RELIAS MODULES EXAMS 2025-2026 FULLY COMPREHENSIVE QUESTIONS BANK WITH 100% CORRECT ANSWERS ALREADY GRADED A+

Which of the following is an example of positive punishment?

Telling someone "no" when they are about to run into the street

Which of the following is an example of a motivating operation?

Jan is hungry, so she works harder to get crackers as a reward.

Differential reinforcement works by:

Reinforcing only the behaviors that should be increased while removing reinforcement from behaviors that should be decreased.

Spontaneous recovery refers to:

Sudden reoccurrence of behavior that was extinguished

Extinction works by:

Abruptly stopping reinforcement for problem behavior

What is the difference between differential reinforcement of alternative behavior (DRA) and differential reinforcement of incompatible behavior (DRI)?

The replacement behavior selected in DRA does not have to be incompatible with the problem behavior.

Which of the following is an example of overcorrection?

Marty had to clean the bathroom wall because she wrote on it.

At what point should a behavior reduction plan be considered?

When environmental variables for behavior are ruled out

Which of the following functions of behavior involves avoiding a task or interaction?

Escape

Differential reinforcement of other behavior (DRO) involves:

Setting an interval for the problem behavior not to be displayed and reinforcing if it is not displayed

Which of the following is an example of negative punishment?

Paying a speeding ticket

Which of the following could ensure that an intervention involving the use of punishment is effective?

Collecting and reviewing intervention data

Extinction of behavior maintained by positive reinforcement works by:

Taking away the reinforcer for problem behavior

Which of the following best explains the primary purpose of the BACB's RBT Ethics Code?

The purpose of the RBT Ethics Code is to provide guidelines for certified and credentialed individuals to follow when they are providing behavior analysis services.

If an RBT is unknowingly assigned to work with a relative, which of the following is the best course of action for the RBT to take?

Inform the supervisor and ask not to work with the client.

Which of the following statements is the best way to describe this particular behavioral intervention to a parent of a child receiving the intervention?

After John has written 3 letters of his name, give him a small piece of crunchy cereal.

According to the RBT Ethics Code, clients and their families have a right to:

Your background check and credentials

When is it acceptable to videotape a client receiving an intervention?

If the client and family provide informed consent, which means they know why the videotaping is occurring.

Before a behavior change plan can be developed, what has to happen?

An assessment of the client's skills and needs must be conducted.

Which of the following is an example of an issue related to boundaries of competence?

Jenny was told to use non-contingent reinforcement with Annie and she does not know what that is.

Which of the following is an example of an exploitive relationships?

A BCBA agreeing to take a child on his caseload if the parent of the child receiving services will agree to give a discount on power tools at his hardware store

Any reinforcer that has the potential to affect the health of the client adversely if used inappropriately or in excess is called a:

Harmful reinforcer

Sarah works as an RBT in the local school system. She was at a party, drank one too many drinks and was arrested for driving while intoxicated. The Monday after the incident, she:

She informed her supervisor and the BACB what had happened.

If an RBT puts a picture of herself and the clients she works with on a social media site, she is:

Violating the client's right to confidentiality

According to the BACB, a client's record should be:

all of the above

If an intervention is implemented with a "high degree of fidelity," it is:

Implemented consistently and accurately

You are working with a young client in a clinic setting and are implementing a toilet training protocol. Which of the following should you do to make sure that this client's dignity is protected?

Make sure that the bathroom door is shut when the client is using the toilet.

Your supervisor tells you to use a strategy you have no idea how to use. What is the best response to the request?

Tell the supervisor immediately that you do not know how to use the strategy and ask for them to demonstrate it.

What percentage of births are affected by OB hemorrhage?

OBH is responsible for how many pregnancy related deaths worldwide?

11% of births

25% of pregnancy deaths worldwide, 10.7% in the US

4 domains of care?

- Readiness (hemorrhage cart, training, protocols)

- Recognition/prevention (risk assessment, accurate EBL)

- Response (standard plan)

- Reporting (debriefs/reviews)

OB Hemorrhage protocols have been shown to decrease maternal death rate by ___ and maternal morbidity by ___.

OB Hemorrhage protocols have been shown to decrease maternal death rate by 50% and maternal morbidity by 21%.

Stages of Hemorrhage

Stage 0 - active mgt 3rd stage

Stage 1 - >500 vaginal, >1000 CS: activate OBH protocol

Stage 2 - 1000 - 1500 QBL, advance through protocol sequentially

Stage 3 - >1500QBL: activate MTP, move to OR

Stage 4 - cardiovascular collapse

Uterotonics and dosages

TXA

Oxytocin: 10-40 units per 500-1000cc IV, or 10 units IM.

Methergine: 0.2mg IM q2-4h (avoid if HTN)

Carboprost: 0.25mg IM q15-90 min, no more than 8 doses =2mg. (avoid if significant asthma)

Misoprostol: 800mcg SL or PO x 1

TXA (not uterotonic): 1g (100mg/mL) infused over 10 min, can repeat at 30 min

Risk factors for OB Hemorrhage

-History of OBH

-Uterine overdistension (multiple gestation, large fibroids, macrosomia, polyhydramnios)

-Grand multiparity or Primiparity

-Obesity (inc atony)

-Prior CS / Uterine surgery

-Abnormal placentation

-Abruption

-Coagulopathy/ Bleeding Disorder

-Personal or FHx OBH in a 1st degree relative

Platelets <100k

-Prolonged or augmented labor

-Prolonged third stage

-Operative Delivery

-Connective tissue disorders

-Preeclampsia/HELLP

-Use of MgSO4

-Malpresentation (inc risk of trauma)

-General anesthesia

Recurrence risk of OBH?

ranges 8-28% depending on contributing factors

May be as high as 80% in patients with vWF disease

High risk factors for OBH include:

Previa/low lying placenta

Accreta spectrum

Hct <30 + other risk factor

Platelets <100k

Active bleeding on admission

Known bleeding d/o

Multiple lower level risk factors

TYPE AND CROSS these peeps

Signs/symptoms of hypovolemia and concealed hemorrhage to tell patients?

dizziness, rapid HR, fatigue, rectal or pelvic pressure, abdominal pain

Atony is the cause of OBH at delivery in about ___% of cases.

About ____% of OBH is secondary (late).

80% atony

1-3%, rarely atony

When does primary and secondary hemorrhage occur?

Primary (early): within 24h of delivery

Secondary (late): 24h - 12 weeks after delivery

Women who deliver by primary CS have a ___% chance of subsequent CS.

90%

Women over 40 statistics:

2x as likely as moms <20yo to have a CS.

death rate 81.9 per 100k births

7.7x more likely to die of pregnancy than women <25yo

Physiologic cardiovascular changes of pregnancy peak at ___weeks.

Plasma volume expands by ____% while red cell volume increases by ____%, resulting in maternal ______.

Physiologic cardiovascular changes of pregnancy peak at 32 weeks.

Plasma volume expands by 40-50% while red cell volume increases by 20-30%, resulting in maternal anemia.

Clinical signs of maternal blood loss such as tachycardia and hypotension may not appear until _____% of circulating blood volume is lost.

Tachycardia: 15-20%

(1000-1500cc)

Hypotension w/tachycardia: 25-40%

(>2000cc)

What is the rate of uterine blood flow at term?

up to 750cc/min

(10-15% of maternal cardiac output)

3 mechanisms that control uterine bleeding at delivery:

-Contractions compress blood vessels

- Tissue factor is released from the decidua (combines with FVIIa to initiate the extrinsic clotting cascade)

- Circulating clotting factors including platelets, fibrinogen form clots at the uterine blood supply

What factors increase clotting?

What factors decrease clotting?

Increase: 5,7,8,9 and thrombin

Decrease: C, S, plasmin, antifactor Xa, antithrombin 3

What makes pregnancy a hypercoagulable state?

Increased clotting factors

Decreased anti-clotting factors

What is the shock index and its relevant cutoff?

Shock index = HR/SBP

Sensitive indicator of blood loss

>=1.4 requires urgent intervention

What is the lethal triad of excessive hemorrhage?

Hypothermia (halts coagulation)

Coagulopathy (increases lactic acidosis)

Acidosis (decreases myocardial performance)

Calcium, lactate, base deficit, temperature goals?

Ca >2

Lactate <2

Base Deficit <3

T 96.8-99.5

1 cc blood weighs ___.

1 cc blood = 1 gm

Types of peripartum hematoma?

Risk factors for developing?

Vulvar, vulvovaginal, paravaginal, retroperitoneal

Risks: nulliparity, episiotomy, forceps delivery

What are the processes in DIC?

Consumptive coagulopathy:

- Triggering event releases TF (thromboplastin), activating clotting cascade

- Platelets and clotting factors are used up > Bleeding

- Intravascular clots cause end-organ damage

Amniotic fluid embolism is also called ______.

What is the cause?

What is the maternal triad?

What are the two phases?

AFE = ASP (Anaphylactoid syndrome of pregnancy)

- maternal immunologic reaction to fetal antigens entering maternal circulation during labor/delivery, causing release of excessive catecholamines

Triad: hypovolemia, hypotension, coagulopathy

Phase 1 - cardiopulmonary phase

Phase 2 - late hemorrhagic phase (DIC)

How should oxytocin be used for active management of the third stage?

Give 10 units within 30 min (can be diluted in IVF or given IM)

Continue at 10 units per hour for 4 hours

Can give 10 - 40 units in 1000 mL saline

Up to 80 units in 1000mL can be given, but no extra benefit is shown

What is the mechanism of methergine?

Dosing?

Contraindications?

Alpha-adrenergic agonist that causes vasoconstriction

IM - 0.2mg, 2-5 min effect

PO - 0.2mg, 5-10 min effect

Intrauterine (can be transabominal) - 0.2mg, 2-5 min

AVOID IF: preeclampsia/HTN, Raynauds, scleroderma, CAD, or on protease inhibitors

What is the mechanism of prostaglandin F2-alpha?

Dosing?

AKA Hemabate / carboprost

IM or Intrauterine - 0.25mg

Given every 15 - 90 min to a max of 2 mg (up to 8 doses)

Must be refrigerated

AVOID if active asthma requiring treatments

What is the mechanism of prostaglandin E1?

Dosing?

AKA Cytotec / misoprostol

SL, PO, Rectal - 400-800mcg

How does TXA work? Dosing?

inhibits fibrinolysis by competitively blocking plasminogen activation on the surface of fibrin (clots can't break down)

Opposite of tPA, which activates plasmin from plasminogen

1g in 100mL over 10 min, can give another 1g after 30 min

What is a uterine tourniquet?

A method to reduce blood loss at the time of laparotomy

A foley catheter is tied tightly around the lower uterine segment for vascular occlusion

What is a good indicator that uterine compression sutures will be effective?

If manual compression of the uterus slows bleeding

What is an O'Leary stitch?

Compresses the uterine artery to the uterine wall just above the level of the cervix

What is a pelvic pressure pack?

A sterile tamponade device used after hysterectomy in the setting of coagulopathy, placed into the general pelvis through the open vaginal cuff

What vital signs criteria are used to transfuse prior to return of labs?

QBL 1000cc or more

HR 110 or more

BP < 85/45

Ongoing bleeding with a negative clot tube

Unstable vitals

What is the transfusion Hb level for a patient who has STOPPED bleeding?

8 mg/dL

What does the INR tell you about clotting factors?

INR 1.6 suggests that clotting factors are at 30% of their normal level, and FFP may be needed

3-6 units of FFP required to increase clotting factors by 20%

1 unit FFP raises fibrinogen 10mg/dL

What is the usual dosing of cryoprecipitate?

1 unit per 10kg body weight

Criteria for activating MTP?

Stage 3 cumulative blood loss >1500cc

2u PRBC given with persistent hemodynamic instability

Coagulopathy

Anticipated EBL 50% or more of total blood volume in 2h

Persistent bleeding after 4u PRBC

Uncontrolled bleeding with maternal hypovolemia

What is ANH?

Acute normovolemic hemodilution

1L blood drawn immediately before surgery and replaced with 1L crystalloid

Person's own blood transfused back after surgery

Point is to reduce loss of RBCs by diluting

Escape extinction works by

Not allowing the individual to escape what they were trying to avoid

An example of positive punishment

Telling someone "no" when they are about to run into the street

Punishment is the result of a stimulus following a behavior that serves to

Reduce the behavior

Differential reinforcement of other behavior (DRO) involves

Setting an interval for the problem behavior not to be displayed & reinforcing if it is not displayed

What functions of behavior involves avoiding a task or interaction?

Escape

What is the best course of action to take in the event of an extinction burst?

Continue the intervention

An example of a motivating operation

Jan is hungry, so she works harder to get crackers as a reward

Extinction of behavior maintained by positive reinforcement works by

Taking away the reinforcer for problem behavior

Spontaneous recovery refers to

Sudden reoccurrence of behavior that was extinguished

The quote "All behavior has a communicative intent" (Carr, 1977) can be best explained by the statement

Behavior always serves a purpose for the person engaging in the behavior

In which situations are differential reinforcement of low rates of behavior (DRL) used?

Behaviors that are acceptable at low rates

Differential reinforcement works by

Reinforcing only the behaviors that should be increased while removing reinforcement from behaviors that should be decreased

Extinction works by

Abruptly stopping reinforcement for problem behavior

What could ensure that an intervention involving the use of punishment is effective

Collecting & reviewing intervention data

An example of overcorrection

Marty had to clean the bathroom wall because she wrote on it

Type 1 Punishment involves

Adding a condition to reduce a behavior

An example of negative punishment

Paying a speeding ticket

What is the difference between differential reinforcement of alternative behavior (DRA) & differential reinforcement of incompatible behavior (DRI)?

The reinforcement behavior selected in DRA does not have to be incompatible with the problem behavior

An example of type 1 punishment

When Austin hits his sister, his mother reprimands him & he doesn't hit her anymore

What are common reasons or "functions" of behaviors?

Gain attention, gain items, escape, & sensory stimulation

Variables that play a role in the frequency & intensity of behavior or the effectiveness of reinforcement for behaviors are called

Motivating Operations

An example of a behavior that could be placed on a differential reinforcement of incompatible behavior (DRI) plan?

Rosa sings instead of screaming

What is extinction?

Is a behavior reduction procedure that works by abruptly stopping reinforcement for a previously rewarded behavior

An example of escape extinction

When the individual refuses to do a task, the task is kept near him until he attempts it

A definitive diagnosis of Alzheimer's disease can be made by:

Examining brain tissue on autopsy.

Dementia cause by Alzheimer's disease is:

Irreversible.

Which condition, if treated, could reverse the course of dementia?

Depression.

Which of the following would be an early sign of dementia?

Forgetting a conversation from earlier in the day

True or False: The FDA has NOT approved any medications for the treatment of Alzheimer's disease.

False.

When should antipsychotic medications be used in a patient with dementia?

When symptoms are severe or cause the patient distress

One sign of typical aging is:

A slowing in the learning of new information.