Rehabilitation Registered Nurse Certification Flashcards

A patient with a C5 spinal cord injury is at risk for autonomic dysreflexia. Which blood pressure reading should prompt immediate intervention?

Answer: Systolic 20 mmHg above baseline

Autonomic dysreflexia is defined as a sudden rise in systolic BP of 20–40 mmHg above the patient's baseline, which requires immediate assessment and intervention.

Which intervention is the FIRST priority when autonomic dysreflexia is suspected in a patient with a T6 complete spinal cord injury?

Answer: Sit the patient upright and loosen any constrictive clothing

Sitting the patient upright uses orthostatic hypotension to lower BP and removing constricting clothing helps identify and eliminate the noxious stimulus first.

A rehabilitation nurse is educating a patient with paraplegia about preventing pressure injuries. Which statement by the patient indicates a need for further teaching?

Answer: Redness that goes away after 30 minutes is not a concern.

Redness (erythema) that does not blanch or that persists after pressure relief is a Stage 1 pressure injury and should always be reported and addressed.

When setting functional goals for a patient after a stroke, the rehabilitation nurse should ensure goals are:

Answer: Specific, measurable, attainable, relevant, and time-bound (SMART)

SMART goals provide a clear framework that guides interdisciplinary care planning, tracks progress, and promotes patient-centered rehabilitation outcomes.

A patient with a TBI demonstrates impulsive behavior and poor safety awareness. Which nursing intervention best addresses this deficit?

Answer: Use consistent cueing, structured routines, and environmental modifications

Structured routines, consistent cues, and environmental modifications reduce cognitive overload and compensate for executive function deficits common after TBI.

Which nutritional parameter is most useful for monitoring a rehabilitation patient's short-term protein status?

Answer: Prealbumin (transthyretin)

Prealbumin has a half-life of 2–3 days, making it the most sensitive short-term marker of protein status and response to nutritional intervention.

A patient using a manual wheelchair asks about the most effective technique to prevent carpal tunnel syndrome. The CRRN should recommend:

Answer: Propelling with the heel of the hand in a smooth arc

Propelling with the heel of the hand in a semicircular arc reduces repetitive wrist flexion and nerve compression, lowering carpal tunnel risk.

A patient with multiple sclerosis reports worsening fatigue by early afternoon. Which energy conservation strategy should the CRRN teach first?

Answer: Schedule most demanding activities in the morning and plan rest periods

Energy conservation principles prioritize high-demand tasks when energy is greatest (morning) and incorporate planned rest breaks to prevent fatigue-induced exacerbation.

Which scale is most widely used in rehabilitation settings to measure a patient's functional independence across motor and cognitive domains?

Answer: Functional Independence Measure (FIM)

The FIM is the standard rehabilitation outcome tool rating 18 items across motor and cognitive subscales on a 1–7 scale, with 7 indicating complete independence.

A patient with a hip fracture after total hip replacement (posterior approach) asks which movement to avoid. The nurse correctly identifies:

Answer: Hip flexion greater than 90 degrees

Posterior approach hip precautions restrict flexion beyond 90°, adduction past midline, and internal rotation to prevent prosthetic dislocation.

A spinal cord injury patient with an incomplete T10 injury is classified by the ASIA Impairment Scale as 'D'. This means:

Answer: Motor function is preserved below the level and most key muscles grade ≥3/5

ASIA D indicates motor-incomplete injury where more than half of key muscles below the neurological level have a muscle grade of 3 or greater.

During discharge planning for a patient with dysphagia following a stroke, the CRRN should coordinate with which specialist first?

Answer: Speech-language pathologist

The speech-language pathologist (SLP) is the primary specialist for evaluating swallowing function and recommending diet texture modifications in post-stroke dysphagia.

A rehabilitation nurse notices a patient with Parkinson's disease is having difficulty initiating gait. Which cueing strategy is MOST effective for this patient?

Answer: Verbal counting or rhythmic auditory cues

Rhythmic auditory cues (counting, metronome, music) bypass defective basal ganglia timing circuits in Parkinson's disease and effectively improve gait initiation.

Which of the following best describes the role of the CRRN as a patient advocate in the rehabilitation team?

Answer: Ensuring the patient's goals and preferences are communicated and integrated into the care plan

Patient advocacy in rehabilitation nursing centers on amplifying the patient's voice, ensuring their values and preferences drive individualized goal-setting and care planning.

A patient with a C4 complete spinal cord injury is most likely to require which form of respiratory support?

Answer: Mechanical ventilation, at least initially

C4 injuries affect the phrenic nerve (C3–C5) that drives diaphragm function, often necessitating mechanical ventilation because spontaneous breathing is severely impaired or absent.

A patient with neurogenic bladder after SCI is being taught intermittent catheterization (CIC). The nurse should instruct the patient to catheterize every:

Answer: 4–6 hours with a goal of volumes under 400–500 mL

CIC every 4–6 hours maintains bladder volumes below 400–500 mL, which prevents overdistension, reduces infection risk, and protects upper urinary tract function.

When caring for a patient in the subacute phase of a stroke, the CRRN observes shoulder subluxation on the hemiplegic side. The priority nursing action is:

Answer: Position the arm with proper support and educate the patient and family on handling techniques

Proper positioning, arm support troughs, and education on safe handling prevent further subluxation and shoulder-hand syndrome without restricting therapeutic use of the limb.

A CRRN is teaching a patient with a T6 SCI about bowel management. Which statement about a neurogenic bowel program is correct?

Answer: A consistent scheduled time after a meal is recommended to utilize the gastrocolic reflex.

Scheduling bowel care 20–30 minutes after a meal exploits the gastrocolic reflex, which increases colonic peristalsis and facilitates more predictable and complete evacuation.

Which outcome measure is specifically designed to assess ambulation ability and community mobility in patients with lower-limb impairment?

Answer: 10-Meter Walk Test (10MWT)

The 10-Meter Walk Test measures walking speed over a short distance and is a reliable, sensitive indicator of gait speed changes and functional ambulation in rehabilitation populations.

A patient with an acquired brain injury has difficulty with memory consolidation. Which nursing strategy best supports this patient's learning of new self-care skills?

Answer: Use errorless learning and spaced retrieval techniques with frequent repetition

Errorless learning prevents the reinforcement of incorrect responses, while spaced retrieval strengthens long-term memory retention in patients with memory impairment after brain injury.