CRRN Certified Rehabilitation Registered Nurse 5 — Questions and Answers
Question 1: A rehabilitation nurse is applying the Americans with Disabilities Act (ADA) framework when helping a patient plan community reintegration. Which principle does the ADA PRIMARILY protect?
- Guaranteed employment for individuals with disabilities
- Equal opportunity and reasonable accommodation in employment and public settings (Correct answer)
- Free home health services for all persons with physical disabilities
- Priority access to government-funded rehabilitation programs
Correct answer: Equal opportunity and reasonable accommodation in employment and public settings
The ADA mandates equal opportunity and reasonable accommodation for individuals with disabilities in employment, public services, and accommodations, but does not guarantee employment.
Question 2: Which psychological stage according to Kübler-Ross is a patient demonstrating when they say, 'If I work hard enough in therapy, maybe I'll walk again by Christmas'?
- Anger
- Bargaining (Correct answer)
- Depression
- Acceptance
Correct answer: Bargaining
Bargaining involves making deals or setting conditional goals as a way of coping with loss—hoping that effort or behavior can reverse or limit the disability.
Question 3: A CRRN is evaluating a patient's readiness to learn how to perform self-catheterization at home. Which factor MOST affects the patient's ability to learn this skill?
- The patient's insurance coverage for catheter supplies
- The patient's hand function, cognition, and motivation (Correct answer)
- The distance from the patient's home to the outpatient clinic
- Whether the patient has a caregiver available at all times
Correct answer: The patient's hand function, cognition, and motivation
Adequate hand function, cognitive ability to follow a multi-step procedure, and motivation are the core patient-centered factors that determine ability to perform self-catheterization.
Question 4: A family member of a patient with a traumatic brain injury (TBI) tells the nurse, 'He seems fine most of the time but just doesn't act like himself.' Which TBI sequela BEST explains this observation?
- Retrograde amnesia
- Personality and behavioral changes due to frontal lobe injury (Correct answer)
- Receptive aphasia affecting comprehension
- Post-traumatic seizure disorder
Correct answer: Personality and behavioral changes due to frontal lobe injury
Frontal lobe injury from TBI commonly produces personality changes, disinhibition, and impaired judgment that are noticeable to family even when the patient appears outwardly intact.
Question 5: Which ethical principle is MOST directly applied when a rehabilitation nurse ensures that a patient with cognitive deficits has a legally designated surrogate decision-maker involved in care planning?
- Beneficence
- Justice
- Autonomy (Correct answer)
- Nonmaleficence
Correct answer: Autonomy
Autonomy requires respecting the patient's right to make informed decisions; when capacity is lacking, a surrogate preserves that right by making decisions consistent with the patient's known values.
Question 6: A patient who sustained a stroke 6 months ago reports feeling hopeless and has lost interest in therapy activities. Which standardized tool is MOST appropriate for screening for post-stroke depression?
- Hamilton Anxiety Rating Scale (HAM-A)
- Patient Health Questionnaire-9 (PHQ-9) (Correct answer)
- Beck Anxiety Inventory (BAI)
- Montreal Cognitive Assessment (MoCA)
Correct answer: Patient Health Questionnaire-9 (PHQ-9)
The PHQ-9 is a validated, widely used 9-item self-report tool for screening and monitoring the severity of depression, including post-stroke depression.
Question 7: A CRRN is advocating for a patient who requires home modifications prior to discharge. Which FIRST step best exemplifies the nurse's advocacy role?
- Order the home modifications directly through the hospital supply department
- Conduct or coordinate a home assessment to identify specific environmental barriers (Correct answer)
- Instruct the family to purchase a wheelchair ramp before discharge
- Contact the state disability agency for funding without assessing the home first
Correct answer: Conduct or coordinate a home assessment to identify specific environmental barriers
A thorough home assessment (in-person or via questionnaire with OT) is the essential first step to identify actual barriers before recommending or ordering specific modifications.
CRRN Certified Rehabilitation Registered Nurse 5
A rehabilitation nurse is applying the Americans with Disabilities Act (ADA) framework when helping a patient plan community reintegration.
Which principle does the ADA PRIMARILY protect?