CERTIFIED BRAIN INJURY SPECIALIST
(CBIS) COMPREHENSIVE EXAM NEWEST
VERSION 2026/UPGRADED AND RATED A+
Maximize your success with the Certified Brain Injury
Specialist (CBIS) Comprehensive Exam, designed to
assess advanced knowledge in brain injury care and
rehabilitation. It focuses on neuroanatomy, cognitive and
behavioral effects of brain injury, rehabilitation
strategies, patient management, and ethical
considerations in care. The exam strengthens clinical
reasoning and evidence-based practice in
neurorehabilitation settings. Suitable for healthcare
professionals preparing for CBIS certification and brain
injury specialty roles.
1. A client sustains a brain injury when a golf ball strikes the left temporal
region. This type of injury is classified as:
• A) Anoxic brain injury
• B) Focal closed head injury
• C) Diffuse axonal injury
• D) Penetrating open head injury
,Rationale: A focal closed head injury results from a direct impact to the
head that does not penetrate the skull. It causes damage localized to the
area of impact (coup) and sometimes the opposite side (contrecoup).
2. A client is found unconscious after a car crash. The brain is subjected
to rapid acceleration-deceleration forces, causing widespread shearing
of axons. This mechanism is best described as:
• A) Focal contusion
• B) Diffuse axonal injury (DAI)
• C) Anoxic encephalopathy
• D) Epidural hematoma
Rationale: Diffuse axonal injury occurs when rotational forces shear
nerve fibers throughout the brain, often producing widespread cognitive
impairment without large structural lesions on CT.
3. Which of the following is the most common cause of traumatic brain
injury (TBI) in older adults (age 65+)?
• A) Motor vehicle crashes
• B) Falls
• C) Assaults
• D) Sports-related injury
Rationale: Falls are the leading cause of TBI in older adults due to
age-related balance issues, polypharmacy, and environmental hazards.
Motor vehicle crashes are more common in younger adults.
4. A patient experiences a brain injury due to carbon monoxide
poisoning. This type of injury is classified as:
• A) Traumatic brain injury
, • B) Anoxic brain injury
• C) Hypoxic brain injury
• D) Infectious brain injury
Rationale: Anoxic brain injury means complete lack of oxygen to the
brain. Carbon monoxide poisoning reduces oxygen delivery by binding to
hemoglobin; however, it produces hypoxia (reduced oxygen) rather than
complete anoxia. The term anoxic is often used broadly, but strictly it is
hypoxic. For exam purposes, carbon monoxide injury is typically
classified as anoxic/hypoxic brain injury.
5. Which of the following is the most sensitive diagnostic tool for
detecting diffuse axonal injury in the acute setting?
• A) Non-contrast CT head
• B) MRI (especially gradient-echo or SWI sequences)
• C) EEG
• D) Lumbar puncture
Rationale: MRI, particularly susceptibility-weighted imaging (SWI) or
gradient-echo sequences, is far more sensitive than CT for detecting
microhemorrhages and shearing injuries of diffuse axonal injury.
6. A patient with a severe TBI is in a coma for 2 weeks. The Rancho Los
Amigos Levels of Cognitive Function (LCF) scale is used to assess:
• A) Physical disability
• B) Level of cognitive functioning and recovery
• C) Motor impairment
• D) Sleep quality
, Rationale: The Rancho Los Amigos scale (LCF) measures cognitive and
behavioral recovery after TBI, ranging from Level I (no response) to Level
VIII (purposeful and appropriate).
7. The Glasgow Coma Scale (GCS) score of a patient is 9. This indicates:
• A) Mild TBI
• B) Moderate TBI
• C) Severe TBI
• D) No brain injury
*Rationale: GCS 13-15 = mild; 9-12 = moderate; 3-8 = severe.*
8. A patient who was unconscious for 30 minutes after a fall and has
post-traumatic amnesia lasting 4 hours would be classified as having:
• A) Mild TBI (concussion)
• B) Moderate TBI
• C) Severe TBI
• D) Penetrating injury
Rationale: Mild TBI (concussion) typically involves loss of consciousness
< 30 minutes and post-traumatic amnesia < 24 hours.
9. Which of the following is a primary injury mechanism in TBI?
• A) Cerebral edema
• B) Contusion at the site of impact
• C) Hypoxia from airway obstruction
• D) Intracranial hypertension
(CBIS) COMPREHENSIVE EXAM NEWEST
VERSION 2026/UPGRADED AND RATED A+
Maximize your success with the Certified Brain Injury
Specialist (CBIS) Comprehensive Exam, designed to
assess advanced knowledge in brain injury care and
rehabilitation. It focuses on neuroanatomy, cognitive and
behavioral effects of brain injury, rehabilitation
strategies, patient management, and ethical
considerations in care. The exam strengthens clinical
reasoning and evidence-based practice in
neurorehabilitation settings. Suitable for healthcare
professionals preparing for CBIS certification and brain
injury specialty roles.
1. A client sustains a brain injury when a golf ball strikes the left temporal
region. This type of injury is classified as:
• A) Anoxic brain injury
• B) Focal closed head injury
• C) Diffuse axonal injury
• D) Penetrating open head injury
,Rationale: A focal closed head injury results from a direct impact to the
head that does not penetrate the skull. It causes damage localized to the
area of impact (coup) and sometimes the opposite side (contrecoup).
2. A client is found unconscious after a car crash. The brain is subjected
to rapid acceleration-deceleration forces, causing widespread shearing
of axons. This mechanism is best described as:
• A) Focal contusion
• B) Diffuse axonal injury (DAI)
• C) Anoxic encephalopathy
• D) Epidural hematoma
Rationale: Diffuse axonal injury occurs when rotational forces shear
nerve fibers throughout the brain, often producing widespread cognitive
impairment without large structural lesions on CT.
3. Which of the following is the most common cause of traumatic brain
injury (TBI) in older adults (age 65+)?
• A) Motor vehicle crashes
• B) Falls
• C) Assaults
• D) Sports-related injury
Rationale: Falls are the leading cause of TBI in older adults due to
age-related balance issues, polypharmacy, and environmental hazards.
Motor vehicle crashes are more common in younger adults.
4. A patient experiences a brain injury due to carbon monoxide
poisoning. This type of injury is classified as:
• A) Traumatic brain injury
, • B) Anoxic brain injury
• C) Hypoxic brain injury
• D) Infectious brain injury
Rationale: Anoxic brain injury means complete lack of oxygen to the
brain. Carbon monoxide poisoning reduces oxygen delivery by binding to
hemoglobin; however, it produces hypoxia (reduced oxygen) rather than
complete anoxia. The term anoxic is often used broadly, but strictly it is
hypoxic. For exam purposes, carbon monoxide injury is typically
classified as anoxic/hypoxic brain injury.
5. Which of the following is the most sensitive diagnostic tool for
detecting diffuse axonal injury in the acute setting?
• A) Non-contrast CT head
• B) MRI (especially gradient-echo or SWI sequences)
• C) EEG
• D) Lumbar puncture
Rationale: MRI, particularly susceptibility-weighted imaging (SWI) or
gradient-echo sequences, is far more sensitive than CT for detecting
microhemorrhages and shearing injuries of diffuse axonal injury.
6. A patient with a severe TBI is in a coma for 2 weeks. The Rancho Los
Amigos Levels of Cognitive Function (LCF) scale is used to assess:
• A) Physical disability
• B) Level of cognitive functioning and recovery
• C) Motor impairment
• D) Sleep quality
, Rationale: The Rancho Los Amigos scale (LCF) measures cognitive and
behavioral recovery after TBI, ranging from Level I (no response) to Level
VIII (purposeful and appropriate).
7. The Glasgow Coma Scale (GCS) score of a patient is 9. This indicates:
• A) Mild TBI
• B) Moderate TBI
• C) Severe TBI
• D) No brain injury
*Rationale: GCS 13-15 = mild; 9-12 = moderate; 3-8 = severe.*
8. A patient who was unconscious for 30 minutes after a fall and has
post-traumatic amnesia lasting 4 hours would be classified as having:
• A) Mild TBI (concussion)
• B) Moderate TBI
• C) Severe TBI
• D) Penetrating injury
Rationale: Mild TBI (concussion) typically involves loss of consciousness
< 30 minutes and post-traumatic amnesia < 24 hours.
9. Which of the following is a primary injury mechanism in TBI?
• A) Cerebral edema
• B) Contusion at the site of impact
• C) Hypoxia from airway obstruction
• D) Intracranial hypertension
