ACBIS EXAM Actual Exam 2026/2027
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SECTION 1: BRAIN INJURY FUNDAMENTALS (Questions 1-15)
Q1: A 45-year-old patient presents to the emergency department following a motor vehicle
accident. The patient was unconscious at the scene for approximately 3 minutes and now
reports confusion, headache, and nausea. The patient is alert and oriented to person and place
but is disoriented to time. What is the MOST appropriate classification of this brain injury?
A. Severe traumatic brain injury
B. Moderate traumatic brain injury
C. Mild traumatic brain injury (concussion) [CORRECT]
D. Acquired brain injury
Correct Answer: C
Rationale: Mild TBI (concussion) is characterized by a Glasgow Coma Scale score of 13-15, loss
of consciousness for less than 30 minutes, and post-traumatic amnesia lasting less than 24
hours. This patient's presentation with brief unconsciousness, confusion, and headache aligns
with concussion criteria. The brain injury rehabilitation approach emphasizes monitoring for
symptom progression and cognitive rest.
Q2: A patient with severe traumatic brain injury is demonstrating decerebrate posturing in
response to painful stimuli. Which of the following structures is MOST likely affected?
A. Frontal lobe
B. Temporal lobe
C. Brainstem [CORRECT]
D. Cerebellum
Correct Answer: C
,Rationale: Decerebrate posturing (extension of arms and legs) indicates damage to the
brainstem, specifically the midbrain and pons. This is a sign of severe neurological impairment
and carries a poor prognosis. Brain injury rehabilitation focuses on managing these patients in
acute care settings with close neurological monitoring.
Q3: During a rehabilitation team conference, the physiatrist describes a patient's injury as a
"coup-contrecoup" injury. Which mechanism of injury does this describe?
A. The brain strikes the skull at the point of impact and then rebounds to strike the opposite
side [CORRECT]
B. The brain rotates within the skull causing shearing of axons
C. The brain experiences increased intracranial pressure
D. The brain is compressed by a penetrating object
Correct Answer: A
Rationale: Coup-contrecoup injury occurs when the brain strikes the skull at the initial impact
site (coup) and then rebounds to strike the opposite side of the skull (contrecoup). This dual
impact creates damage at both sites and is common in motor vehicle accidents and falls.
Rehabilitation professionals must assess for multiple areas of injury and associated deficits.
Q4: A 28-year-old male sustained a traumatic brain injury from a fall. The rehabilitation nurse
notes that the patient is now in a minimally conscious state (MCS). Which of the following best
describes MCS?
A. Complete absence of awareness and wakefulness
B. Eye-opening with sleep-wake cycles and inconsistent but reproducible purposeful behaviors
[CORRECT]
C. Eye-opening with sleep-wake cycles but no evidence of awareness
D. Full awareness with inability to communicate verbally
Correct Answer: B
Rationale: Minimally conscious state is characterized by inconsistent but reproducible
purposeful behaviors, including visual tracking, command-following, or intentional
communication. This represents a higher level of consciousness than vegetative state. Brain
injury rehabilitation emphasizes early intervention to promote responsiveness.
,Q5: A patient with a brain injury exhibits difficulty with spatial awareness, neglect of the left
side of the body, and challenges with visual-perceptual tasks. Which lobe of the brain is MOST
likely affected?
A. Frontal lobe
B. Temporal lobe
C. Parietal lobe [CORRECT]
D. Occipital lobe
Correct Answer: C
Rationale: The parietal lobe is responsible for sensory processing, spatial awareness, and visual-
perceptual integration. Left-sided neglect is commonly associated with right parietal lobe
damage. Brain injury rehabilitation includes compensatory strategies such as visual scanning
training and environmental modifications.
Q6: What is the PRIMARY difference between traumatic brain injury (TBI) and acquired brain
injury (ABI)?
A. TBI is always more severe than ABI
B. TBI is caused by an external force while ABI occurs from internal causes [CORRECT]
C. ABI is always caused by stroke
D. TBI only affects children and young adults
Correct Answer: B
Rationale: Traumatic brain injury results from external mechanical forces (falls, accidents,
assault), while acquired brain injury encompasses all non-traumatic causes including stroke,
tumor, infection, and anoxia. Brain injury rehabilitation approaches are similar for both
etiologies, though specific interventions may vary based on the nature of injury.
Q7: A patient scoring 9 on the Glasgow Coma Scale would be classified as having which severity
of brain injury?
A. Mild TBI
B. Moderate TBI [CORRECT]
C. Severe TBI
D. No brain injury
Correct Answer: B
, Rationale: Glasgow Coma Scale scores range from 3-15. Scores of 13-15 indicate mild TBI, 9-12
indicate moderate TBI, and 3-8 indicate severe TBI. A score of 9 requires close monitoring and
acute intervention. Brain injury rehabilitation begins with acute stabilization and progresses to
subacute rehabilitation.
Q8: Which of the following best describes diffuse axonal injury (DAI)?
A. Focal brain injury from a penetrating object
B. Brain injury from increased pressure inside the skull
C. Widespread shearing of nerve fibers from rotational forces [CORRECT]
D. Bleeding between the dura mater and arachnoid mater
Correct Answer: C
Rationale: Diffuse axonal injury is caused by rotational or acceleration-deceleration forces that
shear axons throughout the brain, particularly at gray-white matter junctions. It is a common
mechanism in severe TBI. Brain injury rehabilitation often addresses multiple cognitive and
motor deficits from DAI.
Q9: A patient presents with expressive aphasia following a stroke. Which area of the brain is
MOST likely damaged?
A. Wernicke's area
B. Broca's area [CORRECT]
C. Primary visual cortex
D. Motor cortex
Correct Answer: B
Rationale: Broca's area, located in the frontal lobe, is responsible for speech production.
Damage results in expressive aphasia—difficulty producing fluent speech despite intact
comprehension. Brain injury rehabilitation emphasizes speech-language therapy with
compensatory strategies and communication devices.
Q10: Which of the following is considered a secondary brain injury mechanism?
A. Initial impact from a fall
B. Diffuse axonal shearing
– Complete Exam-Style Questions |
100% Verified – Pass Guaranteed –
A+ Graded.
SECTION 1: BRAIN INJURY FUNDAMENTALS (Questions 1-15)
Q1: A 45-year-old patient presents to the emergency department following a motor vehicle
accident. The patient was unconscious at the scene for approximately 3 minutes and now
reports confusion, headache, and nausea. The patient is alert and oriented to person and place
but is disoriented to time. What is the MOST appropriate classification of this brain injury?
A. Severe traumatic brain injury
B. Moderate traumatic brain injury
C. Mild traumatic brain injury (concussion) [CORRECT]
D. Acquired brain injury
Correct Answer: C
Rationale: Mild TBI (concussion) is characterized by a Glasgow Coma Scale score of 13-15, loss
of consciousness for less than 30 minutes, and post-traumatic amnesia lasting less than 24
hours. This patient's presentation with brief unconsciousness, confusion, and headache aligns
with concussion criteria. The brain injury rehabilitation approach emphasizes monitoring for
symptom progression and cognitive rest.
Q2: A patient with severe traumatic brain injury is demonstrating decerebrate posturing in
response to painful stimuli. Which of the following structures is MOST likely affected?
A. Frontal lobe
B. Temporal lobe
C. Brainstem [CORRECT]
D. Cerebellum
Correct Answer: C
,Rationale: Decerebrate posturing (extension of arms and legs) indicates damage to the
brainstem, specifically the midbrain and pons. This is a sign of severe neurological impairment
and carries a poor prognosis. Brain injury rehabilitation focuses on managing these patients in
acute care settings with close neurological monitoring.
Q3: During a rehabilitation team conference, the physiatrist describes a patient's injury as a
"coup-contrecoup" injury. Which mechanism of injury does this describe?
A. The brain strikes the skull at the point of impact and then rebounds to strike the opposite
side [CORRECT]
B. The brain rotates within the skull causing shearing of axons
C. The brain experiences increased intracranial pressure
D. The brain is compressed by a penetrating object
Correct Answer: A
Rationale: Coup-contrecoup injury occurs when the brain strikes the skull at the initial impact
site (coup) and then rebounds to strike the opposite side of the skull (contrecoup). This dual
impact creates damage at both sites and is common in motor vehicle accidents and falls.
Rehabilitation professionals must assess for multiple areas of injury and associated deficits.
Q4: A 28-year-old male sustained a traumatic brain injury from a fall. The rehabilitation nurse
notes that the patient is now in a minimally conscious state (MCS). Which of the following best
describes MCS?
A. Complete absence of awareness and wakefulness
B. Eye-opening with sleep-wake cycles and inconsistent but reproducible purposeful behaviors
[CORRECT]
C. Eye-opening with sleep-wake cycles but no evidence of awareness
D. Full awareness with inability to communicate verbally
Correct Answer: B
Rationale: Minimally conscious state is characterized by inconsistent but reproducible
purposeful behaviors, including visual tracking, command-following, or intentional
communication. This represents a higher level of consciousness than vegetative state. Brain
injury rehabilitation emphasizes early intervention to promote responsiveness.
,Q5: A patient with a brain injury exhibits difficulty with spatial awareness, neglect of the left
side of the body, and challenges with visual-perceptual tasks. Which lobe of the brain is MOST
likely affected?
A. Frontal lobe
B. Temporal lobe
C. Parietal lobe [CORRECT]
D. Occipital lobe
Correct Answer: C
Rationale: The parietal lobe is responsible for sensory processing, spatial awareness, and visual-
perceptual integration. Left-sided neglect is commonly associated with right parietal lobe
damage. Brain injury rehabilitation includes compensatory strategies such as visual scanning
training and environmental modifications.
Q6: What is the PRIMARY difference between traumatic brain injury (TBI) and acquired brain
injury (ABI)?
A. TBI is always more severe than ABI
B. TBI is caused by an external force while ABI occurs from internal causes [CORRECT]
C. ABI is always caused by stroke
D. TBI only affects children and young adults
Correct Answer: B
Rationale: Traumatic brain injury results from external mechanical forces (falls, accidents,
assault), while acquired brain injury encompasses all non-traumatic causes including stroke,
tumor, infection, and anoxia. Brain injury rehabilitation approaches are similar for both
etiologies, though specific interventions may vary based on the nature of injury.
Q7: A patient scoring 9 on the Glasgow Coma Scale would be classified as having which severity
of brain injury?
A. Mild TBI
B. Moderate TBI [CORRECT]
C. Severe TBI
D. No brain injury
Correct Answer: B
, Rationale: Glasgow Coma Scale scores range from 3-15. Scores of 13-15 indicate mild TBI, 9-12
indicate moderate TBI, and 3-8 indicate severe TBI. A score of 9 requires close monitoring and
acute intervention. Brain injury rehabilitation begins with acute stabilization and progresses to
subacute rehabilitation.
Q8: Which of the following best describes diffuse axonal injury (DAI)?
A. Focal brain injury from a penetrating object
B. Brain injury from increased pressure inside the skull
C. Widespread shearing of nerve fibers from rotational forces [CORRECT]
D. Bleeding between the dura mater and arachnoid mater
Correct Answer: C
Rationale: Diffuse axonal injury is caused by rotational or acceleration-deceleration forces that
shear axons throughout the brain, particularly at gray-white matter junctions. It is a common
mechanism in severe TBI. Brain injury rehabilitation often addresses multiple cognitive and
motor deficits from DAI.
Q9: A patient presents with expressive aphasia following a stroke. Which area of the brain is
MOST likely damaged?
A. Wernicke's area
B. Broca's area [CORRECT]
C. Primary visual cortex
D. Motor cortex
Correct Answer: B
Rationale: Broca's area, located in the frontal lobe, is responsible for speech production.
Damage results in expressive aphasia—difficulty producing fluent speech despite intact
comprehension. Brain injury rehabilitation emphasizes speech-language therapy with
compensatory strategies and communication devices.
Q10: Which of the following is considered a secondary brain injury mechanism?
A. Initial impact from a fall
B. Diffuse axonal shearing
