CRRN Rehabilitation Registered Nurse Certification 2 — Questions and Answers
Question 1: A patient with a C5 spinal cord injury is at risk for autonomic dysreflexia. Which blood pressure reading should prompt immediate intervention?
- Systolic 20 mmHg above baseline (Correct answer)
- Systolic 140 mmHg in a previously normotensive patient
- Diastolic above 90 mmHg
- Any reading above 120/80 mmHg
Correct answer: Systolic 20 mmHg above baseline
Autonomic dysreflexia is defined as a sudden rise in systolic BP of 20–40 mmHg above the patient's baseline, which requires immediate assessment and intervention.
Question 2: Which intervention is the FIRST priority when autonomic dysreflexia is suspected in a patient with a T6 complete spinal cord injury?
- Administer antihypertensive medication
- Sit the patient upright and loosen any constrictive clothing (Correct answer)
- Call the physician immediately
- Apply a cold compress to the forehead
Correct answer: Sit the patient upright and loosen any constrictive clothing
Sitting the patient upright uses orthostatic hypotension to lower BP and removing constricting clothing helps identify and eliminate the noxious stimulus first.
Question 3: A rehabilitation nurse is educating a patient with paraplegia about preventing pressure injuries. Which statement by the patient indicates a need for further teaching?
- I will perform weight shifts every 15–30 minutes while sitting.
- I will use a mirror to inspect my skin daily.
- Redness that goes away after 30 minutes is not a concern. (Correct answer)
- I should report any persistent redness to my care team.
Correct answer: Redness that goes away after 30 minutes is not a concern.
Redness (erythema) that does not blanch or that persists after pressure relief is a Stage 1 pressure injury and should always be reported and addressed.
Question 4: When setting functional goals for a patient after a stroke, the rehabilitation nurse should ensure goals are:
- Set exclusively by the physician based on imaging findings
- Broad and long-term to allow flexibility
- Specific, measurable, attainable, relevant, and time-bound (SMART) (Correct answer)
- Based solely on the nurse's clinical experience
Correct answer: Specific, measurable, attainable, relevant, and time-bound (SMART)
SMART goals provide a clear framework that guides interdisciplinary care planning, tracks progress, and promotes patient-centered rehabilitation outcomes.
Question 5: A patient with a TBI demonstrates impulsive behavior and poor safety awareness. Which nursing intervention best addresses this deficit?
- Restrict all mobility until behavior improves
- Use consistent cueing, structured routines, and environmental modifications (Correct answer)
- Administer sedatives before therapy sessions
- Document the behavior and defer to psychiatry alone
Correct answer: Use consistent cueing, structured routines, and environmental modifications
Structured routines, consistent cues, and environmental modifications reduce cognitive overload and compensate for executive function deficits common after TBI.
Question 6: Which nutritional parameter is most useful for monitoring a rehabilitation patient's short-term protein status?
- Serum albumin
- Hemoglobin A1c
- Prealbumin (transthyretin) (Correct answer)
- Total cholesterol
Correct answer: Prealbumin (transthyretin)
Prealbumin has a half-life of 2–3 days, making it the most sensitive short-term marker of protein status and response to nutritional intervention.
Question 7: A patient using a manual wheelchair asks about the most effective technique to prevent carpal tunnel syndrome. The CRRN should recommend:
- Propelling with the heel of the hand in a smooth arc (Correct answer)
- Using finger-tip propulsion for greater control
- Switching to an electric wheelchair immediately
- Wearing rigid wrist splints during all propulsion
Correct answer: Propelling with the heel of the hand in a smooth arc
Propelling with the heel of the hand in a semicircular arc reduces repetitive wrist flexion and nerve compression, lowering carpal tunnel risk.
CRRN Rehabilitation Registered Nurse Certification 2
A patient with a C5 spinal cord injury is at risk for autonomic dysreflexia.
Which blood pressure reading should prompt immediate intervention?