1
NR 607 Comprehensive Exam QUESTIONS
AND ANSWERS A+ Guaranteed 2026/2027
1. Traumatic Brain Injury (TBI) - ANSWER -alteration in normal brain function
following some type of trauma to the head
-90-95% of clients improve within days to weeks
• some TBIs can result in mild, moderate, or severe symptoms for months to years
and may cause lasting disability
-Repeated TBIs lead to poorer outcomes
• including chronic traumatic encephalopathy
2. factors that influence the long-term outcome of TBI and CTE - ANSWER -
Biological factors
-Age when disease occurs
-Severity of the injury
-Social & family support
-Availability of services
-School support
-Access to rehabilitation
-Psychiatric & social services
3. TBI symptoms - ANSWER -physical or psychiatric
• trouble sleeping
• headaches
• difficulty with concentration and memory
• irritability aggression
• PTSD
• depression
• anxiety disorders
4. Concussion - ANSWER -mild traumatic brain injury
-alteration in mental state that results from injury to the head
-typically arise from MVAs, falls, or hits to the head while playing sports
-Symptoms arise minutes to hours after injury
• vacant stares
• disorientation
• inability to focus
, 2
• memory impairment
• slurred speech
• stumbling
• may or may not involve a LOC
-Symptoms typically resolve on their own within a few months
5. The brain is encased by three coverings, called ______________, and a
protective layer of _________________. These structures keep the brain supported
and floating within the skull. - ANSWER meninges, cerebrospinal fluid
6. coup injury - ANSWER Brain injury at the initial point of impact
7. contrecoup injury - ANSWER brain injury that occurs when brain bounces back
and hits the opposite side of the skull
8. What leads to characteristic concussion symptoms - ANSWER Damaged
neurons
-When the brain hits the skull, neurons (brain cells) are stretched, sheared, or
transected (cut into pieces)
• cannot effectively transmit brain signals
9. TBI may be classified as: - ANSWER -blunt, penetrating, or blast injury
• based on the causative factor
-clinical severity using the Glasgow Coma Scale (GCS):
• mild injury: GCS 13-15
• moderate injury: GCS 9-12
• severe injury: GCS 3-8
10. leading causes of TBI in the U.S. - ANSWER -Falls
-Assaults
-Sports injuries
-Motor vehicle crashes
11. Chronic-Post Traumatic Headaches - ANSWER -18-58% of clients with TBI
will have chronic post-traumatic headaches
-Risk factors:
• female gender
• older age
• PMH of headaches
, 3
-presentation may be similar to migraine, tension, or cluster
12. Chronic-Post Traumatic Headaches Preventative pharmacologic treatment: -
ANSWER -tricyclic antidepressants
• amitriptyline
• nortriptyline
-anti-epileptics
• topiramate
• valproic acid
• gabapentin
• zonisamide
-beta-blockers
• propranolol
• timolol
• metoprolol
-calcium channel blockers
• flunarizine
-angiotensin-converting enzyme inhibitors
• Candesartan
-anti-CGRP monoclonal antibodies
• erenumab
• fremanezumab
-onabotulinumtoxinA injections
-nerve blocks
-trigger point injections
-epidural steroid injections
-radiofrequency ablation
13. Chronic Traumatic Encephalopathy (CTE) - ANSWER -degenerative brain
disease caused by repeated head trauma
-seen in athletes, such as boxers & football players, & veterans
-course of disease progression is highly variable with a broad range of non-specific
behavioral, emotional, & cognitive changes
• Depression
, 4
• Confusion
• Irritability
• Impulsivity
• Aggression
• Memory problems
• Attention problems
• Poor decision-making
14. CTE can only be diagnosed definitively _______________ - ANSWER upon
autopsy
-client hx & presenting signs/symptoms may lead to a working dx
15. Long-Term Management of TBI and CTE - ANSWER -Symptoms of anxiety
& depression can be treated with antidepressants
• clients taking bupropion or tricyclic medications should be monitored for seizures
-Amantadine, stimulants, or wakefulness-promoting agents such as modafinil or
armodafinil
• may help with irritability, fatigue, & attention
-may benefit from social, support, and caregiver support services similar to those
offered to clients with dementia
-Acetylcholinesterase inhibitors such as rivastigmine or donepezil
• may help treat memory symptoms
16. The PMHNP (Psychiatric Mental Health Nurse Practitioner) is providing care
to a 29-year-old client who presents with persistent sadness and hopelessness for
the last two months. She is having difficulty sleeping and has a decreased appetite.
This is the patient's first contact with with the healthcare system about her
concerns.
PMHNP role:
17. Acute PMHNP Care
Telehealth
Case Management
Primary Care
Pharmacologic Intervention
Crisis Intervention
Partial Hospitalization/Intensive Outpatient Tx
Community-Based Care
Self-Employment
Psychotherapy - ANSWER Primary Care
NR 607 Comprehensive Exam QUESTIONS
AND ANSWERS A+ Guaranteed 2026/2027
1. Traumatic Brain Injury (TBI) - ANSWER -alteration in normal brain function
following some type of trauma to the head
-90-95% of clients improve within days to weeks
• some TBIs can result in mild, moderate, or severe symptoms for months to years
and may cause lasting disability
-Repeated TBIs lead to poorer outcomes
• including chronic traumatic encephalopathy
2. factors that influence the long-term outcome of TBI and CTE - ANSWER -
Biological factors
-Age when disease occurs
-Severity of the injury
-Social & family support
-Availability of services
-School support
-Access to rehabilitation
-Psychiatric & social services
3. TBI symptoms - ANSWER -physical or psychiatric
• trouble sleeping
• headaches
• difficulty with concentration and memory
• irritability aggression
• PTSD
• depression
• anxiety disorders
4. Concussion - ANSWER -mild traumatic brain injury
-alteration in mental state that results from injury to the head
-typically arise from MVAs, falls, or hits to the head while playing sports
-Symptoms arise minutes to hours after injury
• vacant stares
• disorientation
• inability to focus
, 2
• memory impairment
• slurred speech
• stumbling
• may or may not involve a LOC
-Symptoms typically resolve on their own within a few months
5. The brain is encased by three coverings, called ______________, and a
protective layer of _________________. These structures keep the brain supported
and floating within the skull. - ANSWER meninges, cerebrospinal fluid
6. coup injury - ANSWER Brain injury at the initial point of impact
7. contrecoup injury - ANSWER brain injury that occurs when brain bounces back
and hits the opposite side of the skull
8. What leads to characteristic concussion symptoms - ANSWER Damaged
neurons
-When the brain hits the skull, neurons (brain cells) are stretched, sheared, or
transected (cut into pieces)
• cannot effectively transmit brain signals
9. TBI may be classified as: - ANSWER -blunt, penetrating, or blast injury
• based on the causative factor
-clinical severity using the Glasgow Coma Scale (GCS):
• mild injury: GCS 13-15
• moderate injury: GCS 9-12
• severe injury: GCS 3-8
10. leading causes of TBI in the U.S. - ANSWER -Falls
-Assaults
-Sports injuries
-Motor vehicle crashes
11. Chronic-Post Traumatic Headaches - ANSWER -18-58% of clients with TBI
will have chronic post-traumatic headaches
-Risk factors:
• female gender
• older age
• PMH of headaches
, 3
-presentation may be similar to migraine, tension, or cluster
12. Chronic-Post Traumatic Headaches Preventative pharmacologic treatment: -
ANSWER -tricyclic antidepressants
• amitriptyline
• nortriptyline
-anti-epileptics
• topiramate
• valproic acid
• gabapentin
• zonisamide
-beta-blockers
• propranolol
• timolol
• metoprolol
-calcium channel blockers
• flunarizine
-angiotensin-converting enzyme inhibitors
• Candesartan
-anti-CGRP monoclonal antibodies
• erenumab
• fremanezumab
-onabotulinumtoxinA injections
-nerve blocks
-trigger point injections
-epidural steroid injections
-radiofrequency ablation
13. Chronic Traumatic Encephalopathy (CTE) - ANSWER -degenerative brain
disease caused by repeated head trauma
-seen in athletes, such as boxers & football players, & veterans
-course of disease progression is highly variable with a broad range of non-specific
behavioral, emotional, & cognitive changes
• Depression
, 4
• Confusion
• Irritability
• Impulsivity
• Aggression
• Memory problems
• Attention problems
• Poor decision-making
14. CTE can only be diagnosed definitively _______________ - ANSWER upon
autopsy
-client hx & presenting signs/symptoms may lead to a working dx
15. Long-Term Management of TBI and CTE - ANSWER -Symptoms of anxiety
& depression can be treated with antidepressants
• clients taking bupropion or tricyclic medications should be monitored for seizures
-Amantadine, stimulants, or wakefulness-promoting agents such as modafinil or
armodafinil
• may help with irritability, fatigue, & attention
-may benefit from social, support, and caregiver support services similar to those
offered to clients with dementia
-Acetylcholinesterase inhibitors such as rivastigmine or donepezil
• may help treat memory symptoms
16. The PMHNP (Psychiatric Mental Health Nurse Practitioner) is providing care
to a 29-year-old client who presents with persistent sadness and hopelessness for
the last two months. She is having difficulty sleeping and has a decreased appetite.
This is the patient's first contact with with the healthcare system about her
concerns.
PMHNP role:
17. Acute PMHNP Care
Telehealth
Case Management
Primary Care
Pharmacologic Intervention
Crisis Intervention
Partial Hospitalization/Intensive Outpatient Tx
Community-Based Care
Self-Employment
Psychotherapy - ANSWER Primary Care
