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Certified Brain Injury Specialist (CBIS) Exam
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES
Certified Brain Injury Specialist (CBIS) Exam – Practice Questions
10 Most Tested Coverage Areas
1. Neuroanatomy and Brain Function - Brain structures and their functions; lobe-specific
functions; differences between traumatic and non-traumatic brain injury; primary versus
secondary brain injury
2. Mechanisms of Brain Injury - Traumatic Brain Injury (TBI) from external force; Non-traumatic
Brain Injury from lack of oxygen, toxins, pressure from tumors, or other neurological disorders ;
primary vs secondary injury mechanisms
3. Cognitive and Behavioral Consequences - Memory deficits, executive dysfunction, attention
problems, social disinhibition, irritability, low frustration tolerance; pseudobulbar affect
(sudden, unexpected crying or laughing)
4. Disorders of Consciousness - Coma, Vegetative State, Minimally Conscious State (MCS); PPCS
(Persistent Post-Concussive Syndrome)
5. Rehabilitation and Treatment Interventions - Post-acute community-based neurorehabilitation
for medically stable patients; task analysis (breaking tasks into small steps with positive
reinforcement); pharmacological interventions (amantadine for arousal/attention)
6. Behavioral Management - Least restrictive interventions first for agitated patients;
environmental modifications, 1:1 supervision, bed alarms; restraint and seclusion as last resort
7. Seizures and Post-Traumatic Epilepsy - Early seizures (within 7 days) vs. late seizures; late post-
traumatic seizures are a known complication requiring antiepileptic medication; recurrence risk
8. Spasticity Management - Velocity-dependent increased tone; initial treatment: stretching and
range-of-motion exercises; botulinum toxin and surgical options for refractory cases
9. Community Reintegration and Long-Term Support - Community reintegration programs for
persistent cognitive/behavioral deficits; supported living vs. independent living; family
education and support
10. Ethics and Professional Practice - Confidentiality, informed consent, patient rights, professional
boundaries, interdisciplinary collaboration, cultural competence
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1. A Certified Brain Injury Specialist is working with a client who sustained a traumatic brain injury 6
months ago. The client has developed new-onset seizures. What is the most appropriate
understanding of this clinical presentation?
A) This is rare and likely not related to the TBI
B) Late post-traumatic seizures (after 7 days) are a known complication and require antiepileptic
medication
C) No treatment is needed for a single seizure
D) The client should stop all rehabilitation activities
Answer: B
Rationale: Post-traumatic epilepsy can develop months to years after TBI. Late seizures (after 7 days)
confer a higher risk of recurrence and are typically treated with antiepileptic drugs. Early seizures are
treated prophylactically for a short period .
2. A 19-year-old male with a TBI is in the agitated phase. He is pulling at his IV line and attempting to
get out of bed. What is the CBIS's first intervention?
A) Apply soft wrist restraints
B) Administer a sedative
C) Remove the IV line if no longer needed, and use environmental modifications (e.g., bed alarm, 1:1
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supervision)
D) Move him to a seclusion room
Answer: C
Rationale: Least restrictive interventions first. If the IV line is not essential, removing it reduces the
target for pulling. Bed alarms, lowered bed, one-on-one supervision, and a calm environment are
preferred over restraints or sedation .
3. A client with a TBI is 2 years post-injury and has persistent memory problems, irritability, and social
disinhibition. His family is considering a program for him. Which service is most appropriate?
A) Acute inpatient rehabilitation
B) Long-term acute care hospital (LTACH)
C) Post-acute community-based neurorehabilitation program
D) Skilled nursing facility
Answer: C
Rationale: For clients who are medically stable but have persistent cognitive, behavioral, and social
deficits, community-based neurorehabilitation (day treatment, outpatient, or supported living) is
appropriate for continued skill building and community re-entry .
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4. A client with a TBI is being evaluated for spasticity in the left arm. The CBIS notes that the arm is
rigid with increased tone that is velocity-dependent. What is the most appropriate initial treatment?
A) Surgical tendon release
B) Botulinum toxin injection
C) Stretching and range-of-motion exercises
D) Casting
Answer: C
Rationale: Initial management of spasticity includes regular passive stretching and range-of-motion
exercises. Botulinum toxin, casting, and surgical interventions are considered for refractory cases .
5. A client with a TBI has a low frustration tolerance and becomes aggressive when tasks are too
difficult. The CBIS uses a "task analysis" approach. What is the primary goal of task analysis?
A) To make tasks more difficult to build resilience
B) To break tasks into small, achievable steps and provide positive reinforcement
C) To eliminate all challenging tasks
D) To assign tasks to family members
Certified Brain Injury Specialist (CBIS) Exam
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES
Certified Brain Injury Specialist (CBIS) Exam – Practice Questions
10 Most Tested Coverage Areas
1. Neuroanatomy and Brain Function - Brain structures and their functions; lobe-specific
functions; differences between traumatic and non-traumatic brain injury; primary versus
secondary brain injury
2. Mechanisms of Brain Injury - Traumatic Brain Injury (TBI) from external force; Non-traumatic
Brain Injury from lack of oxygen, toxins, pressure from tumors, or other neurological disorders ;
primary vs secondary injury mechanisms
3. Cognitive and Behavioral Consequences - Memory deficits, executive dysfunction, attention
problems, social disinhibition, irritability, low frustration tolerance; pseudobulbar affect
(sudden, unexpected crying or laughing)
4. Disorders of Consciousness - Coma, Vegetative State, Minimally Conscious State (MCS); PPCS
(Persistent Post-Concussive Syndrome)
5. Rehabilitation and Treatment Interventions - Post-acute community-based neurorehabilitation
for medically stable patients; task analysis (breaking tasks into small steps with positive
reinforcement); pharmacological interventions (amantadine for arousal/attention)
6. Behavioral Management - Least restrictive interventions first for agitated patients;
environmental modifications, 1:1 supervision, bed alarms; restraint and seclusion as last resort
7. Seizures and Post-Traumatic Epilepsy - Early seizures (within 7 days) vs. late seizures; late post-
traumatic seizures are a known complication requiring antiepileptic medication; recurrence risk
8. Spasticity Management - Velocity-dependent increased tone; initial treatment: stretching and
range-of-motion exercises; botulinum toxin and surgical options for refractory cases
9. Community Reintegration and Long-Term Support - Community reintegration programs for
persistent cognitive/behavioral deficits; supported living vs. independent living; family
education and support
10. Ethics and Professional Practice - Confidentiality, informed consent, patient rights, professional
boundaries, interdisciplinary collaboration, cultural competence
, Page 2 of 159
1. A Certified Brain Injury Specialist is working with a client who sustained a traumatic brain injury 6
months ago. The client has developed new-onset seizures. What is the most appropriate
understanding of this clinical presentation?
A) This is rare and likely not related to the TBI
B) Late post-traumatic seizures (after 7 days) are a known complication and require antiepileptic
medication
C) No treatment is needed for a single seizure
D) The client should stop all rehabilitation activities
Answer: B
Rationale: Post-traumatic epilepsy can develop months to years after TBI. Late seizures (after 7 days)
confer a higher risk of recurrence and are typically treated with antiepileptic drugs. Early seizures are
treated prophylactically for a short period .
2. A 19-year-old male with a TBI is in the agitated phase. He is pulling at his IV line and attempting to
get out of bed. What is the CBIS's first intervention?
A) Apply soft wrist restraints
B) Administer a sedative
C) Remove the IV line if no longer needed, and use environmental modifications (e.g., bed alarm, 1:1
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supervision)
D) Move him to a seclusion room
Answer: C
Rationale: Least restrictive interventions first. If the IV line is not essential, removing it reduces the
target for pulling. Bed alarms, lowered bed, one-on-one supervision, and a calm environment are
preferred over restraints or sedation .
3. A client with a TBI is 2 years post-injury and has persistent memory problems, irritability, and social
disinhibition. His family is considering a program for him. Which service is most appropriate?
A) Acute inpatient rehabilitation
B) Long-term acute care hospital (LTACH)
C) Post-acute community-based neurorehabilitation program
D) Skilled nursing facility
Answer: C
Rationale: For clients who are medically stable but have persistent cognitive, behavioral, and social
deficits, community-based neurorehabilitation (day treatment, outpatient, or supported living) is
appropriate for continued skill building and community re-entry .
, Page 4 of 159
4. A client with a TBI is being evaluated for spasticity in the left arm. The CBIS notes that the arm is
rigid with increased tone that is velocity-dependent. What is the most appropriate initial treatment?
A) Surgical tendon release
B) Botulinum toxin injection
C) Stretching and range-of-motion exercises
D) Casting
Answer: C
Rationale: Initial management of spasticity includes regular passive stretching and range-of-motion
exercises. Botulinum toxin, casting, and surgical interventions are considered for refractory cases .
5. A client with a TBI has a low frustration tolerance and becomes aggressive when tasks are too
difficult. The CBIS uses a "task analysis" approach. What is the primary goal of task analysis?
A) To make tasks more difficult to build resilience
B) To break tasks into small, achievable steps and provide positive reinforcement
C) To eliminate all challenging tasks
D) To assign tasks to family members
