CRRN Rehabilitation Registered Nurse Certification — 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.

Question 8: A patient with multiple sclerosis reports worsening fatigue by early afternoon. Which energy conservation strategy should the CRRN teach first?

Avoid all exercise to preserve energy
Schedule most demanding activities in the morning and plan rest periods (Correct answer)
Increase caffeine intake to maintain alertness
Perform all activities in one continuous session to reduce transitions

Correct answer: Schedule most demanding activities in the morning and plan rest periods

Energy conservation principles prioritize high-demand tasks when energy is greatest (morning) and incorporate planned rest breaks to prevent fatigue-induced exacerbation.

Question 9: Which scale is most widely used in rehabilitation settings to measure a patient's functional independence across motor and cognitive domains?

Glasgow Coma Scale (GCS)
Functional Independence Measure (FIM) (Correct answer)
Mini-Mental State Examination (MMSE)
Berg Balance Scale

Correct answer: Functional Independence Measure (FIM)

The FIM is the standard rehabilitation outcome tool rating 18 items across motor and cognitive subscales on a 1–7 scale, with 7 indicating complete independence.

Question 10: A patient with a hip fracture after total hip replacement (posterior approach) asks which movement to avoid. The nurse correctly identifies:

Hip abduction past 30 degrees
Hip flexion greater than 90 degrees (Correct answer)
External rotation of the operative hip
Full knee extension while seated

Correct answer: Hip flexion greater than 90 degrees

Posterior approach hip precautions restrict flexion beyond 90°, adduction past midline, and internal rotation to prevent prosthetic dislocation.

Question 11: A spinal cord injury patient with an incomplete T10 injury is classified by the ASIA Impairment Scale as 'D'. This means:

No motor or sensory function below the level of injury
Sensory but not motor function is preserved below the neurological level
Motor function is preserved below the level and most key muscles grade ≥3/5 (Correct answer)
Normal sensory and motor function

Correct answer: Motor function is preserved below the level and most key muscles grade ≥3/5

ASIA D indicates motor-incomplete injury where more than half of key muscles below the neurological level have a muscle grade of 3 or greater.

Question 12: During discharge planning for a patient with dysphagia following a stroke, the CRRN should coordinate with which specialist first?

Occupational therapist
Speech-language pathologist (Correct answer)
Dietitian
Physiatrist

Correct answer: Speech-language pathologist

The speech-language pathologist (SLP) is the primary specialist for evaluating swallowing function and recommending diet texture modifications in post-stroke dysphagia.

Question 13: A rehabilitation nurse notices a patient with Parkinson's disease is having difficulty initiating gait. Which cueing strategy is MOST effective for this patient?

Verbal counting or rhythmic auditory cues (Correct answer)
Dimming room lights to reduce visual distraction
Asking the patient to walk faster to build momentum
Applying light manual resistance to the shoulders

Correct answer: Verbal counting or rhythmic auditory cues

Rhythmic auditory cues (counting, metronome, music) bypass defective basal ganglia timing circuits in Parkinson's disease and effectively improve gait initiation.

Question 14: Which of the following best describes the role of the CRRN as a patient advocate in the rehabilitation team?

Making all care decisions on behalf of the patient
Ensuring the patient's goals and preferences are communicated and integrated into the care plan (Correct answer)
Deferring all advocacy to the social worker
Limiting family involvement to prevent conflicting opinions

Correct answer: Ensuring the patient's goals and preferences are communicated and integrated into the care plan

Patient advocacy in rehabilitation nursing centers on amplifying the patient's voice, ensuring their values and preferences drive individualized goal-setting and care planning.

Question 15: A patient with a C4 complete spinal cord injury is most likely to require which form of respiratory support?

Incentive spirometry only
Mechanical ventilation, at least initially (Correct answer)
Bipap therapy at night only
No respiratory support, as breathing is above the injury

Correct answer: Mechanical ventilation, at least initially

C4 injuries affect the phrenic nerve (C3–C5) that drives diaphragm function, often necessitating mechanical ventilation because spontaneous breathing is severely impaired or absent.

Question 16: A patient with neurogenic bladder after SCI is being taught intermittent catheterization (CIC). The nurse should instruct the patient to catheterize every:

1–2 hours regardless of fluid intake
4–6 hours with a goal of volumes under 400–500 mL (Correct answer)
8–12 hours to reduce urethral trauma
Only when feeling a strong urge to void

Correct answer: 4–6 hours with a goal of volumes under 400–500 mL

CIC every 4–6 hours maintains bladder volumes below 400–500 mL, which prevents overdistension, reduces infection risk, and protects upper urinary tract function.

Question 17: When caring for a patient in the subacute phase of a stroke, the CRRN observes shoulder subluxation on the hemiplegic side. The priority nursing action is:

Apply a tightly bound sling at all times
Position the arm with proper support and educate the patient and family on handling techniques (Correct answer)
Massage the shoulder vigorously to stimulate muscle tone
Restrict all use of the affected arm to prevent further injury

Correct answer: Position the arm with proper support and educate the patient and family on handling techniques

Proper positioning, arm support troughs, and education on safe handling prevent further subluxation and shoulder-hand syndrome without restricting therapeutic use of the limb.

Question 18: A CRRN is teaching a patient with a T6 SCI about bowel management. Which statement about a neurogenic bowel program is correct?

Bowel care should occur at a random time each day to remain flexible.
A consistent scheduled time after a meal is recommended to utilize the gastrocolic reflex. (Correct answer)
High fluid intake should be avoided to prevent loose stools.
Laxatives should be used daily regardless of bowel output.

Correct answer: A consistent scheduled time after a meal is recommended to utilize the gastrocolic reflex.

Scheduling bowel care 20–30 minutes after a meal exploits the gastrocolic reflex, which increases colonic peristalsis and facilitates more predictable and complete evacuation.

Question 19: Which outcome measure is specifically designed to assess ambulation ability and community mobility in patients with lower-limb impairment?

Functional Independence Measure (FIM)
10-Meter Walk Test (10MWT) (Correct answer)
Montreal Cognitive Assessment (MoCA)
Hamilton Anxiety Rating Scale

Correct answer: 10-Meter Walk Test (10MWT)

The 10-Meter Walk Test measures walking speed over a short distance and is a reliable, sensitive indicator of gait speed changes and functional ambulation in rehabilitation populations.

Question 20: A patient with an acquired brain injury has difficulty with memory consolidation. Which nursing strategy best supports this patient's learning of new self-care skills?

Provide all education in one comprehensive session
Use errorless learning and spaced retrieval techniques with frequent repetition (Correct answer)
Rely primarily on written handouts for the patient to review independently
Delay all teaching until the patient demonstrates intact recall

Correct answer: Use errorless learning and spaced retrieval techniques with frequent repetition

Errorless learning prevents the reinforcement of incorrect responses, while spaced retrieval strengthens long-term memory retention in patients with memory impairment after brain injury.

Question 21: A CRRN is discharging a patient who will self-manage anticoagulation therapy after DVT. Which teaching point is the highest priority?

Avoid all physical activity until anticoagulation is complete
Report any unusual bleeding, bruising, or blood in urine or stool immediately (Correct answer)
Take double doses if a scheduled dose is missed
Discontinue medication when leg swelling resolves

Correct answer: Report any unusual bleeding, bruising, or blood in urine or stool immediately

Recognizing and promptly reporting signs of bleeding is the highest priority safety concern for patients on anticoagulation therapy, as hemorrhagic complications can be life-threatening.

CRRN Rehabilitation Registered Nurse Certification

A patient with a C5 spinal cord injury is at risk for autonomic dysreflexia.
Which blood pressure reading should prompt immediate intervention?

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