CRRN Certified Rehabilitation Registered Nurse MCQ — 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.

Question 8: A patient recovering from a right hemisphere stroke demonstrates left-sided spatial neglect. Which nursing intervention is most appropriate?

Place all items on the patient's right side to avoid frustration
Approach and place items on the left side to encourage awareness (Correct answer)
Patch the left eye to eliminate visual input from that side
Avoid verbal cues so the patient develops natural compensation

Correct answer: Approach and place items on the left side to encourage awareness

Approaching from and placing items on the neglected left side encourages the patient to attend to that hemispace and can help remediate unilateral neglect.

Question 9: A patient with multiple sclerosis is experiencing Uhthoff's phenomenon. The nurse should instruct the patient to:

Increase exercise intensity to build heat tolerance
Avoid overheating through cool environments, cooling vests, and cold drinks (Correct answer)
Use warm baths to relax spastic muscles before activity
Restrict fluids to reduce edema-related symptoms

Correct answer: Avoid overheating through cool environments, cooling vests, and cold drinks

Uhthoff's phenomenon is a temporary worsening of MS symptoms with increased body temperature; cooling strategies prevent and manage this effect.

Question 10: Which finding during a bedside swallowing evaluation warrants immediate referral to speech-language pathology for a formal swallowing study?

Patient reports mild dry mouth
Wet or gurgly vocal quality after swallowing water (Correct answer)
Slow oral preparation of solid foods
Patient requires two swallows per bolus

Correct answer: Wet or gurgly vocal quality after swallowing water

A wet or gurgly vocal quality after swallowing indicates residue on or near the vocal cords, suggesting aspiration or penetration requiring formal evaluation.

Question 11: A patient with Parkinson's disease exhibits a festinating gait. The rehabilitation nurse's best intervention is to:

Encourage the patient to take smaller, more rapid steps to match their cadence
Teach the patient to use visual cues such as floor lines or footsteps to regulate stride length (Correct answer)
Restrict ambulation to prevent falls
Apply bilateral ankle weights to slow gait velocity

Correct answer: Teach the patient to use visual cues such as floor lines or footsteps to regulate stride length

Visual cueing strategies (floor stripes, laser canes) help patients with Parkinson's overcome freezing and festination by bypassing impaired basal ganglia automatic movement circuits.

Question 12: When communicating with a patient who has expressive aphasia, which approach is most effective?

Speak in a louder voice to ensure comprehension
Ask open-ended questions to encourage full sentence responses
Use simple sentences, yes/no questions, and allow adequate response time (Correct answer)
Complete the patient's sentences quickly to reduce frustration

Correct answer: Use simple sentences, yes/no questions, and allow adequate response time

Simple sentences, closed-ended questions, and patience allow the patient with expressive aphasia to communicate within their preserved abilities without increasing frustration.

Question 13: A patient with a traumatic brain injury (TBI) is at Rancho Los Amigos Level V (confused-inappropriate). Which nursing approach is most appropriate?

Provide complex multi-step ADL tasks to stimulate cognition
Use consistent routine, simple one-step commands, and minimize environmental distractions (Correct answer)
Encourage group therapy sessions to promote social engagement
Allow unrestricted visitation to provide maximum stimulation

Correct answer: Use consistent routine, simple one-step commands, and minimize environmental distractions

At RLA Level V, patients are confused and need a structured, low-stimulation environment with consistent routine and simple directions to support cognitive recovery.

Question 14: Which complication is a rehabilitation nurse most vigilant for in a patient who is post-stroke and has been prescribed subcutaneous heparin for DVT prophylaxis?

Heparin-induced thrombocytopenia (HIT) (Correct answer)
Adrenal insufficiency
Rebound anticoagulation after discontinuation
Systemic corticosteroid toxicity

Correct answer: Heparin-induced thrombocytopenia (HIT)

HIT is an immune-mediated reaction to heparin causing paradoxical thrombosis and requires platelet monitoring, typically between days 4–14 of therapy.

Question 15: A patient with a below-knee amputation is being fitted with a prosthesis. Which nursing instruction regarding residual limb care is most important?

Soak the residual limb in warm water nightly to maintain skin hydration
Inspect the residual limb daily for redness, skin breakdown, and changes in shape
Apply powder inside the prosthetic socket to reduce friction
Wrap the residual limb with elastic bandage in a figure-of-eight pattern starting distally (Correct answer)

Correct answer: Wrap the residual limb with elastic bandage in a figure-of-eight pattern starting distally

A figure-of-eight elastic wrap applied from distal to proximal shapes the residual limb, controls edema, and prepares it for prosthetic fitting.

Question 16: The Functional Independence Measure (FIM) rates a patient at level 3 for feeding. This means the patient:

Is independent with feeding using adaptive equipment
Requires moderate assistance — the helper does 50–74% of the effort
Requires moderate assistance — the helper does 25–49% of the effort (Correct answer)
Needs only supervision or setup with no physical assistance

Correct answer: Requires moderate assistance — the helper does 25–49% of the effort

FIM level 3 (Moderate Assistance) means the patient performs 50–74% of the task themselves, with the helper contributing 25–49% of the effort.

Question 17: A patient with rheumatoid arthritis attending rehabilitation asks about joint protection strategies for the hands. The nurse should teach the patient to:

Use a tight grip and pinch technique for maximum strength
Use the larger, stronger joints for tasks whenever possible and avoid sustained gripping (Correct answer)
Perform repetitive resistive hand exercises daily to maintain strength
Apply heat before all manual activities to improve flexibility

Correct answer: Use the larger, stronger joints for tasks whenever possible and avoid sustained gripping

Joint protection principles in rheumatoid arthritis include using larger joints for load-bearing tasks, avoiding prolonged static positions, and distributing stress across multiple joints.

Question 18: When assessing pain in a rehabilitation patient with severe cognitive impairment who is unable to self-report, the nurse should use:

Numeric Rating Scale (NRS) with picture cards
PAINAD (Pain Assessment in Advanced Dementia) scale (Correct answer)
Wong-Baker FACES Pain Rating Scale
Visual Analog Scale with verbal prompts

Correct answer: PAINAD (Pain Assessment in Advanced Dementia) scale

The PAINAD scale observes behavioral indicators including breathing, vocalization, facial expression, body language, and consolability to assess pain in non-verbal patients.

Question 19: A patient with C6 tetraplegia is learning to feed themselves. Which adaptive equipment is most appropriate to facilitate independence?

Built-up handled spoon only
Universal cuff with utensil holder to compensate for absent grip (Correct answer)
Weighted fork to reduce tremor-related spilling
Long-handled spoon for shoulder range of motion deficits

Correct answer: Universal cuff with utensil holder to compensate for absent grip

A universal cuff holds utensils without requiring grip, enabling patients with C6 injuries who have wrist extension but no hand function to feed independently.

Question 20: A patient with a hip replacement is being taught posterior hip precautions. Which instruction is correct?

Avoid hip flexion beyond 90°, hip adduction past midline, and internal rotation (Correct answer)
Avoid hip extension, external rotation, and abduction past 45°
Avoid hip flexion beyond 60° and all rotation for 12 months
Avoid hip abduction and keep legs together at all times

Correct answer: Avoid hip flexion beyond 90°, hip adduction past midline, and internal rotation

Standard posterior hip precautions after total hip arthroplasty restrict flexion >90°, adduction past neutral, and internal rotation to prevent prosthetic dislocation.

Question 21: Which principle guides the rehabilitation nurse when setting goals with a patient who has a newly acquired disability?

Goals should be set primarily by the interdisciplinary team based on clinical findings
Goals should be patient-centered, specific, measurable, and reflect the patient's valued roles and activities (Correct answer)
Short-term goals should focus exclusively on preventing medical complications
Long-term goals should always aim for full pre-injury functional status

Correct answer: Goals should be patient-centered, specific, measurable, and reflect the patient's valued roles and activities

Patient-centered, SMART goals grounded in the patient's own priorities and meaningful roles drive motivation, engagement, and relevant functional outcomes in rehabilitation.

CRRN Certified Rehabilitation Registered Nurse MCQ

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:

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