Mixed Deck — All CRRN Topics Flashcards

Which outcome measure is MOST appropriate to track functional independence in rehabilitation patients across multiple diagnoses?

Answer: Functional Independence Measure (FIM)

The FIM is the gold-standard measure of functional independence in rehabilitation settings, assessing 18 items across motor and cognitive domains.

The cause of esophageal speech.

Answer: burping to exert pressure and produce vibration

Esophageal speech is a method of voice production used by individuals who have had their larynx removed (laryngectomy). It involves swallowing air into the esophagus and then expelling it, causing the upper esophageal sphincter to vibrate. This vibration produces a sound that can then be articulated into speech.

What is the maximum recommended daily dose of acetaminophen for a healthy adult patient in a rehabilitation setting?

Answer: 4,000 mg/day

The maximum recommended daily dose of acetaminophen for healthy adults is 4,000 mg/day; however, many clinicians and guidelines recommend limiting to 3,000 mg/day in elderly patients or those with liver disease risk to prevent hepatotoxicity.

When teaching a patient with limited mobility about skin inspection, which tool is MOST helpful for visualizing posterior body surfaces independently?

Answer: Long-handled mirror

A long-handled mirror enables patients with mobility limitations to inspect posterior surfaces such as the sacrum, buttocks, and heels for early pressure injury detection.

Which of the patient's demands must be satisfied FIRST, according to Maslow's hierarchy of requirements?

Answer: Physiological.

Maslow's hierarchy of needs posits that basic physiological needs, such as air, water, food, shelter, and sleep, must be satisfied before individuals can attend to higher-level needs. These are fundamental for survival and well-being, making them the absolute priority in patient care. Addressing these foundational needs is essential for overall health and progress.

A patient with upper motor neuron (spastic/reflexic) neurogenic bowel from SCI requires bowel care. Which intervention is MOST appropriate to trigger reflex defecation?

Answer: Digital rectal stimulation or insertion of a suppository to trigger the gastrocolic reflex

Digital rectal stimulation (DRS) or suppository insertion triggers the anorectal reflex in UMN neurogenic bowel, promoting coordinated reflex evacuation.

A patient with a T6 complete spinal cord injury is at risk for autonomic dysreflexia (AD). Which stimulus is the MOST common trigger?

Answer: Bladder distension or bowel impaction

Bladder distension is the most common trigger of autonomic dysreflexia in SCI at or above T6, causing uncontrolled sympathetic discharge below the injury level.

A rehabilitation nurse is teaching a patient about the risks of long-term NSAID use. Which adverse effect is of greatest concern for patient safety?

Answer: Gastrointestinal bleeding and peptic ulcer formation

Long-term NSAID use inhibits prostaglandin synthesis, which reduces protective gastric mucosa production, significantly increasing the risk of gastrointestinal bleeding and peptic ulcer disease, especially in older rehabilitation patients.

A patient with rheumatoid arthritis is scheduled for hand rehabilitation. Which principle BEST guides joint protection education?

Answer: Distribute force over larger joints and avoid prolonged static gripping

Joint protection principles for RA include using larger joints for heavy tasks, distributing loads, and avoiding prolonged or forceful gripping to reduce joint stress.

A rehabilitation patient has a surgically debrided wound with no signs of infection and no contraindications to healing. Which wound bed characteristic indicates OPTIMAL healing progress?

Answer: Bright red, moist granulation tissue filling the wound base

Bright red, moist granulation tissue indicates robust vascular ingrowth and healthy wound healing; yellow fibrin and eschar indicate stalled or complicated healing.

A patient's sacral wound is being treated with negative pressure wound therapy (NPWT/wound VAC). Which assessment finding requires IMMEDIATE intervention?

Answer: Sudden loss of suction with bright red blood visible in the foam dressing

Bright red blood in the NPWT dressing or canister indicates wound bleeding, which requires immediate foam removal, manual pressure, and urgent physician notification.

What does the term "reliability" mean when analyzing data and results?

Answer: Results are reproducible.

In data analysis and research, 'reliability' refers to the consistency of a measure. If a measurement is reliable, it will produce the same results under the same conditions when repeated. This means that the results are reproducible, indicating the trustworthiness and consistency of the data collection method rather than just the source or evaluation.

Which intervention BEST prevents heterotopic ossification (HO) in a patient with severe TBI?

Answer: Administer prophylactic indomethacin and maintain gentle ROM

NSAIDs such as indomethacin help prevent HO formation, and gentle ROM preserves joint mobility without the trauma that can trigger HO progression.

A patient recovering from a stroke develops central post-stroke pain. Which description BEST characterizes this condition?

Answer: Burning or aching pain on the side affected by the stroke, often allodynia

Central post-stroke pain is a neuropathic pain syndrome with burning, aching, or lancinating pain and allodynia (pain from non-painful stimuli) on the hemiplegic side.

A patient post-total knee arthroplasty (TKA) has a target of 90 degrees of knee flexion before discharge. Which intervention BEST achieves this goal?

Answer: Continuous passive motion (CPM) combined with active ROM exercises

CPM combined with active ROM exercises promotes early joint mobility, reduces adhesion formation, and helps achieve the 90-degree flexion discharge benchmark.

A patient with heart failure (HF) is discharged from inpatient rehabilitation. Which daily monitoring instruction is MOST important for early detection of decompensation?

Answer: Weigh daily at the same time and report a gain of 2–3 lbs in 24 hours or 5 lbs in a week

Daily weights detect fluid retention early in HF; a weight gain of 2–3 lbs in 24 hours or 5 lbs in a week signals impending decompensation requiring immediate medical contact.

Which test is used primarily to determine a patient's risk of falling while the CRRN is evaluating their functional ability?

Answer: Timed Up and Go (TUG).

The Timed Up and Go (TUG) test is a widely used and validated clinical test for assessing mobility, balance, and fall risk in older adults and individuals with various conditions. It measures the time it takes for a person to stand up from a chair, walk three meters, turn around, walk back to the chair, and sit down. This provides a quick and reliable indicator of functional ability related to falling.

Which oxygen saturation level during pulmonary rehabilitation exercise REQUIRES supplemental oxygen to be initiated or increased?

Answer: SpO2 < 88%

An SpO2 below 88% during exercise indicates significant hypoxemia requiring supplemental oxygen to prevent exercise-induced desaturation complications.

The rehabilitation nurse is using the Functional Pain Scale (FPS) to assess a patient. How does this scale differ from the standard Numeric Rating Scale (NRS)?

Answer: It incorporates the impact of pain on the patient's ability to function

The Functional Pain Scale differs from the NRS by combining pain intensity with its functional impact, rating both how much pain the patient has and how it affects their ability to tolerate and perform activities — critical information in a rehabilitation context.

A patient with post-polio syndrome reports new onset fatigue and weakness decades after initial polio. Which nursing recommendation is MOST appropriate?

Answer: Recommend energy conservation techniques and paced activity

Post-polio syndrome requires energy conservation and activity pacing because overexertion accelerates the loss of surviving motor neurons.