CBIS EXAM QUESTIONS AND ANSWERS | CERTIFIED BRAIN INJURY SPECIALIST (CBIS)
CERTIFICATION STUDY GUIDE 2026
Neurocognitive Issues Associated with Frontal Lobe - ANS ✔✔Emotional control, behavioral
control, verbal expression, problem solving, decision making, social control, attention,
motivation
Acquired BI - ANS ✔✔An injury to the brain that is not hereditary, congenital or degenerative or
induced by birth trauma
TBI - ANS ✔✔An alteration in brain function or other evidence of brain pathology, casused by an
external force
Mild TBI Characteristics - ANS ✔✔Brief or no loss of consciousness for 0-30mins, altered state of
consciousness is most common and must be <24 hours, account for 75% of TBIs, 13-15 on the
GCS, normal imaging, highest prevalence of maltreatment as 16-25% never seek care, often
considered a concussion
Moderate TBI Characteristics - ANS ✔✔Loss of consciousness for up to 24 hours, may appear on
scans, skull fractures and bleeding are common, 9-12 on the GCS
Severe TBI Characteristics - ANS ✔✔Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury - ANS ✔✔1 BI increases risk of 2nd by 3x and 2nd BI increases
risk of 3rd by 8x!
Most Frequent Cause of TBI - ANS ✔✔Falls
How many people sustain a BI per year? - ANS ✔✔2.5 million. 81% visit ED, 16% hsopitalized,
3% result in death
,How many people are living with effects of a TBI? - ANS ✔✔13.5 million
Likelihood of BI by gender - ANS ✔✔Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+ - ANS ✔✔Falls!
Most common cause of TBI and death by age - 0-3 - ANS ✔✔AHT!
Most common cause of TBI and death by age - 20-24 - ANS ✔✔MVAs and Firearms
Most common cause of TBI and death by age - 16-19 - ANS ✔✔MVAs!
CARF - ANS ✔✔Accreditation agency for post acute BI programs, residential, outpatient,
vocational, home and community, stroke and pediatric programs - ensures quality of services
through requirements for accreditation and surveys
Joint Commission - ANS ✔✔Accreditation agency for hospital based programs, may accompany
CARF accreditation, ensures quality of services through requirements for accreditation and
surveys
Olmsted Decison - ANS ✔✔Supreme court case stimulated by two women living in a nursing
home in Georgia for community inclusion - resulted in federal and state initiatives to improve
and normalize community living
Model Systems of Care 1987 - ANS ✔✔Resulted in research projects for TBI by the NIDDR,
established rehab facilities to provide care and complete clinical research in the process
,Symptoms of Mild TBI - ANS ✔✔Headache, fatigue, seizures, nausea, numbness, poor sleep,
light sensitivity, noise sensitivity, impaired hearing, blurred vision, dizziness, loss of balance,
neurological abnormality, in attentiveness, decreased concentration, poor memory, impaired
judgment, slow proccessing speed, executive dysfunction, depression, anxiety, agitation,
irritability, aggression, impulsivity
Primary causes of Mild TBI - ANS ✔✔Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI - ANS ✔✔Relaxation techniques, rest, slow return to normal
activity, and reduction of normal activity if symptoms recur
Peristent Post Concussive Symptoms (PPCS) - ANS ✔✔Symptoms of Mild TBI last >1 month,
occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE) - ANS ✔✔Often cause by repeated blows to the head,
is a progressive, degenerative condition characterized by broken nuerons which continually
release tau protein cashing dementia over time
Diffuse axonal injury -> tau protein release -> inflammation of the brain -> progressive dementia
Define Skull - ANS ✔✔Bony shell that protects the brain, has bony prominences inside which
can worsen brain injury
Cerebral Spinal Fluid (CSF) - ANS ✔✔Provides cushion to nerve tissue, produced by ventricles
(4) which also store and circulation CSF through the brain
Meninges - ANS ✔✔Pia Mater - molds around suclhi and gyri, deepest layer
, Arachnoid Mater - spiderweb-like, middle layer
Dura Mater - hard plastic, top layer
Nuerons vs Glial Cells - ANS ✔✔Nuerons communicate electrical impulses throughout brain
while Glial cells support and nourish Nuerons
Synapse - ANS ✔✔A junction between the axon of one neuron and the dendrite of another,
allows for passing of communication fro, nueron to neuron
Functions of the Parietal Lobe - ANS ✔✔Sense of touch; differentiation of size, color, and shape;
visual perception; spatial perception
Functions of the Occipital Lobe - ANS ✔✔Visual functions
Functions of the Frontal Lobe - ANS ✔✔Planning; organizing; problem solving; working
memory; impulse control; decision making; personality; behavior; initiation; anticipation; self-
monitoring; motor planning; emotions; awareness of abilities; attention; concentration; mental
flexibility; speaking - all executive functions
Functions of the Temporal Lobe - ANS ✔✔Hearing functions, memory, understanding language,
organization and sequencing
Functions of the Brain Stem - ANS ✔✔Breathing, HR, arousal, consciousness, sleep/wake
functions, attention, concentration
Transmits all sensory information from body to brain and movement signals from the brain to
the body
CERTIFICATION STUDY GUIDE 2026
Neurocognitive Issues Associated with Frontal Lobe - ANS ✔✔Emotional control, behavioral
control, verbal expression, problem solving, decision making, social control, attention,
motivation
Acquired BI - ANS ✔✔An injury to the brain that is not hereditary, congenital or degenerative or
induced by birth trauma
TBI - ANS ✔✔An alteration in brain function or other evidence of brain pathology, casused by an
external force
Mild TBI Characteristics - ANS ✔✔Brief or no loss of consciousness for 0-30mins, altered state of
consciousness is most common and must be <24 hours, account for 75% of TBIs, 13-15 on the
GCS, normal imaging, highest prevalence of maltreatment as 16-25% never seek care, often
considered a concussion
Moderate TBI Characteristics - ANS ✔✔Loss of consciousness for up to 24 hours, may appear on
scans, skull fractures and bleeding are common, 9-12 on the GCS
Severe TBI Characteristics - ANS ✔✔Loss of consciousness >24 hours, 3-8 on the GCS
Likelihood of Additional Injury - ANS ✔✔1 BI increases risk of 2nd by 3x and 2nd BI increases
risk of 3rd by 8x!
Most Frequent Cause of TBI - ANS ✔✔Falls
How many people sustain a BI per year? - ANS ✔✔2.5 million. 81% visit ED, 16% hsopitalized,
3% result in death
,How many people are living with effects of a TBI? - ANS ✔✔13.5 million
Likelihood of BI by gender - ANS ✔✔Men are 1.4x more likely than women
Most common cause of TBI and death by age - 75+ - ANS ✔✔Falls!
Most common cause of TBI and death by age - 0-3 - ANS ✔✔AHT!
Most common cause of TBI and death by age - 20-24 - ANS ✔✔MVAs and Firearms
Most common cause of TBI and death by age - 16-19 - ANS ✔✔MVAs!
CARF - ANS ✔✔Accreditation agency for post acute BI programs, residential, outpatient,
vocational, home and community, stroke and pediatric programs - ensures quality of services
through requirements for accreditation and surveys
Joint Commission - ANS ✔✔Accreditation agency for hospital based programs, may accompany
CARF accreditation, ensures quality of services through requirements for accreditation and
surveys
Olmsted Decison - ANS ✔✔Supreme court case stimulated by two women living in a nursing
home in Georgia for community inclusion - resulted in federal and state initiatives to improve
and normalize community living
Model Systems of Care 1987 - ANS ✔✔Resulted in research projects for TBI by the NIDDR,
established rehab facilities to provide care and complete clinical research in the process
,Symptoms of Mild TBI - ANS ✔✔Headache, fatigue, seizures, nausea, numbness, poor sleep,
light sensitivity, noise sensitivity, impaired hearing, blurred vision, dizziness, loss of balance,
neurological abnormality, in attentiveness, decreased concentration, poor memory, impaired
judgment, slow proccessing speed, executive dysfunction, depression, anxiety, agitation,
irritability, aggression, impulsivity
Primary causes of Mild TBI - ANS ✔✔Traumatic intertial - brain moving inside skull
Traumatic impact - head hits directly
Early Treatment for Mild TBI - ANS ✔✔Relaxation techniques, rest, slow return to normal
activity, and reduction of normal activity if symptoms recur
Peristent Post Concussive Symptoms (PPCS) - ANS ✔✔Symptoms of Mild TBI last >1 month,
occurs 10% of the time in Mild TBI cases
Chronic Traumatic Encephalopathy (CTE) - ANS ✔✔Often cause by repeated blows to the head,
is a progressive, degenerative condition characterized by broken nuerons which continually
release tau protein cashing dementia over time
Diffuse axonal injury -> tau protein release -> inflammation of the brain -> progressive dementia
Define Skull - ANS ✔✔Bony shell that protects the brain, has bony prominences inside which
can worsen brain injury
Cerebral Spinal Fluid (CSF) - ANS ✔✔Provides cushion to nerve tissue, produced by ventricles
(4) which also store and circulation CSF through the brain
Meninges - ANS ✔✔Pia Mater - molds around suclhi and gyri, deepest layer
, Arachnoid Mater - spiderweb-like, middle layer
Dura Mater - hard plastic, top layer
Nuerons vs Glial Cells - ANS ✔✔Nuerons communicate electrical impulses throughout brain
while Glial cells support and nourish Nuerons
Synapse - ANS ✔✔A junction between the axon of one neuron and the dendrite of another,
allows for passing of communication fro, nueron to neuron
Functions of the Parietal Lobe - ANS ✔✔Sense of touch; differentiation of size, color, and shape;
visual perception; spatial perception
Functions of the Occipital Lobe - ANS ✔✔Visual functions
Functions of the Frontal Lobe - ANS ✔✔Planning; organizing; problem solving; working
memory; impulse control; decision making; personality; behavior; initiation; anticipation; self-
monitoring; motor planning; emotions; awareness of abilities; attention; concentration; mental
flexibility; speaking - all executive functions
Functions of the Temporal Lobe - ANS ✔✔Hearing functions, memory, understanding language,
organization and sequencing
Functions of the Brain Stem - ANS ✔✔Breathing, HR, arousal, consciousness, sleep/wake
functions, attention, concentration
Transmits all sensory information from body to brain and movement signals from the brain to
the body
