CRRN Rehabilitation Registered Nurse Certification 3 — Questions and Answers
Question 1: 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 2: 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 3: 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 4: 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 5: 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 6: 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 7: 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.
CRRN Rehabilitation Registered Nurse Certification 3
A patient with multiple sclerosis reports worsening fatigue by early afternoon.
Which energy conservation strategy should the CRRN teach first?