Deck 22: Traumatic Brain Injury

Question 1

A patient who is functioning at a level III on the Rancho Los Amigos Levels of Cognitive Functioning Scale demonstrates

A)failure to respond to all stimuli.
B)an inconsistent response to stimuli.
C)a localized response to stimuli.
D)full response to all stimulation with agitation.

Answer 1

C

Question 2

Sensory stimulation programs for patients in coma or persistent vegetative state

A)have not been proven to be effective in enhancing recovery.
B)are contraindicated as patients may become overstimulated.
C)should be completed at least three times per day to be effective.
D)should incorporate only visual and auditory stimulation.

Answer 2

A

Question 3

Behavioral changes commonly seen after TBI typically include

A)aggression,sexual disinhibition,euphoria,passivity.
B)sexual inhibition,anxiety,depression,apathy.
C)anxiety,extreme self-consciousness,paranoia,depression.
D)emotional disinhibition,apathy,low frustration tolerance,aggressive disinhibition.

Answer 3

D

Question 4

Which of the following statements is not true with regard to intracranial pressure (ICP)?

A)Normal ICP is between 4 and 15 mm Hg.
B)Ventricular drainage can be used to treat elevated ICP.
C)Elevated ICP is treated by positioning the head elevated to approximately 30º.
D)Elevated ICP is treated with supine positioning and sedating medications.

Question 5

When working with a patient with TBI who is confused and agitated,the physical therapist should

A)restrain the patient at all times; safety is the number one priority.
B)challenge the patient to learn new skills; the agitation is often the result of boredom.
C)be prepared with numerous activities as the patient will have a limited attention span.
D)vary the treatment every day; the patient responds best to change.

Question 6

The Glasgow Coma Scale examines

A)motor skills,sensory integrity,and cognition.
B)extremity movement,head movement,and eye movement.
C)eye opening,verbal response,and motor response.
D)responses to pain,temperature,and touch.

Question 7

A therapist is treating a patient with TBI and limited recovery.During the treatment sessions the patient flexes his leg whenever the therapist stretches out the plantar flexors.The nursing staff reports that they have seen the patient pulling at his NG tube.His mother reports that she thought he squeezed her hand last night when she asked him to.This patient would be best categorized at what level of the Rancho Los Amigos Levels of Cognitive Functioning scale?

A)Level I
B)Level II
C)Level III
D)Level IV

Question 8

Which of the following is true with regard to diffuse axonal injury in patients with traumatic brain injuries?

A)It is characterized by a widespread shearing of axons.
B)It occurs when increased intracranial pressure from edema results in axonal damage.
C)It correlates with a positive prognosis.
D)It is characterized by focal neuronal injury.

Question 9

Which of the following is true with regard to the role of the family of a patient with a TBI during active rehabilitation?

A)Families should not be involved in the day-to-day care of the patient because of the risk that they will get burned out prior to the patient's discharge.
B)Families should become involved in many therapeutic activities such as ROM,positioning,and sensory stimulation programs.
C)Families should assume primary responsibility for the patient's care as they will be expected to do it at home.
D)Husbands/wives should not be expected to be involved in caretaking activities,as this may be detrimental to their marital relationship.

Question 10

Which of the following is true with regard to positioning of patients with severe brain injuries and low response levels.

A)Patients with severe brain injuries should not be positioned up in a wheelchair until they demonstrate good head control.
B)Patients with severe brain injuries should be positioned in a standard wheelchair as soon as they are medically stable.
C)Patients with severe brain injuries should be positioned up in a wheelchair as soon as medically stable,but may require a tilt-in-space for positioning and head support.
D)Patients with severe brain injuries should be positioned up in a bedside chair,but not a wheelchair.

Question 11

A person whose Glasgow Coma Score was a 10 would be classified as a having a

A)concussion.
B)mild head injury.
C)moderate head injury.
D)severe head injury.

Question 12

Patients with severe traumatic brain injuries may be at risk for contracture formation due to

A)hyperkinesis.
B)seizures.
C)abnormal tone and posture.
D)vascular instability.

Question 13

The most common cause of traumatic brain injuries in the young adult population is

A)violence and assaults.
B)motor vehicle accidents.
C)falls.
D)sports injuries.

Question 14

A primary focus of treatment with patients who are functioning at level VII of the Rancho Los Amigos Levels of Cognitive Functioning Scale is to

A)transition the patient from wheelchair mobility to ambulation.
B)allow the patient to return to sports.
C)assist the family in understanding of the patient's physical limitations and dependent handling techniques prior to discharge.
D)integrate cognition,behavior and functional training to allow the patient to function in less structured settings.

Question 15

Post-traumatic amnesia in a patient with a traumatic brain injury (TBI)refers to

A)the time between the injury and the time when the patient is able to remember ongoing events.
B)an inability to remember the details of the injury that resulted in the TBI.
C)an inability to remember the details of one's life prior to injury.
D)how long a person can remember a fact or detail once presented the information.

Question 16

Which of the following statements is true?

A)A patient with declarative memory deficits is unable to learn new motor skills.
B)A patient with declarative memory deficits will be able to learn motor skills only after he is able to verbalize the steps involved in their completion.
C)Repetitive practice of motor skills may result in improved performance even in patients with declarative memory deficits.
D)Repetitive practice of cognitive skills is essential to improve performance of motor skills.

Question 17

Which of the following statements is true with regard to serial casting in patients with TBI?

A)It is contraindicated until patients are at least functioning at a Rancho level V.
B)Its commonly used in the upper extremity but not the lower extremity because it prevents weightbearing and standing activities.
C)Evidence supports that it can be used to improve PROM and tone.
D)It is contraindicated in confused patients.

Question 18

Decorticate rigidity results in sustained positioning in

A)upper extremity flexion and lower extremity extension.
B)upper extremity extension and lower extremity flexion.
C)flexion of both the upper extremities and lower extremities.
D)extension of both the upper extremities and lower extremities.

Question 19

Which of the following is true with regard to the physical therapy examination of the confused and agitated patient?

A)The physical therapy examination should be structured with an systematic examination of strength,active and passive ROM,and sensation.
B)Physical therapy examination and intervention should be delayed until the patient is no longer agitated.
C)The physical therapy examination may consist of primarily observation during functional activities until the patient is able to cooperate.
D)The physical therapy examination should focus on cognitive skills,as this is the patient's primary impairment at this point in recovery.