Understanding TBI Epidemiology, Symptoms, and Consequences, Exams of Nursing

Download Understanding TBI Epidemiology, Symptoms, and Consequences and more Exams Nursing in PDF only on Docsity! CBIS Exam-with 100% verified solutions-2023- 2024 Why is Brain Injury considered the silent epidemic? Many problems that result from a brain injury are not always readily apparent. a. The effects of the brain injury (BI), such as changes in thinking, may not be readily apparent to an outside observer b. Negative consequences occur when the general public and medical providers do not recognize the effect of BI: i. Problems at work/ school ii. Changes in personal relationships iii. Legal problems iv. Homelessness True or False? Brain Injury is frequently not identified. True Define Acquired Brain Injury An injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma Acquired brain injury is an umbrella definition as it includes injuries caused by both __________ and __________ factors external; internal Match the following ABI with its cause: Traumatic Impact- Open & Closed Causes (bank): Blast Assault GSW Hypoxia/ anoxia Fall Stabbing Ischemia Neurotoxic poisoning MVC Sports Tumor Infection CVA Open: GSW, stabbing, fall, sports, MVC Closed: Blast, Assault, Fall, Sports, MVC Match the following ABI with its cause: Traumatic Internal: (3) Sports, MVC, Fall Match the following ABI with its cause: Non-Tramatic Causes (bank): Blast Assault GSW Hypoxia/ anoxia Fall Stabbing Ischemia Neurotoxic poisoning MVC Sports Tumor Infection CVA Tumor, infection, CVA, hypoxia/anoxia, ischemia, neurotoxic poisoning. True or False? The importance of understanding the epidemiology of a brain injury assists in passing legislation. True True or False? 83% of all TBI's are mild False, 75% True or False? G. Typically contract with private brain injury service providers H. People should be allowed to live in the least confining setting that they qualify A, G B, H C, E D, F Those that have survived a TBI have a reduced life expectancy by how many years? A. 5 B. 6 C. 7 D. 8 C. 7 What percent of TBIs are considered to be Mild? A. 50% B. 65% C. 75% D. 85% C. 75% (may be higher due to lack of reporting) True or False? A mild TBI can be defined as any alteration in mental state True Additional issues that arise post mild TBI are all of the following except: A. Metabolic alterations B. Diffuse atonal injury C. Massive release of neurotransmitters glutamate D. Dilation of vessels that impacts neurological function (constriction) E. All of the above D. Dilation of vessels that impacts neurological function (constriction) Common symptoms after a mild TBI are all of the following except: A. Fatigue B. Blurred vision C. Headaches D. Balance problems E. Changes in behavior F. All of the above F. All of the above True or False? Post-concussion syndrome and Persistent Post-concussion syndrome refer to symptoms that persist weeks or months after TBI. True True or False? The correct order for the meninges (inner to outer) is Pia mater, Dura mater, Arachnoid. False; Dura mater, Arachnoid, Pia mater (DAP) Match: A. Pia mater B. Dura mater C. Arachnoid D. Spider web E. Tough mother F. Tender matter A, F B, E C, D Term: Midbrain -Smallest part -Elementary forms of vision and hearing -Vital role in alertness and arousal Term: pons -Connects the cerebellum and cerebral cortex -Essential for facial movements & sensation, hearing and coord eye movements Term: Medulla -Merges with spinal cord -Control center for involuntary -Involved in basic living functions The Diencephalon-Thalamus is responsible for all of the following EXCEPT: A. Sensory inputs pass through to go to higher levels in the brain B. Sits at the top of the Brian stem Term: Pre-frontal cortex Location, c/f, injury L: front of head C/F: evaluates options, predicts outcomes and decides the best course of action, influences ability to learn from consequences. I: causes difficulty making decisions, organizing and prioritizing, initiating and inhibiting actions, controlling emotions and interacting socially Term: Temporal Lobe Location, c/f, injury L: each side around the ear C/F: memory, language, hearing I: auditory. Processing, new learning, understanding, storing, and retrieving new information. Term: Brocca's Area Location, c/f, injury L: Left frontal-temporal C/F: speech production I: language expression is impaired. Speaks haltingly with few words. Term: Wernicke's Area Location, c/f, injury L: left frontal-temporal C/F: speech comprehension I: language comprehension is impaired. Speaks fluent moly but does not make sense Term: Occipital Lobe Location, c/f, injury L: back of head C/F: visual processing, interpret visual information, recognition of size, color, light, motion, dimensions, etc. I: cortical blindness, agraphia, field cuts, movement agnosia, visual agnosia Term: Parietal Lobe primary sensory cortex Location, c/f, injury L: 'headband' across top of head C/F: sensation and perception: responds to touch, temperature and pain, processes sensory information. I: difficult identifying sensation: location, type, temp, pain, movement Term: Parietal Lobe somatosensory Cortex Location, c/f, injury L: 'headband' across top of head C/F: sensory input integration, spatial awareness and perception- awareness of body parts in space. I: agraphia, acalculia, anosognosia, aphasia, impaired attention, neglect, left-right disorientation. True or False? The spinal cord receives messages from the brain through afferent nerve tracts. False, efferent List symptoms in each category: Central Cord Syndrome -cervical area -incomplete injury -often result of a fall -present as weak/numb UE -often B/B incontinence List symptoms in each category: Brown-sequard syndrome -only one side of SC is injured -loss of pain and temp in same side -paralysis and loss of touch on opposite side List symptoms in each category: Anterior cord syndrome -loss of muscle control E. All Secondary injuries of a TBI include the following EXCEPT: A. Apoptosis (sudden death of cells) B. Edema (swelling) C. Excitoxicity (nerve cells suffer damage/ death) D. Mechanical damage E. All the above D. Mechanical damage True or False? Cardiopulmonary issue involves possible ventilator and/or medications abs are usually only the result of secondary damage from TBI False (pg. 98) True or False? Dysautomia or 'autonomic storming', usually resolves in early recovery True The following are examples of musculoskeletal earlier complications except: A. Hyperreflexia B. Contracture C. Spasticity D. Heterotopic Ossification E. Osteoporosis F. All of the above E. Osteoporosis (chronic or late effect) How does a urinary tract infection effect therapy participation? A. Decreased level of alertness B. Increased agitation C. Pain D. Fever E. All of the above F. None of the above- no effect E. All of the above Nutrition after brain injury is complicated by A. Availability of food B. Safety awareness C. Restraints D. Lack of utensils B. Safety awareness Match phases of swallowing: A. Oral preparatory/ oral stage B. Pharyngeal phase C. Esophageal phase D. Includes movement of the bolus past the epiglottis, through the pharynx and past the upper esophageal sphincter E. Mastication, bolus formation, and propulsion of the bolus into the pharynx F. Bolus moves through the esophagus toward the lower esophageal sphincter A, E B, D C, F What percentage of severe TBIs has difficulty with swallowing? A. 65% problems at oral phase B. 73% problems at the pharyngeal phase C. 84% D. 90% D. 90% problems with swallowing What percentage of brain injuries has difficulties with libido, arousal and sexual performance? A. 30-40% B. 30-50% C. 50-60% D. 40-60% D. 40-60% Pressure sores can be prevents by which of the following? A. Keeping skin clean and dry B. Changing positions C. Keeping pt in a supine position with decreased pressure on honey areas -chronic alcohol use List risk factors for each type of seizure: Late Post-Traumatic Seizures -more frequently seen in people more than 65+ y/o -usually from misslle wounds -occur later than one week after initial head trauma -stronger predictor for recurrent seizures List risk factors for each type of seizure: Status Epilepticus -more than 30 mins of continuous seizure activity -two or more sequential seizures without full recovery -high mortality rate What is the difference between nocioceptive pain and neuropathic pain? a. Nocioceptive pain related to peripheral nerve fibers, pharmacological treatments include NSAID, acetaminophen, topical agents, opioids b. Neuropathic pain associated with primary lesion of dysfunction, medications include topical agents, opioids, tramadol, lyrica, anticonvulsants and antidepressants, tricyclics, trigger point injections, nerve blocks, epidural steroids. Study Headaches (Q53) Q53 of guide True or False? The order of stages for a migraine are: Aura- Prodome- Headache- Postdrome False (pg. 123) Headache symptoms include all of the following EXCEPT: A. Character- sensation and intensity B. Onset- pattern to timing C. Location- where does it start? does it radiate? D. Duration- and frequency E. Exit- what action is taken to reduce headache? F. Relief- what reduces headache? E. Exit-what action is taken to reduce headache C.O.L.D.E.R. character, onset, location, duration, EXACERBATION-what intensifies the headache, relief. Match motor learning principles A. Cognitive B. Associative C. Autonomous D. How to succeed E. What to do F. How to do it G. Learner begins to apply and self-monitor performance of task H. Learner acquires knowledge to perform task I. Learner consistently self-regulates and makes corrections to successfully perform task. A,E,H B,F,G C,D,I Risk factors for treatment of hydrocephalus include all EXCEPT: A. Headaches B. Brain bleed C. Fever D. Neck stiffness E. Change in level of alertness F. Dysphasia G. All F. Dysphasia List correct treatment options with the following conditions: Spasticity and Heterotrophic Ossification Bank: Oral Antispasmotics NSAIDS Neurotoxins Intrathecal Baclofen Pump Therapy Surgery Spasticity- oral antispasmotics, intrathecal baclofen pump, neurotoxins, therapy