CRRN Certified Rehabilitation Registered Nurse 2 — Questions and Answers
Question 1: A patient with a T6 spinal cord injury suddenly develops a pounding headache, hypertension (BP 180/100), and profuse sweating above the level of injury. What is the priority nursing action?
- Administer IV labetalol immediately
- Sit the patient upright and identify the triggering stimulus (Correct answer)
- Apply a cooling blanket to reduce fever
- Obtain an ECG to rule out cardiac event
Correct answer: Sit the patient upright and identify the triggering stimulus
Autonomic dysreflexia requires immediately sitting the patient upright (to lower BP via orthostasis) and removing the noxious stimulus, most commonly a full bladder or bowel.
Question 2: When educating a patient with a new stroke about dysphagia precautions, which food consistency is typically SAFEST to introduce first?
- Thin liquids such as water
- Regular solids cut into small pieces
- Nectar-thick liquids (Correct answer)
- Pureed foods only
Correct answer: Nectar-thick liquids
Nectar-thick liquids are commonly the safest starting consistency for dysphagic stroke patients because they move more slowly and allow more time to trigger the swallow reflex.
Question 3: A rehabilitation nurse is assessing a patient who had a right-hemisphere stroke. Which deficit is MOST characteristic of right-hemisphere damage?
- Expressive aphasia (Broca's)
- Left-sided neglect and impulsive behavior (Correct answer)
- Receptive aphasia (Wernicke's)
- Right homonymous hemianopia
Correct answer: Left-sided neglect and impulsive behavior
Right-hemisphere strokes commonly cause left-sided neglect, poor safety judgment, and impulsive behavior, while left-hemisphere strokes more commonly cause aphasia.
Question 4: A patient with a complete C5 spinal cord injury is being taught tenodesis grasp. What is the functional goal of this technique?
- Strengthening intrinsic hand muscles for fine motor tasks
- Using wrist extension to passively close the fingers for functional grip (Correct answer)
- Training the patient to use a power wheelchair joystick
- Preventing contractures through passive range of motion
Correct answer: Using wrist extension to passively close the fingers for functional grip
Tenodesis uses the biomechanical relationship between wrist extension and passive finger flexion, allowing C5-C6 patients to grasp objects without intact hand musculature.
Question 5: Which pressure injury stage is characterized by full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone?
- Stage 3
- Stage 4 (Correct answer)
- Unstageable
- Deep tissue pressure injury
Correct answer: Stage 4
Stage 4 pressure injuries involve full-thickness loss with visible or directly palpable underlying structures such as fascia, muscle, tendon, bone, or cartilage.
Question 6: A CRRN is planning bladder retraining for a patient with a neurogenic bladder following TBI. Which intervention is the foundation of an intermittent catheterization program?
- Limiting fluid intake to 1,000 mL per day
- Catheterizing on a timed schedule to keep bladder volume under 400–500 mL (Correct answer)
- Placing an indwelling Foley catheter until the patient regains consciousness
- Using external condom catheters overnight only
Correct answer: Catheterizing on a timed schedule to keep bladder volume under 400–500 mL
Intermittent catheterization programs are based on timed schedules (typically every 4–6 hours) to prevent overdistension and maintain bladder volumes below 400–500 mL.
Question 7: Which outcome measure is MOST appropriate for assessing functional independence across motor and cognitive domains in an inpatient rehabilitation setting?
- Barthel Index
- Functional Independence Measure (FIM) (Correct answer)
- Glasgow Coma Scale (GCS)
- Berg Balance Scale
Correct answer: Functional Independence Measure (FIM)
The FIM assesses 18 items across motor and cognitive domains using a 7-level ordinal scale and is the standard tool in inpatient rehabilitation settings.
CRRN Certified Rehabilitation Registered Nurse 2
A patient with a T6 spinal cord injury suddenly develops a pounding headache, hypertension (BP 180/100), and profuse sweating above the level of injury.
What is the priority nursing action?