Question 2 Personality changes in patients with Traumatic Brain Injury include all of the following except:
- Hypervigilance
- Impaired Social Judgment (correct answer)
- Apathy
- Impulsivity
Question 3 Common presenting symptoms of dementia include all of the following except:
- Depression
- Irritability
- Inability to find the right words
- Abstract thinking increases (correct answer)
Question 4 Which type of medication may be particularly dangerous when treating aggression in patients with traumatic brain injury (TBI) because it could cause paradoxical agitation?
- Benzodiazepines (correct answer)
- Clonidine
- Haloperidol
- Propranolol
Question 5 Chris is a 28-year-old marine who just returned from active duty from Iraq. He has been complaining of dizziness, extreme headaches, and memory problems related to traumatic brain injury. His neurological injuries are most likely the effect of:
- Changes related to altitude in climate
- Rotational acceleration/deceleration, resulting in focal injury
- Diffuse axonal damage as the result of a blast-induced injury (correct answer)
- Direct blunt trauma, resulting in damage to underlying tissues
Question 6 A pleasant 73-year-old male presents to the clinic with his wife. His wife states that she has noted increasing problems with his memory, including forgetting to get some items on his grocery list and misplacing his car keys. You administer the MMSE in the office, and he scores 24/30, which is consistent with Mild Dementia per the scoring guidelines. Your best response to his wife is:
- The MMSE score alone is a strong indicator of Dementia, and we can proceed with medication based on these results.
- The MMSE score along with the memory issues are more concerning for head injury, so we will pursue a head CT to rule out TBI.
- The MMSE score alone is concerning for Dementia, but the memory issues can be a part of normal brain function, so we need to rule out organic causes before concluding a diagnosis of Dementia (correct answer)
- The MMSE score along with the memory issues you identified are very strong indicators of Dementia, so we will begin first-line treatment with Donepezil (Aricept) today.
Question 7 Collaborating with specialists is an important part of primary care involving patients with neurologic injuries. It is important as an APN to know when to refer to a specialist and what the goal of that referral is: further information, diagnostic testing, or treatment recommendations? Which of the following are accurate goals of referral of a patient for Neuropsychological Testing? Choose all that apply:
- Marital Counseling
- Assist in identifying neurobehavioral or developmental disorders that may influence cognitive and behavioral functions (e.g., dyslexia, attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorders, mental retardation) (correct answer)
- Monitor the results of Court-ordered Drug testing
- Monitor changes in cognition over time (document recovery or progression of symptoms) (correct answer)
- Establish a baseline level of neuropsychological functioning (correct answer)
- Assist in differential diagnosis and determination of the severity of a condition (correct answer)
Question 8 Key early warning signs for Alzheimer’s disease include all of the following except:
- Problem with language
- Loss of initiative
- Memory loss
- Increased fatigue (correct answer)
Question 9 Benzodiazepines are appropriate for which of the following disorders? (Choose all that apply)
- Insomnia
- Mood Disorders (correct answer)
- Acute alcohol withdrawal (correct answer)
- Delirium (correct answer)
Question 10 Match the type of Injury with the neurologic damage.
- Blow to the head with an object: Damage to underlying tissue or vessels (correct answer)
- Punched in the face or head: Contusions/bruising/bleeding (correct answer)
- Being shot in the face or head: Disintegration of brain tissue (correct answer)
- Falling and hitting your head: Focal and diffuse damage (correct answer)
- Near Drowning: Diffuse damage (correct answer)