CRRN Certified Rehabilitation Registered Nurse MCQ 3 — Questions and Answers
Question 1: 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 2: 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 3: 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 4: 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 5: 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 6: 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 7: 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.
CRRN Certified Rehabilitation Registered Nurse MCQ 3
A patient recovering from a right hemisphere stroke demonstrates left-sided spatial neglect.
Which nursing intervention is most appropriate?