CRRN Musculoskeletal and Orthopedic Rehabilitation 2 — Questions and Answers
Question 1: A patient with osteoporosis is being discharged after a vertebral compression fracture. Which activity instruction is MOST appropriate?
- Perform daily sit-ups to strengthen core muscles
- Avoid spinal flexion exercises; focus on extension and balance (Correct answer)
- Resume all pre-fracture activities immediately
- Bed rest for 6 weeks before any mobilization
Correct answer: Avoid spinal flexion exercises; focus on extension and balance
Spinal flexion increases anterior vertebral loading and fracture risk in osteoporosis; extension exercises and balance training are the safer rehabilitation approach.
Question 2: Which assessment finding in a patient with a long leg cast MOST warrants immediate notification of the physician?
- Mild ankle swelling with dependent positioning
- Pallor, pulselessness, and paresthesias distal to the cast (Correct answer)
- Minor itching under the cast
- Slight warmth over the cast
Correct answer: Pallor, pulselessness, and paresthesias distal to the cast
The 5 Ps (pain, pallor, pulselessness, paresthesias, paralysis) indicate compartment syndrome or neurovascular compromise requiring emergent intervention.
Question 3: A patient with a rotator cuff repair is at 6 weeks post-surgery. Which activity is APPROPRIATE at this stage?
- Full active overhead lifting
- Pendulum exercises and passive ROM within prescribed limits (Correct answer)
- Return to heavy manual labor
- Resisted strengthening exercises at full range
Correct answer: Pendulum exercises and passive ROM within prescribed limits
At 6 weeks post rotator cuff repair, passive ROM and gentle pendulum exercises are typically appropriate while the healing tendon is protected from active resistance.
Question 4: A patient with gout is admitted to the rehabilitation unit with an acute flare. Which nursing intervention is PRIORITY during an acute attack?
- Encourage vigorous physical therapy of the affected joint
- Rest the affected joint, apply ice, and administer prescribed anti-inflammatory medication (Correct answer)
- Apply moist heat to the inflamed joint
- Increase dietary purine intake to promote uric acid excretion
Correct answer: Rest the affected joint, apply ice, and administer prescribed anti-inflammatory medication
Acute gout management centers on joint rest, ice application, and anti-inflammatory medications (NSAIDs, colchicine, or corticosteroids) to reduce inflammation.
Question 5: When teaching weight-bearing precautions after a femur fracture, the CRRN distinguishes 'toe-touch weight bearing' (TTWB). Which description is CORRECT?
- Full body weight through the extremity
- Foot contact for balance only, with minimal weight transfer (approximately 10–15% body weight) (Correct answer)
- 50% of body weight through the extremity
- No contact with the ground whatsoever
Correct answer: Foot contact for balance only, with minimal weight transfer (approximately 10–15% body weight)
TTWB (also called touch-down weight bearing) allows only foot contact for balance with minimal weight transfer, protecting fracture or surgical sites during early healing.
Question 6: A patient with fibromyalgia is starting a rehabilitation program. Which exercise approach has the STRONGEST evidence for improving symptoms?
- High-intensity interval training three times weekly
- Low-impact aerobic exercise such as water aerobics or walking (Correct answer)
- Complete rest and activity avoidance
- Heavy resistance training five days per week
Correct answer: Low-impact aerobic exercise such as water aerobics or walking
Low-impact aerobic exercise (aquatic therapy, walking, cycling) is the most evidence-supported intervention for reducing pain, fatigue, and depression in fibromyalgia.
CRRN Musculoskeletal and Orthopedic Rehabilitation 2
A patient with osteoporosis is being discharged after a vertebral compression fracture.
Which activity instruction is MOST appropriate?