CRRN Certified Rehabilitation Registered Nurse MCQ 2 — Questions and Answers
Question 1: A patient with a T6 spinal cord injury develops sudden severe headache, flushing above the injury, and bradycardia. The nurse's priority action is to:
- Administer IV morphine for pain relief
- Sit the patient upright and identify the noxious stimulus (Correct answer)
- Apply a cooling blanket for fever management
- Increase IV fluid rate to improve perfusion
Correct answer: Sit the patient upright and identify the noxious stimulus
These are classic signs of autonomic dysreflexia; sitting the patient upright lowers blood pressure while the noxious stimulus (commonly full bladder or bowel) must be identified and removed immediately.
Question 2: Which bladder management strategy is most appropriate for a patient with a complete T10 spinal cord injury who has a flaccid neurogenic bladder?
- Credé maneuver every 4 hours
- Intermittent catheterization every 4–6 hours (Correct answer)
- Indwelling Foley catheter long-term
- Triggered voiding with suprapubic tapping
Correct answer: Intermittent catheterization every 4–6 hours
Intermittent catheterization is the gold standard for managing a flaccid neurogenic bladder, preserving upper urinary tract function and reducing infection risk.
Question 3: When repositioning a patient with a right-sided hemiplegia due to stroke, which position is considered most therapeutic for the affected upper extremity?
- Shoulder adducted with elbow flexed at 90°
- Shoulder in slight abduction with elbow extended and wrist supported in neutral (Correct answer)
- Shoulder internally rotated with forearm pronated
- Arm positioned across the chest in a sling at all times
Correct answer: Shoulder in slight abduction with elbow extended and wrist supported in neutral
Positioning the hemiplegic arm in slight abduction with elbow extended and wrist in neutral prevents contracture and maintains joint alignment.
Question 4: A rehabilitation nurse is assessing a patient's pressure injury risk. Which tool is specifically validated and widely used in rehabilitation settings?
- Glasgow Coma Scale
- Braden Scale (Correct answer)
- Functional Independence Measure (FIM)
- Berg Balance Scale
Correct answer: Braden Scale
The Braden Scale assesses sensory perception, moisture, activity, mobility, nutrition, and friction/shear to predict pressure injury risk.
Question 5: A patient with SCI at C5 is using a manual wheelchair. To prevent rotator cuff injury during propulsion, the nurse should teach the patient to:
- Use short, rapid push strokes to maximize speed
- Propel with a long, smooth arc keeping hands below the pushrim top (Correct answer)
- Lean forward aggressively with each stroke
- Use wrist extension as the primary propulsion force
Correct answer: Propel with a long, smooth arc keeping hands below the pushrim top
A long, smooth semicircular push pattern reduces repetitive impact on the shoulder joint and preserves rotator cuff integrity over time.
Question 6: In rehabilitation nursing, the term 'learned non-use' most accurately describes:
- A patient refusing to participate in therapy due to depression
- Suppression of movement in an affected limb due to early failed attempts post-injury (Correct answer)
- The tendency of caregivers to perform tasks for patients unnecessarily
- Cognitive neglect of one side of the body following stroke
Correct answer: Suppression of movement in an affected limb due to early failed attempts post-injury
Learned non-use occurs when a patient stops attempting to use an affected limb after early painful or unsuccessful efforts, which can be reversed with constraint-induced movement therapy.
Question 7: A patient with a stage 3 pressure injury over the sacrum is being treated. Which wound care principle should guide the rehabilitation nurse's practice?
- Pack the wound tightly with dry gauze to absorb drainage
- Maintain a moist wound environment to promote healing and granulation (Correct answer)
- Apply hydrogen peroxide daily to reduce bacterial colonization
- Leave the wound open to air to speed epithelialization
Correct answer: Maintain a moist wound environment to promote healing and granulation
Moist wound healing promotes granulation tissue formation, facilitates autolytic debridement, and accelerates re-epithelialization compared to dry wound management.
CRRN Certified Rehabilitation Registered Nurse MCQ 2
A patient with a T6 spinal cord injury develops sudden severe headache, flushing above the injury, and bradycardia.
The nurse's priority action is to: