressure may vary due to production and absorption of CSF following injury. subdural hematoma (SDH) - ✔✔bleeding into the space between the dura mater and the arachnoid layers of the meninges

hydrocephalus - ✔✔Abnormal accumulation of cerebrospinal fluid in the ventricles of the brain diffuse axonal injury (DAI) - ✔✔brain injury occurring when the white matter tracts are stretched and broken, resulting in extensive, widespread damage hypoxia/anoxia - ✔✔decrease in/absence of oxygen getting to the brain; results in cell death major descending nerve tracts - ✔✔-anterior corticospinal tract -lateral corticospinal tract -rubrospinal tract -tectospinal tract major ascending nerve tracts - ✔✔-fasciculus cuneatus and fasciculus gracilis

-Lissauer's tract -anterior and posterior spinocerebellar tracts -spinothalamic tracts -spinoreticular tract -spinotectal tract neuroprotection - ✔✔preservation of neuronal functioning and structure; reducing the rate of neuronal loss over time; refers to the ability of a drug or biological agent to prevent brain cells from dying neuroplasticity - ✔✔the ability of the brain to change its structure or function due to the environment; refers to the ability of the nervous system to regenerate and reorganize itself, and to form new connections in order to compensate for injury or adapt to changes in the environment

secondary injury cascade - ✔✔Primary injury (primary damage/mechanical damage) leads to secondary injury (pathophysiological processes, delayed non-mechanical processes. Phase 1 of secondary injury includes impaired blood flow, tissue damage, metabolic imbalance, membrane permeability--these lead to edema formation, inflammation, and blood-brain barrier breakdown. Phase 2 includes axon terminal depolarization, intracellular breakdown, apoptosis, release of excitatory neurotransmitters, free radical generation, and necrosis--these processes ultimately lead to cell death. experience-dependent learning - ✔✔as our experiences change, the brain's morphology/structure changes; I.e. Hebbian learning, "neurons that fire together wire together"

polytherapies - ✔✔the use of more than one treatment method in a combined therapeutic approach reactive axonal sprouting and synaptogenesis - ✔✔When a subset of neural projections to a brain region is lost, remaining ones sprout and form new synaptic connections onto the partially denervated neurons; this phenomenon supports the idea that the adult injured brain can reorganize and repair itself. excitotoxicity - ✔✔the process by which nerve cells are damaged and die due to overexcitation; occurs when a neuron is no longer able to maintain its resting potential as a result of impairment of the sodium-potassium pump in combination with large-scale increases in extracellular excitatory neurotransmitters such as glutamate apoptosis - ✔✔a naturally occurring process that involves a controlled sequence of steps that tell a cell to terminate itself; cell death

long-term potentiation (LTP) - ✔✔in neuroscientific research, a long-lasting signal that occurs between two neurons when they are stimulated simultaneously neurogenesis and main areas where it occurs in the adult brain - ✔✔the formation of new neurons--in the adult brain, the two main areas of neurogenesis are the subventricular zone (lines the lateral ventricles) and the dentate gyrus of the hippocampus structural plasticity - ✔✔changes in the dendrites and dendritic spines of neurons following learning, stress, LTP, or exposure to toxins brain-derived neurotrophic factor (BDNF) - ✔✔a protein in the neurotrophin family of growth factors that promotes neurogenesis neurorehabilitation - ✔✔an emerging field of practice that attempts to balance the relationship between preventing neurodegeneration and enhancing the potential for

neuroplasticity

transcranial magnetic stimulation (TMS) - ✔✔a non-invasive method of stimulating the brain using electromagnetic induction; used as a treatment modality for depression, stroke, migraines, dystonia, tinnitus, and Parkinson's mild traumatic brain injury (mTBI) - ✔✔injury to the head with either brief (less than 30 minutes) or no loss of consciousness; symptoms may include vomiting, lethargy, dizziness, and inability to recall recent events Glasgow Coma Scale (GCS) - ✔✔a neurologic assessment scale to objectively measure level of consciousness following head injury post-traumatic amnesia - ✔✔a state of confusion immediately following traumatic brain injury TBI Classification of Injury Severity: Mild TBI - ✔✔Normal structural imaging

LOC = 0-30 minutes Alteration of consciousness (AOC) = from a moment up to 24 hours Posttraumatic amnesia (PTA) = 0-1 day GCS = 13- 15 TBI Classification of Injury Severity: Moderate TBI - ✔✔Normal or abnormal structural imaging LOC > 30 minutes and < 24 hours AOC > 24 hr severity based on other criteria PTA >1 and <7 days GCS = 9- 12 TBI Classification of Injury Severity: Severe TBI - ✔✔Normal or abnormal structural imaging LOC > 24 hours PTA > 7 days

GCS = 3- 8

metabolic alterations - ✔✔adverse chemical changes in the brain following head injury axonal shearing - ✔✔a condition of damage to axons, as a result of being twisted and disconnected in a violent agitating motion second-impact syndrome (SIS) - ✔✔Occurs when an athlete or individual sustains an initial concussion and then sustains a second head injury before symptoms from the first have fully resolved; can occur minutes, days, or weeks after the initial concussion; can be fatal or result in severe disability; may occur due to diffuse cerebral swelling or secondary to a subdural hematoma How long does it typically take for mTBI symptoms to resolve? What percentage of people experience persistent problems after that point? - ✔✔Most symptoms

resolve within 2-4 weeks. About 10%-15% of persons experience persistent problems after that point. physical/somatic symptoms of mTBI - ✔✔Headache Fatigue Seizure Nausea Numbne ss Poor sleep Light sensitivity Noise sensitivity Impaired hearing Blurred vision Dizziness/loss of

balance Neurologic abnormalities

cognitive symptoms of mTBI - ✔✔Inattentiveness Diminished concentration Poor memory Impaired judgment Slowed processing speed Executive dysfunction behavioral/emotional symptoms of mTBI - ✔✔Depression Anxiety Agitation Irritability Aggression Impulsivity

convergence insufficiency - ✔✔a condition in which the eyes cannot focus effectively together, creating difficulty with reading, and triggering headaches frontal release - ✔✔a syndrome resulting from damage to the frontal areas of the brain; characterized by disinhibition and abnormal behaviors occipital neuralgia - ✔✔a condition caused by either direct trauma or secondary sensitization from recurring central headaches; usually associated with pain in the back of the head that worsens as the day progresses cervicalgia - ✔✔simple neck pain; frequently associated with mTBI and when not treated swiftly, commonly causes both headaches and chronic pain syndromes trigeminal nucleus - ✔✔bundle of sensory nerves; the largest of the cranial nerve nuclei; extends through the midbrain, pons, and medulla

orthostatic hypotension - ✔✔when a person's blood pressure drops quickly upon standing Benign Paroxysmal Positional Vertigo (BPPV) - ✔✔a disorder of the inner ear resulting in positional vertigo, causing a spinning sensation; an episode of mild-to- extreme dizziness that is a result of a change of position of the head nystagmus - ✔✔involuntary, rapid eye movements known to be a hallmark of BPPV; may be side-to-side, up-and-down, or rotary (horizontal/vertical/torsional) persistent post-concussive symptoms (PPCS) - ✔✔a complex disorder following a concussion, lasting for weeks or months, consisting of symptoms such as headaches or dizziness; symptoms lasting longer than 4 weeks post mTBI predictive PPCS risk factors - ✔✔Age

40 Being female

Traumatically injured Low SES History of substance misuse Pending litigation Previous psychiatric diagnoses disorder of consciousness (DOC) - ✔✔a state of impaired consciousness as a result of an injury to the brain three levels of DOC from lowest to highest functioning - ✔✔coma

vegetative state > minimally conscious state coma - ✔✔a state of unconsciousness that can last for long periods of time, ranging from days to years; a condition caused by a severe brain injury or resulting brain swelling, leaving a patient unaware of their surroundings and unable to respond to even simple commands

vegetative state - ✔✔after a coma, a low level of consciousness in which a person appears awake but can only perform certain involuntary responses, not the more complex thoughts or actions associated with awareness such as following commands, planning, remembering, and communicating minimally conscious state - ✔✔a condition of altered consciousness where the person displays some acknowledgment of self or environment physical management - ✔✔Range of motion, orthotic use, positioning to keep the muscles and ligaments functional sensory stimulation - ✔✔Focused presentation of different stimuli to gauge responses to sensory input and facilitate increased response consistency.

DOC prevalence in the U.S. - ✔✔Estimated that 315,000 people in the US present with a DOC. Of those, 35,000 present in a vegetative state and 280,000 present in a minimally conscious state. arousal vs awareness - ✔✔Arousal refers solely to primitive, involuntary responsiveness to the world (e.g., generalized reflex responses to both internal/external stimuli)--maintained by RAS Awareness refers to an individual's ability to receive and process sensory information and use that info to relate in an intentional way to the outside world- -required for voluntary responses to stimuli and regulated by higher cortical areas reticular activating system (RAS) - ✔✔the RAS modulates or changes arousal, alertness, concentration, and basic biological rhythms

autonomic dysfunction syndrome - ✔✔a problem with the autonomic nervous system that controls processes such as digestion, heart rate, the immune system, and more metabolic distress - ✔✔a condition following injury in which the body becomes overwhelmed and cannot respond properly dystonia - ✔✔the involuntary contraction of muscles causing uncontrollable movements of the particular muscle Common medical challenges associated with DOC - ✔✔Skin breakdown Respiratory issues Bowel/bladder dysfunction Autonomic dysfunction syndrome

tracheostomy tube - ✔✔a tube inserted into an opening in the neck below the level of the vocal folds to provide oxygen-rich air into the lungs, bypassing the mouth and nose obstructive vs. central sleep apnea - ✔✔Obstructive sleep apnea: decreased muscle tone in the structures of the mouth and throat may cause reduced airway opening Central sleep apnea: the injury to the nervous system disrupts the message sent from the brain to the muscles that control respiration, causing disruption in breathing tracheal aspiration - ✔✔entry of foreign matter, such as enteral feeding, into the respiratory system pharmacologic neuromodulation - ✔✔The use of medicine for the electrical stimulation of nerves.