Bonus Quiz - Traumatic Brain Injury

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| By Mitolectomy
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Bonus Quiz - Traumatic Brain Injury - Quiz

PURPOSE
To provide student nurses with an understanding of the treatment of service members with severe traumatic brain injury (TBI). OBJECTIVES
After reading the article and taking the test, you will be able to: Identify the mechanisms of injury and classification of TBIs. Describe the levels of acute care and the rehabilitation for a service member with a TBI.


Questions and Answers
  • 1. 

    Which of the following is not one of the factors that determine the type of TBI?

    • A.

      Genetic variations

    • B.

      Nature of the external force

    • C.

      Motivation of the patient

    • D.

      Strength of the force

    Correct Answer
    C. Motivation of the patient
    Explanation
    Motivation of the patient is not one of the factors that determine the type of Traumatic Brain Injury (TBI). TBI is determined by factors such as genetic variations, the nature of the external force, and the strength of the force. Motivation of the patient may influence their recovery and rehabilitation process, but it does not directly determine the type of TBI they have.

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  • 2. 

    What type of injury most often results from blunt force trauma?

    • A.

      Coup or coup-contra-coup

    • B.

      Epidural hematoma

    • C.

      Penetrating injury

    • D.

      Subarachnoid hemorrhage

    Correct Answer
    A. Coup or coup-contra-coup
    Explanation
    Blunt force trauma refers to an injury caused by a non-penetrating impact, such as a punch or a fall. Coup or coup-contra-coup injury is a specific type of brain injury that occurs when the brain hits the skull on the side of impact and then rebounds and hits the opposite side. This type of injury is commonly seen in situations where the head is struck forcefully, such as in car accidents or falls. Therefore, it is the type of injury that most often results from blunt force trauma.

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  • 3. 

    A penetrating brain injury is defined by

    • A.

      A depressed skull fracture.

    • B.

      Foreign matter disrupting the dura.

    • C.

      Increased intracranial pressure.

    • D.

      A linear skull fracture.

    Correct Answer
    B. Foreign matter disrupting the dura.
    Explanation
    A penetrating brain injury is defined by foreign matter disrupting the dura. This means that an object has penetrated through the skull and entered the brain, causing damage to the protective layer called the dura mater. This can occur due to various reasons such as gunshot wounds, sharp objects, or accidents. The presence of foreign matter inside the brain can lead to severe complications and requires immediate medical attention.

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  • 4. 

    What is the most common mechanism of brain injury on the Iraq and Afghanistan battlefields?

    • A.

      Blast/explosions

    • B.

      Falls

    • C.

      Gunshot wounds to the head or neck

    • D.

      Motor vehicle accidents

    Correct Answer
    A. Blast/explosions
    Explanation
    The most common mechanism of brain injury on the Iraq and Afghanistan battlefields is blast/explosions. This is because these war zones are prone to frequent explosions caused by bombs, landmines, and other explosive devices. The force generated by these blasts can cause severe trauma to the brain, leading to various types of brain injuries such as concussions, contusions, and traumatic brain injuries (TBI). The high prevalence of blast/explosions as a cause of brain injury in these battlefields is attributed to the nature of modern warfare and the widespread use of explosive weapons.

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  • 5. 

    What causes secondary blast injury from an explosion?

    • A.

      Direct exposure to the overpressurization wave of the explosion

    • B.

      Inhalation of gases or other toxic substances

    • C.

      The body is displaced and impacts another object

    • D.

      Energized debris or explosive fragments impact the head

    Correct Answer
    D. Energized debris or explosive fragments impact the head
    Explanation
    Secondary blast injuries occur when energized debris or explosive fragments impact the head. This can happen when there is an explosion and objects are propelled at high speeds, causing them to collide with the head. These impacts can result in various types of injuries, including fractures, lacerations, and concussions. It is important to protect the head during explosions to minimize the risk of these types of injuries.

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  • 6. 

    What is 1 indicator that characterizes moderate TBI?

    • A.

      Glasgow Coma Scale (GCS) score of 13 to 15

    • B.

      Loss of consciousness/alteration of consciousness between 1 and 24 hours

    • C.

      Posttraumatic amnesia >7 days

    • D.

      GCS score of 3 to 8

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    Moderate TBI is characterized by a Glasgow Coma Scale (GCS) score of 13 to 15, which indicates mild impairment of consciousness. Additionally, moderate TBI can involve a loss of consciousness or alteration of consciousness between 1 and 24 hours, indicating a significant disruption in brain function. Posttraumatic amnesia lasting more than 7 days is another indicator of moderate TBI, suggesting a prolonged period of memory loss following the injury. Therefore, all of the above options accurately characterize moderate TBI.

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  • 7. 

    If the patient has a mild TBI with positive radiologic findings, the patient has a

    • A.

      Moderate TBI.

    • B.

      Prognosis of a severe TBI.

    • C.

      Complicated mild TBI.

    • D.

      Simple severe TBI.

    Correct Answer
    C. Complicated mild TBI.
    Explanation
    If a patient has a mild TBI with positive radiologic findings, it indicates that there are abnormalities or complications present in the brain despite the injury being categorized as mild. This suggests that the injury is more complex than initially thought and falls into the category of a complicated mild TBI.

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  • 8. 

    TBI is classified by

    • A.

      Functional status at 12 months.

    • B.

      Progress more than 6 months.

    • C.

      Severity of the initial injury.

    • D.

      Rate of recovery.

    Correct Answer
    C. Severity of the initial injury.
    Explanation
    TBI, or traumatic brain injury, is classified based on the severity of the initial injury. This means that the classification takes into account the extent of the damage caused by the injury, such as the severity of the physical trauma to the brain. This classification helps healthcare professionals determine the appropriate treatment and prognosis for individuals with TBI. It is an important factor in understanding the long-term effects and outcomes of the injury.

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  • 9. 

    What type of care is included in “buddy aid”?

    • A.

      Cover fire and evacuation to a safe zone

    • B.

      Documentation of mental status

    • C.

      Prevention of hypoxia and hypothermia

    • D.

      Triagé

    Correct Answer
    A. Cover fire and evacuation to a safe zone
    Explanation
    "Buddy aid" refers to the concept of providing immediate assistance and support to a wounded or injured individual in a combat or emergency situation. This includes covering fire, which means suppressing enemy fire to ensure the safety of the injured person and the rescuer, and evacuating the injured person to a safe zone where they can receive further medical care.

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  • 10. 

    What type of care is provided at the Combat Support Hospital?

    • A.

      Aggressive intracranial pressure therapy

    • B.

      Emergent neurosurgical care

    • C.

      Field management of a TBI

    • D.

      Long-term intensive care

    Correct Answer
    B. Emergent neurosurgical care
    Explanation
    The Combat Support Hospital provides emergent neurosurgical care. This means that they specialize in providing immediate surgical treatment for patients with neurological conditions that require urgent attention. This could include procedures such as brain surgery or spinal surgery to address critical injuries or conditions affecting the nervous system. The hospital is equipped to handle these types of cases and has the necessary expertise and resources to provide timely and life-saving care to patients in need.

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  • 11. 

    At Landstuhl Regional Medical Center, patients are treated and evacuated stateside, usually within

    • A.

      36 hours.

    • B.

      48 hours.

    • C.

      72 hours.

    • D.

      96 hours.

    Correct Answer
    A. 36 hours.
    Explanation
    Patients at Landstuhl Regional Medical Center are treated and evacuated stateside within 36 hours. This indicates that the medical center aims to provide timely and efficient care to their patients. By evacuating patients within a relatively short period of time, they ensure that patients can receive further treatment, if necessary, in the United States. This prompt evacuation also suggests that the medical center has the resources and capabilities to quickly transfer patients to a more suitable location for their medical needs.

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  • 12. 

    What special provision must be made during air transfer of a patient with a comorbid pulmonary injury?

    • A.

      Nonpressurized cabin

    • B.

      Presence of a physician on board

    • C.

      Shorter flight time

    • D.

      Lower flight altitude

    Correct Answer
    D. Lower flight altitude
    Explanation
    During air transfer of a patient with a comorbid pulmonary injury, a special provision that must be made is to lower the flight altitude. This is because lower flight altitudes have higher oxygen levels, which is beneficial for patients with pulmonary injuries. Higher altitudes have lower oxygen levels, which can worsen the condition of the patient. Therefore, lowering the flight altitude ensures that the patient receives an adequate amount of oxygen during the transfer, reducing the risk of complications.

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  • 13. 

    The GCS is less strongly associated with

    • A.

      Acute morbidity.

    • B.

      Long-term functional outcome.

    • C.

      Acute mortality.

    • D.

      Neurologic status.

    Correct Answer
    B. Long-term functional outcome.
    Explanation
    The GCS (Glasgow Coma Scale) is a scoring system used to assess the level of consciousness in a patient. It evaluates three components: eye-opening response, verbal response, and motor response. The GCS is commonly used in emergency settings to determine the severity of brain injury and predict short-term outcomes such as acute morbidity (complications), acute mortality (death), and neurologic status (brain function). However, it is less strongly associated with long-term functional outcome, which refers to the patient's ability to perform everyday activities and live independently.

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  • 14. 

    According to the Rancho Los Amigos Scale, Level VIII is reported as

    • A.

      Confused—appropriate.

    • B.

      Localized response.

    • C.

      No response.

    • D.

      Purposeful and appropriate response.

    Correct Answer
    D. Purposeful and appropriate response.
    Explanation
    Level VIII on the Rancho Los Amigos Scale indicates a purposeful and appropriate response. This means that the individual is able to respond to their environment in a goal-directed and meaningful way. They are able to follow commands and engage in appropriate social interactions. This level suggests a higher level of cognitive functioning and indicates progress in the recovery process.

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  • 15. 

    During rehabilitation at the polytrauma center, who coordinates and directs the rehabilitation team?

    • A.

      Case manager

    • B.

      Neuropsychologist

    • C.

      Physiatrist

    • D.

      Physical therapist

    Correct Answer
    C. Physiatrist
    Explanation
    The physiatrist is responsible for coordinating and directing the rehabilitation team during the rehabilitation process at the polytrauma center. They are specialized in physical medicine and rehabilitation, and their role involves managing the overall treatment plan, coordinating different therapies, and ensuring the patient's progress and well-being. They work closely with other healthcare professionals to provide comprehensive and individualized care to the patients.

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  • 16. 

    What is one of the ways that the Department of Veterans Affairs and Department of Defense communicate and coordinate care?

    • A.

      Secure records transfers

    • B.

      Teleconferencing

    • C.

      Through Department of Veterans Affairs social workers

    • D.

      Videoconferencing

    Correct Answer
    A. Secure records transfers
    Explanation
    One of the ways that the Department of Veterans Affairs and Department of Defense communicate and coordinate care is through secure records transfers. This means that they exchange medical records and other relevant information in a secure manner, ensuring that both departments have access to the necessary information to provide comprehensive care to veterans. This method helps in streamlining the communication process and ensures that all healthcare providers involved have access to the same information, leading to better coordination and continuity of care.

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  • 17. 

    According to I. Schwartz et al (2008), how many of the “terror victims” who suffer more severe TBI return to their previous work or school?

    • A.

      14%

    • B.

      22%

    • C.

      38%

    • D.

      47%

    Correct Answer
    D. 47%
    Explanation
    According to I. Schwartz et al (2008), nearly half (47%) of the "terror victims" who experience more severe Traumatic Brain Injury (TBI) are able to return to their previous work or school.

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  • 18. 

    What is one of the biomarkers that shows promise in the evaluation of TBI?

    • A.

      Creatine kinase

    • B.

      Nitrotyrosine

    • C.

      Rubidium chloride

    • D.

      Troponin-I

    Correct Answer
    B. Nitrotyrosine
    Explanation
    Nitrotyrosine is one of the biomarkers that shows promise in the evaluation of Traumatic Brain Injury (TBI). Nitrotyrosine is a marker of oxidative stress and inflammation, both of which are common in TBI. Elevated levels of nitrotyrosine have been found in the brains and blood of TBI patients, indicating its potential as a diagnostic and prognostic biomarker for TBI.

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  • 19. 

    How did you find this quiz

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Nov 12, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jan 25, 2013
    Quiz Created by
    Mitolectomy

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